Breast Reduction

What is breast reduction?

A breast reduction will remove excess weight and reshape the breasts by tightening the breast tissue and skin. 

Dr. Eckhaus’ preferred technique is a short scar vertical breast reduction.  This technique minimizes scars and improves the final breast shape. Other advantages to this technique include:

  • Liposuction is used to remove weight from the breasts thereby minimizing the amount of breast tissue that needs to be excised
  • Minimizing blood loss during procedure.
  • Less overall scarring.
  • A lower horizontal incision is often not needed.

Liposuction is also performed up towards the armpit and along the chest wall below the armpit to improve the shape of the breast. As less excision is performed, overall blood loss is minimized. The scars are around the areola and straight down. A lower horizontal incision is often not needed.

An application to the Ministry of Health and Long Term Care is required for the excision portion of a breast reduction to be covered by OHIP.

**Please note the liposuction portion of the procedure is not an insured benefit of OHIP.

The Surgery

Performed under general anesthetic, breast reduction surgery takes approx. 2.5 hours and requires no overnight stay. On the morning of surgery, markings are made on the chest wall and breast for pre-operative planning.

The final scars are placed around the areola and vertically down towards the lower breast fold. Only dissolvable sutures are used and a compression garment is applied at the end of the procedure. There are no post-operative drains used.

After Your Surgery

Some things to expect after your surgery:

  • An initial wrap and post-operative compression bra are kept in place for three days. You may shower with a hand held shower or sponge bath ensuring the dressings stay dry.
  • The initial dressing change is done in the office on the third day after surgery.
  • The post-operative compression bra is worn for two weeks during both the day and night and then following this, an additional two weeks during the day only (four weeks in total).
  • Dry dressings should be changed daily and the underlying tapes (steristrips) left intact until they come off on their own.
  • Post-operative swelling and bruising begins to subside after 7 days.
  • Though most of the swelling will have subsided by week 3, you are advised to wait 3 months to be re-sized for a new bra.
  • Patients usually require 1-2 weeks of downtime and should avoid strenuous exercise for 4 weeks.
Pre-Operation & Post-Operation Recovery Guide

Many women with very large breasts encounter a variety of medical problems, as well as feeling self-conscious and at times negative about their appearance. The most common problems encountered are upper back, neck and shoulder pain, inability to exercise, limitation of clothing choices and intertrigo (rash under the breasts).

A breast reduction is the surgical procedure used to remove excessive fat, glandular tissue and skin from the breast. The new breasts will be smaller, lighter, and usually more in proportion to the woman’s overall shape and size. We also reduce the size of the areola, the skin surrounding the nipple, if it has been stretched, and reposition the nipple if that is required. 

A breast lift (mastopexy) is done to lift breast that have become droopy (ptotic) with weight fluctuations, age, and following breastfeeding.  The skin and very little breast gland is excised to tighten, re-shape and elevate the breasts.

Initial Consultation

Consultation time required: New patient 30 mins.

Approx. total cost: Provided at consultation.

Usual length of operation: 2-3 hours.

Usual length of stay: Day surgery

Type of anaesthesia (usually): General.

Are there permanent scars? Yes. On the breasts. Exact location will be reviewed at the initial consultation as it depends on the technique used.

Pre-Operative Instructions

Pre-Operative Instructions: No aspirin two weeks before, fast according to instructions, take usual meds with a sip on the day of surgery. If you get ill, i.e. flu before surgery, notify us.

Post-Operative Course

On discharge: Go home to rest under supervision, drink well, take pain meds and antibiotics as directed, start a light diet if you feel able to.

Next Day: Mobilize around the house, rest, drink well, take meds as directed, we encourage walking.

Day 2 – 7: Increase mobility as you feel better.

After Day 7: Return to all but heavy exercise and work.

When is my first post-op visit? Usually day 3 following surgery.

Is there pain? Expect moderate pain – will need painkillers for a few days.

Is there swelling? Yes, especially first 7 days.

Is there bruising?  Yes, particularly where liposuction is used.

Are there stitches to be removed? No, they are dissolving.

Are there dressings? Yes.

How do I manage these? Leave them for the first 72 hours until your first post op visit to the office where they will be changed. Following this, keep the skin tapes clean.  Change dressing daily after that using dry pads and the post-operative garment.

Can I shower? Usually at 72 hours after (after the first dressing change).  You can use a handheld shower or sponge bath in the first few days if the dressings are kept dry.

When can I see people without surgery being obvious? As for all surgery of the body- immediately you get dressed and feel fairly comfortable.

When can I drive? Must be able to see clearly, be off strong painkillers and able to move comfortably, usually around 4-7 days.

When can I go back to work? Office work 3-7 days.  Heavy lifting jobs: 14-21 days.

When can I exercise? Lower body 2 weeks after surgery, upper body 4 weeks after surgery.

When can I resume heavy lifting, etc? 4 weeks after surgery.

Things I should phone about: Pain not controlled by the medication. Sudden onset of swelling and pain on one side or the other.  Vomiting or unable to take plenty of fluids.  Excessive oozing from the wound or dressings.  Fever over 38 degrees.  Difficulty breathing well.  Swelling or pain in the lower leg.  Progressive swelling or redness in the area of surgery.

First Post-Operative Visit

What we do: Check your progress and the incisions. Remove compression dressings and wrap.  Apply a new dry dressing and show you how to care for the incisions.

Sutures: Dissolving.