Expert Answers: The consequences of cosmetic surgery

Breast reduction (or reduction mammaplasty) is an operation to remove excess tissue and skin from your breasts. Your breasts are then reshaped to make them smaller, and your nipples repositioned.

The procedure can also be used to even up the size of your breasts if one is much larger than the other.

Breast reduction surgery can relieve the discomfort you may have if you have large breasts, such as: back, neck and shoulder pain, grooves in the shoulders from bra straps, excessive sweating, rashes and skin infections under the breasts.

Many women find it easier to participate in sport and feel happier and less self-conscious about the way they look after the operation.

It is important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or advise you about choosing which hospital to be treated in.

Before you opt for breast reduction, you should consider the result you hope to achieve, and think about what will fit with your body shape. Some women initially want a radical reduction in size, but this can affect the final shape and appearance of the breasts, so a more moderate reduction may be a better option.

Because breast size alters with body weight, you will be more suitable for surgery if your weight is stable. Your breasts won't grow back after surgery, but they may increase in size if you put on weight or become pregnant.

It is sometimes possible to breast feed, but this depends on the type of breast reduction surgery that you have.

It is important to consider breastfeeding in the future when you are deciding whether to have breast reduction. You won't be able to breastfeed after the surgery if the procedure involves separating your nipples completely from your milk ducts. However, some surgical techniques may mean that you could breastfeed to some degree. Ask your surgeon about techniques where the nipples are left connected (even partially) to the milk ducts.

It is also important to talk to your surgeon about how pregnancy after a breast reduction might change the shape of your breasts. Pregnancy is likely to increase the size of your breasts and may therefore affect your surgical results. Some surgeons recommend waiting until after you have had children before going ahead with a breast reduction.

Further information: British Association of Plastic Reconstructive and Aesthetic Surgeons. 020 7831 5161, www.bapras.org.uk

British Association of Aesthetic Plastic Surgeons. 020 7405 2234. www.baaps.org.uk

Paul Charlson

GP from Brough

You have the opposite problem to many girls who are desperate to have your figure. However if you feel uncomfortable you should certainly consider a breast reduction. There are strict criteria for obtaining a breast reduction on the NHS and your GP will be able to advise.

Breast reduction operations do have a high satisfaction rate. However, the operation will hamper your ability to breast feed as you will not be able to produce milk as effectively. You have a variety of choices – stay as you are, wait until you have completed your family and then have a reduction or have the reduction and accept that you will probably not be able to breast feed.

After some thought you should be able to come to the right decision for you. I think there is an unnecessary obsession with breast feeding which causes no end of anxieties among mothers.

Elaine Douglas

A chartered psychologist who specialises in family and child relationships

I think you have some difficult decisions to make about this, not least of which is because you are still very young. There are sites on the internet that will answer a number of questions you may have about going through with this kind of procedure, but I can tell you what they say about breastfeeding. It is possible to breastfeed after having this kind of surgery but you need to talk to the surgeon about whether you can have a procedure that leaves your nipples connected to the milk ducts. Apparently some surgeons are reluctant to perform surgery on women who have not had children because during pregnancy the shape and size of a woman's breasts changes and this can cause problems.

Have you tried some of the more specialist bra companies that do a range for women in your position. It may work out expensive in the short term, but maybe you could consider going to a reputable shop or manufacturer and having something made that is just right for you. This is worth a try and perhaps when you are a little older you could consider whether a breast reduction is the right course of action for you.

Cary Cooper

Professor of Organisational Psychology and Health at Lancaster University

It is obvious you need more information about the consequences of a breast reduction operation, both in terms of what could be achieved by it and the implications down the line (ie breast feeding). If the size of your breast is really troubling you, you need more information about it from your GP and/or a consultant surgeon.

It is your body not your friends' but you do need more information about the implications, once you have these you can think through your options, which you can discuss with your family as well.

Dr Carol Burniston

Consultant Clinical Child Psychologist

This is not an area I know much about, although I can appreciate how difficult you find your situation. Such operations can be carried out for medical reasons, such as strain on the back and shoulders, but I suggest that you see your GP and ask them about referral to a good cosmetic surgeon. It is important that you see someone who is appropriately qualified as they will be able to answer your questions and reassure you about the advantages and disadvantages of the procedure. All surgery carries some element of risk and you need to ensure that you get the best available advice.