Breast reduction can help you achieve your desired silhouette and relieve pain.
“Breast reduction surgery can help you achieve your desired breast size and shape with minimal scarring.”
‑ Associate Professor Dean White
What is breast reduction surgery?
Breast reduction surgery, also known as a reduction mammoplasty is a surgical procedure to reduce the size of overly large breasts. Many women choose to have a reduction surgery due to how they feel about having large breasts, and also due to the health issue it can cause.
Common reasons women consider breast reduction surgery
- Reduce the weight of heavy breasts which may be contributing to neck or back pain. Heavy breasts may also cause bra straps to dig into the shoulders.
- Skin irritations such as rashes/fungal infections beneath the breasts.
- Clothing may be difficult to find that fits well.
- Breasts that get in the way of your arms at the side Improve posture and ability to exercise.
- A desire to achieve a more pleasing shape with a proportionate balance between breasts and body.
- Above issues resistant to exercise and diet.
What is involved with breast reduction surgery?
- General anaesthetic.
- Surgery Duration: Approximately 2 -3 hours.
- Complex pre-operative markings are made by Mr White which are created to best achieve the desired surgical outcome.
- Breast tissue including skin, glandular tissue and fat is excised.
- The breast is re-modelled and sutured together including repositioning of the nipple.
- Final scar pattern is around the areolar (coloured skin around the nipple) and vertically down from there.
- Dressings are applied.
- Drains are routinely used generally coming out the day after surgery.
Minimal scar breast reduction surgery
The traditional breast reduction technique involves an “anchor” type scar pattern. There is a circular scar around the areolar (coloured area around the nipple), a vertical component and a long horizontal scar based in the fold beneath the breast.
The minimal scar technique that Mr White uses for most breast reductions eliminates the long horizontal scar beneath the breast.
In Mr White’s opinion, the advantages of this are:
- Reduction in the amount of scars. Sometimes the scars that result from traditional breast reduction surgery are visible in the cleavage area and give rise to puckers or “dog ears” – either in the cleavage area or under the arms.
- Preserving breast tissue in the cleavage area and removing it in the lower parts and beneath the arm (lateral).
- Better projection (perkiness of the breasts).
- More durable, long term results.
- Less wound healing issues.
- Better sensation and less risk of nipple necrosis (tissue death).
The disadvantages are:
- Initial large gathering of excess skin beneath the breast.
- The bigger the reduction the more excess skin there can be.
- A non-natural shape in the first few weeks with over projection.
These appearances start to resolve quite quickly in the first few weeks post-surgery. It is usually at about 6 weeks after surgery that a true idea about the end result will be possible. In the vast majority of cases these issues settle – in a small group some minor revision may be necessary at about 12 months.
Recovery after surgery for breast reduction surgery
- Patients most commonly require a hospital stay of 1-2 nights.
- The area will feel a little uncomfortable for a few days.
- Gradually increase mobility and activity; generally back to most normal day to day activities at two weeks.
- Most women allow approximately two – three weeks off work. However, you may require additional time if your job is more physically demanding. This can be discussed with Mr White.
- Able to drive when feel comfortable to do so.
- No heavy lifting or exercise for 6 weeks e.g. Avoid gym, aerobics, running.
Post operative and review of breast reduction
Post-operative visits with Mr White
- Approximately one week after surgery
– Aim: To ensure you are healthy and to review the surgical wounds.
- Six weeks post-surgery
– At this time you will have a better idea of what the final result from surgery will be like. If all is progressing well, Mr White will give you the all clear to resume normal activities.
- 12 months
– If there are any concerns you will be seen more frequently.
Our surgical goals:
- YOUR SAFETY.
- Address the individual issues you will have discussed with Mr White related to your decision to have this particular surgery.
- Achieve good projection (“perkiness”) of the breasts.
- Achieve good cleavage area.
- Minimise scars.
- Durable, long term pleasing shape.
Before deciding to have breast reduction surgery you should consider the following:
- Desire for any further children:
– Breast reduction (and breast lift) surgery may have a potential impact on being able to successfully breast feed in the future.
- Stable, healthy weight.
- If a smoker: STOP Smoking.
- Generally fit and healthy.
- Be over 18 years old and have finished breast development.
- Breast screening up to date: In women over 50 and/or where regular breast screening and mammograms have been recommended.
Alternatives to breast reduction surgery
- No surgery or delaying surgery.
- Using a professionally fitted and comfortable bra to enhance or improve your natural shape and appearance of your breasts.
- Liposuction – Rarely good for reduction and will make sagging worse as it doesn’t adequately address the ‘loose’ skin.
Risks to consider with Breast Reduction surgery
Anaesthetic – In otherwise well people, general anaesthesia is very safe with modern techniques. Mr White’s rooms will give you the details of your anaesthetist prior to surgery to discuss any specific concerns.
Bleeding/Haematoma – This may need a return to the operating theatre to evacuate a blood clot. This can impact on wound healing or skin survival. Infection in the wound – If this does occur, can usually be cleared up with antibiotic tablets.
DVT/PE (Deep venous thrombosis/pulmonary embolus) – Blood clots that are potentially very serious and even life threatening, which can form in the legs and travel to the lungs. Multiple strategies are employed to minimise the risk of these occurring.
Wound healing issues – Stretch marks may not all be removed or new ones may be created. Gathers in the wound are often present at either end. These settle over several weeks to months in the majority of cases but sometimes may need a small revision often under local anaesthetic. Initially there is almost always some contour issues or puckers. These settle down in most cases over several weeks.
Scars – Typically are at their thickest and reddest at 6-10 weeks after surgery. Scars continue to mature and improve for up to 18 months after surgery. Scar management advice will be discussed in your follow up visit with Mr White to assist in achieving the goal of a thin, barely noticeable scar. Note: The resulting scar is across the lower abdomen from hip to hip and designed to be hidden by most underwear/bathers as well as a small scar around the umbilicus (belly button).
Asymmetry – The scars may be slightly different on your right compared to left side.
Wound separation/delayed healing – This is much more common in smokers or if there is an infection.
Skin necrosis/loss – Very rare complication and almost only seen in smokers. If it does occur it needs significant aftercare, possibly more surgery and even skin grafting in the most extreme cases.
Seroma – Clear/straw like fluid that can collect following surgery. Usually it settles down with no intervention but if persistent or large may require drainage in the rooms (sometimes on several occasions) or even a drain tube to be inserted.
Numbness – Almost always occurs in the skin of the abdomen. Generally settles down over weeks to months.