Breast Reduction

Excessive breast enlargement (mammary hypertrophy) causes a number of medical problems:

✓ back and neck pain
✓ strap marks and shoulder strain
✓ poor posture
✓ skin irritation and infections (intertrigone)
✓ shortness of breath
✓ difficulty participating in recreational activities
✓ difficulty fitting bras, swimming costumes and clothes
✓ social/sexual embarrassment / harassment
✓ depression

Being a medical condition rather than cosmetic your Health Fund may contribute toward the cost of the procedure.

Breast reduction surgery, also known as reduction mammaplasty, is a commonly performed operation designed to make large breasts smaller, lighter, symmetrical and more proportionate. As a result of surgery there will be scars but these are carefully placed to be relatively inconspicuous once faded. Liposuction can be used on excess fat but it is almost invariably necessary to remove the excess glandular tissue and skin. It is important to have realistic expectations about the results and discuss these frankly with your surgeon. Every patient - and every surgeon, as well - has a different view of what is a desirable size and shape for breasts. The aim of surgery is to make your breasts proportionate but it is difficult to guarantee what cup size will result.

Breast reduction is routinely undertaken as an inpatient procedure with only a one night stay in hospital usually required. The techniques for breast reduction vary, but the most common ‘inferior pedicle’ procedure results in an anchor-shaped scar that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Excess glandular tissue, fat, and skin is removed and the skin from both sides of the breast is draped down and around the areolar and nipple, in their new position, shaping the contour of the breast. The nipples remain attached to their blood vessels and nerves. However, if the breasts are extremely large the nipples may have to be removed and grafted in to the correct position which resultants in loss of sensation. Liposuction may also be used.

As with all surgery there are general complications inherent from having any surgical procedure & anaesthetic as well as specific complications from the type of procedure itself. Your surgeon should carefully explain these to you. As with any surgery, smokers should be advised that nicotine can delay healing, resulting in conspicuous scars and prolonged recovery. Less than 5% of women will develop a significant post-operative complication. Prompt treatment of any complication reduces the chance of long-term problems. Depending on your age you should continue with regular mammograms.

After surgery, your breasts will be wrapped in an elastic bandage over dressings. A small suction drain will be placed in each breast to drain off blood and fluids for the first day. The bandages will be removed the day after surgery before you go home although you'll continue wearing a sports bra/lycra crop top day and night for 4 weeks and then during the day for a further 4 weeks. Although you will be up and about the day after surgery, your breasts may still ache occasionally for a couple of weeks. Take your prescribed painkillers regularly for 3-5 days, then as required. Most women can return to work (if it's not too strenuous) in about 7-10 days but you'll have less stamina for several weeks, and should limit exercise until your energy level returns. Do not wear an underwire bra for at least 8 weeks. Avoid swimming or immersing your breasts under water for 4 weeks. 

The procedure does leave permanent scars, although your bra or bathers will cover them. The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may be possible and is encouraged if applicable. Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. Your surgeon will make every effort to make your scars as inconspicuous as possible. Most scars take three months to reach their full strength and during this period they may become itchy, firm, red and a little raised. The scars will then gradually mature until they become a fine, white line over nine to twelve months, although this is variable according to individual skin types. After 6 weeks when the wound has healed soundly you may massage the scar with moisturising cream or oil twice daily for two to three months. It is not essential to use Vitamin E cream or oil