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Breast Reduction

Breast Reduction in Newcastle & Sydney NSW

Breast reduction is one of the most common cosmetic surgery procedures performed worldwide and not only addresses the physical aspects of heavy and pendulous breasts but also a women’s aesthetic concerns to provide a more youthful, lifted breast with improved shape and symmetry. Many women describe their experience after breast reduction as life-changing, with improved self-confidence, and wished they had undertaken the procedure many years before.

Quick Facts

Anesthesia: General Anaesthesia
In/Outpatient: Inpatient with overnight stay
Length of surgery: 3 – 4 hours
Recovery: Most patients are back to work in approximately 10 days. They can resume light exercise at 4 weeks and more high intensity exercise at 6-8 weeks.
Results: Final results are seen within 3 – 6 months, and the duration of those results vary from one person to another.

Do you need Breast Reduction Surgery?

Women of all ages including teenagers, women after childbearing and post-menopausal women have all sought breast reduction in order to relieve the following factors

  • Inability to fit into normal size clothes
  • Neck, should, back and breast pain that is related to the weight and traction effect of the breasts
  • Post lactation ptosis (sagging)
  • Irritation of infection in the breast crease
  • Difficulty with exercise or any physical activity due to heavy breasts

What Can Breast Reduction Do For Me?

The impact on women with exceptionally large, disproportionate breast size can be quite debilitating both physically and emotionally. Women of all ages including teenagers, women after childbearing, and post-menopausal women have all sought breast reduction surgery.

Some of the many benefits of breast reduction surgery include:

  • Reduce the size of the breasts
  • Improve breast shape and symmetry
  • Improve neck, back and shoulder discomfort
  • Elevate the nipple and reshapes the areola
  • Ability to fit into normal clothes
  • Correct fitting of bras that are comfortable to wear
  • Reduce irritation, chafing and infections under the breast
  • Improve exercise tolerance and assist with weight loss activities

Am I Suitable for Breast Reduction?

The best candidates for breast reduction surgery are those close to their ideal weight, in good health, non-smokers and whose oversized breasts cause health problems, interfere with routine activities, self-conscious, or even disrupt sleep.

Please note: Dr Turner does not perform breast reduction surgery on current smokers – it is important that all patients undergoing breast reduction cease smoking or nicotine intake (including patches/gums) for at least 6 weeks pre & post surgery.

About Breast Reduction Surgery

Breast reduction surgery is performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. The operation takes between two and three hours to perform and generally you stay overnight at the hospital, occasionally patients may be discharged the same day.

There have been significant advances in breast reduction techniques over the past few years making it now safer and more reliable than ever. The breast reduction technique used will vary depending on the patient’s anatomy and individual desires. Of the many techniques available to reduce the size of the breasts, the techniques vary largely based on the incision used to reduce the skin envelope and the glandular resection or pedicle type utilized.

Breast reduction surgery can take up to six months to reach its final shape. Breast reduction scars will be noticeable at first, but they will fade over time. Patients should expect discomfort and swelling of the breasts for several weeks, although patients usually return to almost normal activity within two weeks. Patients should plan to avoid activities that require raising of the arms above the chest for 10 days after surgery. Patients can usually return to work within 1-2 weeks post-surgery.

The breast reduction technique used will vary depending on your anatomy and individual choice.  There are two common incision patterns for breast reduction;

  • Short scar Vertical incision or Lollipop pattern incision
  • Inverted T Shape or Anchor pattern incision

Recovery After Your Breast Reduction Surgery

At the completion of your surgery Dr Turner will apply a specialized dressing to aid wound healing and this remains on for the first 3 weeks after surgery. You will be placed into a surgical garment in the recovery room when you are fully awake and comfortable. It is important to wear the garment full time for the first six weeks to assist wound healing and settling of the new breast shape. Very infrequently we may require a drain to be placed in each breast to drain off excess blood and fluids for the first day or two.

The majority of breast reduction patients stay in hospital overnight and go home the next morning. You are able to take the garment of for short periods of time while at home and shower over the dressings the very next day.

Patients report minor post-operative pain, which is treated with oral medication. You will be given a prescription for pain management and antibiotics. Have someone fill the prescription, drive you home and take care of you as you recover during the first few days after your surgery.

You can return to your normal activities at a slow and gradual pace. You may be back to work as soon as one week after breast reduction surgery and may begin light exercise at two weeks. Most activities can be resumed fully at six weeks following your procedure.

You will have an appointment to see Dr Turner within the first week after surgery to check that your wounds are healing as expected and to review your new breast shape. Dr Turner will see you frequently over the first year to monitor your progress and will give you advice on scar management, wearing garments and resuming normal activities.

It is extremely important to your final result that you follow all post-operative instructions given to you by Dr Turner.

Longer-Term Results

Breast reduction surgery can take up to one year to reach its final shape, which is when you can fully appreciate the permanent change in your appearance.

Types of Breast Reduction Incisions

The incision type used depends on:

1.  The amount of skin that needs to be removed
2.  The distance the nipple needs to be lifted
3.  The amount of breast tissue that needs to be removed

There are two common skin design patterns for breast reduction:

Short Scar – Vertical (Lollipop) Incision – Preferred Technique

Breast Reduction Surgery Vertical Scar Incision

• Incision around the nipple-areola complex and vertically down to the breast crease
• This is Dr Turner’s preferred technique to minimize the amount of scarring around the breast and is used in patients who require smaller breast reductions and have good skin quality

Inverted T (Anchor) Incision – for Larger Reductions or Ptosis

Breast Reduction Surgery Anchor Scar Incision

• Incision around the nipple-areola complex, vertically down to the breast crease and horizontally along the breast fold
• In larger breast reductions or significant breast ptosis the additional scar is often required

While incision lines are permanent, they are concealed within the bra and in most cases these will fade over time. Dr Turner takes great care to leave the smallest scar possible by using an advanced surgical technique aimed at reducing scar tissue.

Types of Breast Reduction Glandular Pedicle – 3 Approaches to Surgery

The tissue that maintains the blood supply and innervation to the nipple after resection of the excessive breast tissue is commonly referred to as a pedicle; this pedicle can come superiorly, inferiorly, centrally, medially, or laterally. The three most common pedicle designs used in modern breast reductions are:

Inferior Pedicle

The inferior pedicle is the most popular technique used worldwide due to its versatility and safety in maintaining nipple blood supply and sensation, as well as postoperative ability to breastfeed. The inferior pedicle technique is frequently combined with an inverted T shape incision for larger breast reductions.

Superior Pedicle

The superior pedicle is ideal for those patients that need only a small amount of nipple elevation with tightening of the inferior breast skin. This is an excellent approach in breast lift and small breast reduction procedures with a short scar technique.

Medical Pedicle

The development of the medial pedicle technique has allowed the maintenance of superior and medial fullness of the breast to enhance breast cleavage, which has been a problem with other techniques. The ability to combine the medial pedicle with either a short scar or inverted T shape incision gives it versatility for small to very large breast reduction procedures.

Combining Liposuction and Breast Reduction Surgery

Liposuction is often added to a breast reduction to further contour the outer portion of the breast, lateral chest and back regions.

Liposuction-only breast reduction is a favourable concept, as it leaves no scars on the breast. However, as the technique involves no skin resection that would otherwise be necessary to recontour and elevate the breasts, droopy breasts will remain that way. If there is breast ptosis and the nipple is low on the breast mound, it will not provide the lift needed to create a more youthful look and potentially make any breast ptosis worse after the procedure.

Risks Associated with Breast Reduction Surgery

As with any surgery, it is important that you are fully informed of the potential risks associated with breast reduction surgery. While all care is taken to minimize these complications, they may and do occur despite the best medical care.

It is important that you carefully read and understand the potential risks and they will be discussed in further detail when you have your consultation with Dr Turner.

GENERAL RISKS ASSOCIATED WITH SURGERY

• Wound breakdown and delayed healing
• Postoperative infection
• Bleeding or haematoma
• Poor Scarring including keloid scars
• Blood clots in legs or lungs
• Revision surgery to correct or improve outcome

SPECIFIC RISKS ASSOCIATED WITH BREAST REDUCTION SURGERY

• Partial or total loss of the nipple and/or areola
• Loss of sensation to the nipple
• Breast asymmetry
• Inability to breastfeeding
• Lumpiness or fat necrosis

Your Breast Reduction consultation with Dr Turner

Firstly, you are fully informed of the normal surgery process, plus possible complications. After a thorough history and discussion about your desires, Dr Turner will examine you to assess if you are a good surgical candidate. The initial consultation is the ideal time for all your questions about your surgery to be answered as you have to be sure this surgery is for you.

During the consultation, measurements are then made of your chest wall and breasts. We assess the quality of your breast skin, breast volume, your weight/height and routine pre-op photographs are taken. Finally, Dr Turner will provide you with a detailed discussion of which of the various techniques will be used during your breast reduction surgery to achieve your goals.

Once your initial breast reduction consultation is completed, you’ll receive a quote from our friendly practice manager including your costs for your surgery, anaesthetic and hospital stay. Deposit details will also be provided so that you can confirm your surgery date once you’re ready to proceed. Once confirmed, you’ll receive a consent form and hospital admission paperwork to complete and will be guided and supported in the lead-up to your procedure date.

Breast Reduction FAQs

How long will I need to stay in hospital?

Most patients who undergo breast reduction stay in hospital for one night. Those patients who undergo small breast reduction or breast lift you can go home the same day of surgery.

What are the scars like after breast reduction?

Immediately after breast reduction, scars can be prominent. However they won’t be visible under clothing and are within the bra line. The scars are pink to start with and can be slightly thick to touch but over time will flatten and soften, gradually fading to blend with your surrounding skin.
How well the scars heal and the quality of the final scars depends on numerous factors, such as how well your skin generally heals, or whether you are prone to hypertrophic or keloid (thickening) scars. Dr Turner will advise you of scar treatment techniques to help your scars heal optimally in the shortest time possible.

Will my nipples retain their sensitivity after the surgery?

Almost all women who undergo breast reduction have some alteration in the sensitivity of the nipples immediately postoperatively. However most return to near normal within 6 months. During the healing phase the sensitivity of your nipples may increase and you may require some padding in your bra until it returns to normal.

When can I return to work?

Depending on your occupation you can return to work about a week after surgery, if your work involves more physical activity you may require two weeks of work.

When can I drive after Breast Reduction Surgery?

Most people are able to drive after 7-10 days when they are comfortable and not taking strong pain killers.

What about exercise?

You may commence light exercise after 2 weeks and increase to normal exercise after 6 weeks. You must not do any heavy lifting for 6 weeks.

Can I still Breastfeed after breast reduction?

As the nipple areola always remains attached to the underlying breast glandular tissue it is often possible for women to breast feed after surgery. However there is no guarantee that this will be successful, so you should not consider breast reduction if you have a strong desire to breastfeed in the future.

Am I too fat for Breast Reduction?

Ideally with any cosmetic procedure it is preferable that you are close to your ideal body weight to give you the very best aesthetic outcome. If you are above your ideal weight you still may be eligible to undergo a breast reduction procedure. However with body mass index (BMI) over 35 the risks of poor healing and infection increases significantly.

Is there an age restriction for breast reduction?

It is generally recommended that women wait until they are at least eighteen years of age and their breast growth has stopped. In teenage girls we selectively offer breast reduction surgery however there needs to be clear indications for surgery. In juvenile breast enlargement, performing a breast reduction at an early age while the breast is still developing may require revision surgery in the future as the breasts continue to enlarge. Also there is concerns regarding future breast-feeding and scaring on the breast which needs to be considered.
For women in their seventies and eighties, as long as they are in good health, have received medical clearance, are experiencing debilitating symptoms and the benefits would outweigh the risks, surgery can surely be considered.

How long will it take for the swelling to go down after surgery?

Swelling is normal after breast reduction and it can increase over the first week. Most of the swelling will by gone after one month, however it takes 3-6 months for the swelling to completely resolve and the shape settle.

How long must I wear a special bra after breast reduction?

The surgical garment is essential to assist in the healing of the breast after surgery, the bra should be worn day and night for 6 weeks. After this time you may start wearing a comfortable sports bra. It is not until 3 months that we recommend you start wearing more structured / underwire bras.

“In our practice, breast reduction patients are our happiest patients.” – Dr Scott Turner, Specialist Plastic Surgeon

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