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 INCISION
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 which needs to be removed
There are two common skin design patterns for breast reduction:
Short Scar – Vertical (lollipop) 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
• 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.
BREAST REDUCTION GLANDULAR PEDICLE
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:
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 breast-feed. The inferior pedicle technique is frequently combined with an inverted T shape incision for larger breast reductions.
The superior pedicle is ideal for those patients that need only a small amount of nipple elevation with tightening of the inferior breast skin. Thus is an excellent approach in breast lift and small breast reduction procedures with a short scar technique.
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.
HOW ABOUT LIPOSUCTION AND BREAST REDUCTION?
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.
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.
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.
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 breast feeding
• Lumpiness or fat necrosis