Suitable Candidates for Breast Reduction Surgery?
Suitable candidates for breast augmentation surgery should meet the following criteria:
- Physical Health: Be in good overall health with no underlying medical conditions that could interfere with the wound healing process.
- Emotional Well-being:Have realistic expectations and a positive mindset regarding the outcomes of reduction mammoplasty. As of 1st of July 2023, patients are required to have a psychological evaluation to ensure they are suitable to proceed with surgery.
- Stable Weight:It is recommended to be near your target weight before undergoing the procedure, as weight fluctuations can affect the cosmetic results.
- Non-smoker: Smoking or vaping dramatically interferes with the healing process and increases the risk of complications. Therefore, candidates are required to cease smoking for a minimum 6 weeks before and after the surgery.
Breast reduction surgery can help address these concerns.
- Discomfort: Can improves neck, shoulder and back pain that is related to the weight and traction effect of heavy pendulous breasts.
- Irritation or Infection: Alleviate intertrigo or infections in the breast crease due to heavy breast size.
- Physical Activity: Breast reduction can improve ability to exercise and resume a more active lifestyle.
How is Breast Reduction Surgery Performed?
Breast reduction surgery is performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. Depending on the complexity of the procedure it may take 2-3 hours to perform and Dr Turner recommends patients rest in hospital overnight before being discharged home the next day.
There are several important considerations to be made during the planning of your reduction mammoplasty surgery with Dr Scott J Turner, Specialist Plastic Surgeon.
Incision Types
The surgical incision pattern Dr Turner selects depends on the amount of skin that needs to be removed, the distance the nipple areola complex (NAC) needs to be lifted, and the volume of breast tissue that needs to be removed to achieve your aesthetic goals.
There are two common skin design patterns for breast reduction:
01.
Vertical Scar - Lollipop Incision
The incision is placed around the areolar edge and vertically down to the breast crease. This is recommended only in patients who require small volume breast reductions and have good skin elasticity. The advantage of this incision type is avoiding a scar along the breast fold.
02.
Inverted T - Anchor Incision
The incision is placed around the areola edge, vertically down to the breast crease and horizontally along the inframammary fold. This is the most frequent type of breast reduction performed by Dr Turner as it allows larger volume reduction and improved shaping of the heavy ptotic breast.
While all surgical incision lines are permanent, they are concealed within the bra and will continue to fade over time.
Glandular Resection – Pedicle Type
The glandular pedicle in reduction mammoplasty refers to the tissue that maintains both the blood supply and sensory nerves to the nipple and areolar tissue after Dr Turner removes the excess breast tissue and repositions the areolar to its new position.
The are three common glandular pedicles used in modern breast reduction:
01.
Inferior Pedicle
The inferior pedicle has traditionally been the most popular technique used worldwide due to its reliability and safety in maintaining adequate blood supply to the nipple areolar complex, especially in large volume reductions. It also has the highest success rate in being able to breast-feed post-surgery. The inferior pedicle technique is frequently combined with an inverted T shape incision for very large breast reductions.
02.
Medial Pedicle
The medial pedicle is a modern development in breast reduction surgery to maintain the fullness in the cleavage area – upper and medial aspects of the breast, which is a frequent complaint of inferior pedicle breast reductions. The ability to combine the medial pedicle with either a short scar or inverted T shape incision gives it versatility for small to larger breast reduction procedures.
03.
Superior Pedicle
The superior pedicle is suitable for patients that need only a small degree of nipple elevation with tightening of the inferior breast skin. This is used more commonly in breast lift (mastopexy) surgery with or without a breast implant.
What about Liposuction and Breast Reduction
Liposuction is regularly combined with a breast reduction procedure to further contour the outer portion of the breast and lateral chest wall and minimise irregularities like dog ear formation.
While liposuction-only breast reduction has been touted as an alternative to formal breast reduction surgery without the need for scars placed on the breast, it rarely achieves an acceptable outcome.
Recovery after Breast Reduction Surgery
Recovering from a breast reduction surgery involves several stages and requires careful attention to the post-operative instructions provided by Dr Turner to ensure the best results.
- Rest & Elevation: Rest is crucial. It is important for the first 2 weeks after your procedure to keeping your head and back elevated on a few pillows while sleeping. Most patients can sleep on their sides after 3 weeks comfortably.
- Post-Operative Dressings: The sutures for all breast incisions are self-dissolving, eliminating the need for suture removal. Specialised dressings will be applied to support the wound during the first week, this will be changed by Dr Turner at your follow up appointment.
- Surgical Drains: Infrequently Dr Turner may use drains as part of your surgery. These drains are generally removed the day after surgery prior to you being discharged from hospital.
- Cold Compresses: Bruising, swelling and discomfort in your breast region is expected, especially with larger breast reduction and those requiring liposuction. The use of cold compress to your cleavage area in the first few days is a simple and effective measure to assist your healing.
- Compression Garments: You will be provided a surgical compression bra to wear full time for the first month post-surgery. This assists with settling of the breast shape and also assists with postoperative breast discomfort. After this time, Dr Turner recommends sleeping in the surgical garment at night for 6 months and wearing a supportive sports bra during the day.
- Incision Care:Scar management is an important part of any plastic surgery procedure. Scars on breast naturally will mature over 3 years before they look their best. During this time, we recommend a protocol of scar management, which includes silicone scar therapy and laser treatments.
- Medications: The anaesthetist will provide you with antibiotics and prescription pain medication that you can take at home over the first week.
- Normal Activities & Exercise: Most women can gradually return to normal activities over the first 2 weeks. However, more high intensity exercise needs to be avoided in the first 6 weeks, with strong upper body / chest exercise should be avoided for 3 months.
- Follow Up Appointments:Dr Turner recommends frequent follow up during the first 1 year after breast implant surgery. It is highly advisable that these reviews are in person at our Sydney clinic at 1 week, 1 month, 3 months, 6 months and 1 year.
Risks and Complications of 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.
- Scarring: Visible scarring is common, though it typically fades over time. In some cases, scars may remain more prominent or raised (hypertrophic scars or keloids).
- Infection: Infections can occur at the incision sites, which may require antibiotic treatment or, in rare cases, additional surgery.
- Sensation: Some patients may experience a loss of sensation in the nipples or breasts. This may be temporary or permanent.
- Asymmetry: Breast size, shape, or nipple position may differ slightly after surgery. Revision surgery may be required to correct significant asymmetry.
- Delayed Wound Healing: Delayed wound healing can happen, especially along incision lines. This is more likely in smokers (vaping) or individuals with certain health conditions (e.g., diabetes).
- Breastfeeding Issues: In some cases, the ability to breastfeed may be affected, especially if significant tissue is removed. Some people can breastfeed after the surgery, but it’s not guaranteed.
- Nipple Necrosis: Rarely, the blood supply to the nipple can be affected, leading to necrosis (tissue death).
- Blood Clots: There is a risk of blood clots, particularly in the legs (deep vein thrombosis) or lungs (pulmonary embolism), after surgery.
- Bleeding or Hematoma: Some patients may experience excessive bleeding during or after surgery, leading to the formation of a hematoma (a collection of blood under the skin). In rare cases, this may require additional surgery.
- Fat Necrosis: In rare instances, fat tissue in the breast may die and form firm lumps.
- Anaesthesia Risks: General anaesthesia carries its own set of potential risks, such as adverse reactions or complications.
- Unsatisfactory Results: Despite the best efforts of the surgeon, breast reduction surgery may not result in the patient’s desired outcome.
