July 20, 2022
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By Dr. Andrew Campbell-Lloyd

Breast reduction surgery

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Information

PROCEDURE:

Breast reduction surgery for ladies with large, heavy or pendulous breasts causing pain (shoulder/neck), skin irritation or other functional concerns

COSTS:
Plastic surgeon’s fee: from $6,700

Total approximate cost (uninsured patient, day surgery only): from $12,600

Total approximate cost (insured patient where item number applicable): from $5,950

Associated item number: 45523

LENGTH OF PROCEDURE/HOSPITAL STAY:
~3 hours

Day surgery for most patients.

Optional overnight stay covered by insurance for patients with appropriate cover.

Key Features

Size/weight reduction

The fundamental reason most ladies seek breast reduction surgery is to alleviate the discomfort of large, heavy breasts which are often associated with shoulder & neck pain, bra straps cutting in, poor posture, difficulty exercising and difficulty finding clothes that fit.

Breast reduction is perhaps best considered as a “functional” procedure with a cosmetic side-effect.

Whilst breast reduction will certainly improve the appearance of the breasts, the main benefits for most ladies are the enormous day-to-day functional improvements that come from having smaller, lighter breasts.

Breast “lift”

Whilst a breast can be lifted without performing any reduction, every breast reduction also entails a breast lift. In the course of the breast reduction:

  • the nipple will be elevated into a higher position
  • the retained upper and inner breast tissue will be elevated and supported to sit higher on the chest whilst creating an improved cleavage line
  • the excess skin and breast tissue at the bottom and the outer part of the breast will be reduced in volume, which narrows and supports the breast in a higher position.

“Internal bra technique”

So-called internal bra techniques are often mentioned by other surgeons, but it is sometimes hard to understand exactly what is meant by this. Essentially, an internal bra involves some form of reinforcement of the position of the crease under the breast, using stitches. This technique ensures that the scar remains positioned in the crease, and it also helps the support the breast in the new, higher position. The internal bra is also responsible for some of the discomfort that patients will experience after breast reduction surgery, due to the large stitches placed internally.

Nipple repositioning and areola reshaping

Elevating the nipple position so that the nipple is centred on the breast mound ensures that the nipple is directed forwards, rather than pointing downwards as is the case for many ladies with large breasts. Repositioning the nipple also allows an opportunity to reduce and reshape the areola.

“Anchor” scar

Dr Campbell-Lloyd uses an “anchor” or“inverted-T” scar for all breast reduction procedures. This ensures optimal control of the breast shape and breast position. Dr Campbell-Lloyd does not offer “vertical scar” techniques.

Liposuction

Many ladies will have some heaviness extending from the side of the breast towards the arm pit. Some ladies will notice this as fullness which bulges over the bra strap. Dr Campbell-Lloyd will perform liposuction as a component of the breast reduction procedure to ensure a smooth contour around the side of the breast and to reduce any heaviness extending under the arm.

Drainless

Dr Campbell-Lloyd does not use drains for breast reduction procedures. This allows for patients to go home on the day of surgery, and is associated with less pain.

Reasons To Consider This Procedure

Large, heavy breasts

Breast enlargement may be a consequence of hormonal stimulation, natural breast development, weight change, pregnancy or a combination of causes. Breast enlargement affects women of all ages. Regardless of age, heavy breasts can create discomfort, embarrassment,and functional limitations.

Disproportionate breast size

Some ladies (especially our younger patients) may be very slim whilst still struggling with large and heavy breasts. Disproportionately large breasts, especially in younger patients, may be a cause of acute social embarrassment.

Large breasts can cause unwanted attention, especially for younger ladies who develop large breasts whilst still at school – and sadly, in some cases we hear stories of young ladies seeking surgery in response to harassing behaviour from others.

Many of our patients experience difficulty shopping for clothes (especially bras and swimsuits), as well as functional challenges in pursuing an active lifestyle. Large breasts can limit our patients' involvement in sport, create difficulty exercising, or may simply make playing with their children awkward.

Breast reduction may offer truly life-changing outcomes.

Drooping or pendulous breasts

Heavy breasts will nearly always be pendulous or ptotic to some degree. It is the drooping of the breast which results in the breast sitting on the abdominal skin, with resulting perspiration and chafing in some cases.

Asymmetry

Many ladies with large breasts will also struggle with size differences between the breasts. Breast reduction is an ideal opportunity to correct any asymmetry.

What To Expect

Initially, the breast will sit high on the chest, and may appear tight and flat in the lower part of the breast. This appearance will gradually soften and relax over about 3 months as the breast settles post-operatively.

Some ladies may experience sensory changes in the nipple, which may be temporary or permanent. Some ladies will have a loss of sensation after breast reduction surgery. Other ladies may have a temporarily heightened sensation which can be uncomfortable for about 4-6 weeks.

For younger ladies who have breast reduction surgery, there is a risk that the breast will enlarge again over time, due to factors such as pregnancy, weight gain or age. It is possible to safely re-do breast reduction surgery in the future, but it is impossible to predict who may require repeat surgery.

All sutures are dissolving sutures, under the skin. A layer of glue is then applied to any incisions. There are no “sticky” dressings applied as this will tend to cause irritation and prevent showering.

After breast reduction surgery, patients are discharged home with a surgical compression bra which must be worn at all times for the first 4-6 weeks.

Patients are discharged with antibiotic tablets, and pain-relief medications.

Patients are discharged home with detailed instructions. The instructions include emergency contact details for Dr Campbell-Lloyd.

Routine follow-up appointments are made for (although patients may be seen more frequently):

  • 3-4 days post-op,
  • 4-6 weeks post-op,
  • and 3-4 months post-op

There will be some pain. Most patients will experience pain at the incision sites for the first 7-10 days. Some patients will experience occasional discomforts relating to movement after that time as the healing process continues.

The nature of this surgery is such that patients should expect to require pain relief medication for at least the first 2-3 weeks. Some patients will require simple pain relief (such as Nurofen) for up to 6 weeks as they increase activity.

It is vital to maintain a decreased level of activity for 6 weeks after surgery.

It will take at least 3-4 months for full recovery. Final results can only be appreciated after that time, once scars have softened and relaxed. Scars may only fade after 6-12 months on the breast.

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