Breast Reduction Surgery

What is breast reduction surgery?

Breast reduction surgery, also known as reduction mammaplasty, is a procedure to reduce breast volume by removing excess fat, tissue and skin from the breasts. It can help to alleviate discomfort and improve quality of life.

Why do you need breast reduction surgery?

Breast reduction surgery is used to resolve certain issues that arise from having large breasts. It can help to:

• Reduce nerve pain
• Resolve chronic rash or skin irritation under the breasts
• Improve chronic back, neck and shoulder pain that requires pain medications
• Improve self-image related to large breasts

Breast reduction surgery can also make it easier to move and do daily activities and make it easier to fit into bras and clothing.

Who should not undergo breast reduction surgery?

In general, breast reduction surgery is not recommended if you:

• Are a smoker
• Are very obese with a BMI of over 30
• Are a teenager whose breasts have not fully developed
• Have chronic conditions such as diabetes or heart problems
• Want to avoid scars on your breasts

You may also wish to postpone breast reduction surgery if you:

• Wish to have children, as breastfeeding might be challenging after breast reduction surgery. Although new surgical techniques can help to preserve the ability to breastfeed.
• Are still in the process of losing weight, as this can affect breast size. You might be advised to wait until your weight stabilises before undergoing breast reduction surgery.

If you are overweight with a BMI of over 30, please speak with your doctor about breast reduction weight requirements as this can impact the success of your surgery.

What are the risks and complications of breast reduction surgery?

Breast reduction surgery has similar risks to any other type of major surgery. Some general risks include:

• Infection
• Blood clots
• Excessive bleeding
• Allergic reaction to anaesthesia

Other possible risks and complications include:

• Scarring
• Temporary bruising
• Difficulty or inability to breast-feed
• Loss of sensation in the nipples and skin surrounding the nipples (areolae)
• Differences in the size, shape and symmetry of the breasts, which might require further surgery
• Nipple necrosis, which can disrupt the blood supply to the nipple and areolar areas

How do you prepare for breast reduction surgery?

Before the operation, your doctor will review your medical history and discuss your expectations for breast size and appearance after surgery. This will help your doctor to decide on the best technique/s to use so as to achieve the results you want.

You may also undergo the following physical examinations, scans and tests:

• A physical examination and measurement of your breasts
• Blood tests to assess your general health
• A baseline mammogram

Once your breast reduction surgery is scheduled, your doctor will advise you on how to prepare. In general, you need to fast 6 – 8 hours before the procedure.

Note: If you are taking any medication or herbal supplements, you should inform your doctor. You may need to adjust or stop taking some medication before the procedure (e.g. aspirin, blood thinners). If you smoke, you will be asked to stop for a certain period of time before and after surgery.

What can you expect in breast reduction surgery?

Breast reduction surgery is usually done under general anaesthesia.

Estimated duration

The procedure lasts about 2 – 5 hours. Depending on the extent of the surgery, it may take longer.

During the procedure

Your doctor may use the following techniques to reduce the size of your breasts:

Surgery through incisions

This procedure uses incisions to remove excess tissues. The shape of the incision will depend on:

• The shape and size of your breasts
• How much tissue needs to be removed
• How do you want to look after surgery

There are 2 types of incisions:

1. Vertical or 'lollipop' incisions are used to address moderate breast reduction and visible sagging. A cut is made around the areola and down beneath the breast. Extra tissue and fat are removed and the breast is reshaped and lifted.
2. Inverted-T or 'anchor' incisions go around the areola down to the breast crease and along the crease underneath the breast. This type of surgery is used for large reductions and to improve more extensive sagging or unevenness.

Liposuction used in combination with surgery

This procedure uses liposuction to remove excess fat. It is best for small reductions and for people with more skin elasticity.

During the procedure, small cuts are made to insert a thin tube connected to a vacuum. This vacuum is used to remove excess fat and fluids.

After the procedure

Post-operative pain is normal and will be managed with medication. You may be given antibiotics to decrease the risk of infection.

Care and recovery after breast reduction surgery

Once your dressings and drain tubes are removed, you may be asked to wear an elastic compression bra to protect your breasts.

You will need to limit physical activity for 2 – 4 weeks for your breasts to heal. Depending on the surgery, most people recover in about 1 month.

Some scarring is expected after surgery, but usually fades over time.