Breast Reduction Surgery

Breast reduction surgery reduces the size of the breast, lifts the nipple and can correct differences in breast size.

The techniques of breast reduction and breast lift overlap and scar patterns may be similar. For breast reduction surgery there are many techniques with the choice depending on the amount of reduction, the position of the nipples and your concerns regarding scarring.

Fatty tissue, glandular tissue and skin are excised. The resultant breasts are smaller and are better shaped and have lifted nipples. The final size is an important consideration and should be in proportion with your body. However, it should be noted that your cup size cannot be guaranteed, and that your chest size will not change, only your cup size.

At consultation a medical and breast history (both personal and family) and examination is completed and under arm glands are assessed. The pre-operative workup, the surgical techniques and likely post-operative course is outlined. Before and after photographs are used to ensure your expectations are realistic and scar patterns are explained. Measurements are needed to plan the surgery. At the hospital it is necessary to draw and measure the breast reduction pattern, either in a sitting or standing position.

Surgical Procedure

Surgery is performed in hospital, usually with a general anaesthetic. The surgical time depends on the amount of reduction and is usually between two and three hours. Drainage tubes are not routinely used.

The breasts are carefully dressed and bandaged which may feel tight in the immediate post-operative period. Early walking and mobilisation are encouraged.

Post Operative Care

Post-operative pain is usually well controlled. Sedentary work and activities can be resumed in 1-2 weeks. At post-operative visits this will be carefully monitored. Advice will be given on the wearing of bras and on wound care. In general, sport-type bras without underwires are preferred and it may be necessary to use a hospital-supplied binder until swelling has settled to allow accurate fitting of new bras. You will need to be seen on a regular basis until the swelling has settled.

A mammogram is suggested at six months after surgery to establish a base line to compare your scar pattern should subsequent mammograms be required.

A loss of weight or gain of weight or subsequent pregnancy and breast feeding can affect the final outcomes.

Risks and Considerations

All surgery has some risks and these include bleeding, bruising, infection, scar and problems associated with wound healing. Excessive pain on one side may indicate a problem on that side. Discomfort should be about equal on both sides.

There are some risks specific to breast surgery. These usually increase with larger volume of reduction. Numbness of the nipples is common and usually resolves or improves. It may, however, take up to eighteen months before it settles and in some cases numbness may be permanent. A few people get an increase in nipple sensitivity. At times nipples may not survive and may need to be reconstructed. A degree of asymmetry is fairly common and there may be small differences in breast size, shape, lift, height, nipple position and areola size.

Breast feeding may still be possible after breast reduction surgery. A rough guide is that one third of women can breastfeed, one third can breastfeed with supplementation and one third cannot breastfeed. Again, this is proportional to the amount of breast tissue that needs to be removed. The larger the reduction the less likely breast feeding will be possible.

Wound healing problems may occur with breast reduction surgery. Two sites below the nipple, the T-junctions, are the most common associated with problems which may vary from a small blister to partial opening of the wounds. These usually settle with dressings.

There is a rare incidence of finding breast cancer in association with breast reduction surgery. This can either be at the time of initial examination or during the surgery, or from the breast tissue that is sent away for analysis. Should this occur it will be treated on its merits depending on the site, size and type of cancer discovered.

Overall, there may be an improvement in breast pain, breast heaviness, posture, back pain, neck pain and bra-strap grooving. In general breast reduction is extremely well tolerated, with very good outcomes.

Consultation with Dr John Kippen

At the time of consultation, Dr Kippen will give a far more comprehensive explanation of the procedure and likely recovery. He will give you brochures to read as well as showing before and after photographs.

You should read the information presented here in conjunction with the information contained on the Frequently Asked Questions page of the website.