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Breast Reduction

Breast reduction surgery, also known as reduction mammaplasty, is intended to reduce the size of your breasts by removing excess breast tissue and skin, and improve their shape and position. In addition to the emotional and social distress, overly large breasts often cause physical discomfort, including back, neck and shoulder pain. Dr Dona offers the latest techniques in breast reduction surgery, including a number of minimal scar techniques. Breast reduction surgery relieves pain and discomfort, and often makes a dramatic improvement to your lifestyle. In fact, the level of patient satisfaction after undergoing breast reduction surgery is among the highest of any cosmetic surgery.

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YOUR CONSULTATION WITH DR DONA

During your initial consultation you’ll be able to inform Dr Eddy Dona why you want reduction mammaplasty and express any concerns that you have. Your medical history will also be taken where you should disclose any health problems, symptoms and concerns as well as a list of all medications you are currently taking and have taken in the past. Dr Dona will then perform a physical examination to assess and advise you on your options, taking into consideration your desires and expectations. Dr Eddy Dona will go discuss the procedure including the usual post-operative course and potential issues. During this time you will of course have the opportunity to discuss with Dr Dona any questions you have in relation to your breast reduction procedure.

PREPARATION FOR SURGERY

During your consultation with Dr Eddy Dona you will be asked about your medical history. You should disclose any health problems, symptoms and concerns as well as a list of all medications you are currently taking and have taken in the past.

If you plan to lose a large amount of weight then we recommend that you stabilise your weight before breast reduction surgery.

If you have a family history of breast cancer Dr Dona may recommend a mammogram before surgery.

Do not take any blood thinning medication such as aspirin, any medicine containing aspirin, large amounts of vitamins or anti inflammatory drugs for two weeks prior to surgery.

Do not smoke for at least 2 weeks before surgery, as smoking increases surgical and anaesthetic risks and can lead to serious complications.

REASONS FOR HAVING A BREAST REDUCTION

Are you embarrassed by large breast or are your breasts restricting your day to day life? Having large breasts can have serious psychological and physiological impact on women which should not be taken lightly. Breast reduction surgery can:

  • Reduce your breast size if your breasts are heavy and pendulous, or too large for your body frame
  • Improve your posture
  • Ease pain in your back, neck and shoulders, and relieve grooves in your shoulders from bra straps caused by heavy breasts
  • Relieve pain in breast tissue
  • Allow you to participate in sporting activity and exercise
  • Raise position of downward pointing nipples and areolas (the skin surrounding the nipple)
  • Balance the size and shape of unequal breasts
  • Reduce skin irritation in the breast folds
  • Improve your self esteem and self confidence if you are self conscious about your breast size

WHAT ARE THE DIFFERENT TECHNIQUES?

Depending on the size and shape of your breasts, the amount of skin and tissue to be removed, quality of skin and positioning of the nipples, Dr Eddy Dona will recommend one of these methods.

Robbins Method – Anchor shaped scar technique is the most common and involves an incision with the resultant scars extending around the areola, vertically down from the lower edge of the areola to the fold/crease of the breast and horizontally along the natural curve of the breast. After the excess skin, fat and breast tissue are removed the nipple and areola are moved to a higher position and stitched to reshape the breast. This is ideal for most moderate to large reductions.

Lejour Method (or other vertical scar techniques) – This technique does not include the scar running horizontally along the curve of the breast, but results in a vertical scar or “lollipop” type scar. This is ideal for most mild to moderate reductions.

Benelli Method – Involves two circular incisions around the areola, one larger than the other. Skin and breast tissue are then removed between the two. This method results in one scar around the areola but can leave the breast looking flat. It also doesn’t allow for a significant “lift” of the breast tissue. This is most suitable for very minimal reductions.

In almost all breast reduction procedures the nipples and areolas remain attached to their blood and nerve supply while they are repositioned. However if the breasts are extremely large and the nipples and areolas are near waist level then they may have to be completely removed and repositioned. This will cause permanent loss of sensation in the nipple and you will not be able to breastfeed.

ADDITIONAL FACTS

Age – healthy women of any age can have a breast reduction. Whilst it is sometimes considered and performed in teenagers with extremely large breasts, we recommend you wait until your breasts have fully developed.

Permanency – the reduction in breast volume is permanent but will increase and decrease with lifestyle factors, such as weight gain or pregnancy.

Breastfeeding – prior to any surgery women with large breasts often have troubles breastfeeding as they tend to have a low milk output anyway.

WHAT TO EXPECT DURING YOUR RECOVERY?

Whilst in some cases you may be able to go home a few hours after surgery, it is likely we will recommend an overnight or longer stay. Some discomfort and pain is normal and pain relief medicatioN will be prescribed if required. Do not drive while you are taking prescription pain relief or sedatives.

Do not take aspirin or other blood thinning drugs for at least two weeks after surgery as they increase the risk of bleeding.

During recovery, make sure you should get lots of rest, drink plenty of fluids and eat small and healthy meals regularly.

All surgery results in some swelling and bruising but should start to settle after a couple of weeks.

For the first two weeks it is recommended that you sleep on your back or side. Do not smoke for at least two weeks after surgery as it impairs wound healing.

Dr Dona will advise you when you can return to normal activities and work, however, avoid heavy upper body activities and sports for at least four weeks after surgery.

We will give you a post-operative surgical bra for support which you will need to wear for six weeks. Following this, you can go out and be fitted for your new bras!

Like any wounds, the surgical scar from the incision will be slightly red for a few months before it fades.

We will take photographs of you after your operation as part of your ongoing evaluation. You will need to come in for periodic check-ups so that we can observe the long term results of your surgery.

WHEN CAN YOU EXPECT YOUR FINAL RESULTS?

Breast reduction surgery patients are amongst some of the happiest. Not only will you find that a significant weight is literally lifted from your shoulders, but your breasts will now have a more youthful, perky appearance.

However, gravity, aging, weight gain, weight loss, childbirth, breastfeeding or hormonal factors will continue to affect the size and shape of your breasts.

WHAT ARE THE POSSIBLE COMPLICATIONS?

As with any surgery, there are always potential risks and complications.
Fortunately, they are few and infrequent, but may include – wound infection, bleeding, chest infection, blood clots, bruising and swelling.

Other potential complications include:

Scarring – It is impossible to avoid scarring with any surgery, and the scar itself can have an unpredictable healing response. Our aim is to provide the best possible scar.

Asymmetry of Breast Shape and Size – Prior to any surgery, all breasts have some slight asymmetry. Such slight asymmetry can exist post-operatively.

Loss of Sensation in Nipple and Areola – This can occur in a small percentage of women. If it does, it is usually temporary and feeling usually returns over a period of several months. In some cases the loss of sensation may become permanent. Sometimes the nipple sensation can become too sensitive and uncomfortable.

Loss of Nipple and Areola Tissue – Is fortunately rare. It happens when the nipple and areola loses its blood supply. Reconstruction can be performed at a later stage. Smoking (or any nicotine) significantly increases the risk of this happening.

Inability to Breastfeed – There is a reduction in the potential to breastfeed after surgery.

Breast Lumps – Uncommon and likely due to a small collection of blood or dead fat cells that are still healing. If it does occur it generally resolves on its own over time.

Excess Skin – in extremely large breasts sometimes an excess of breast tissue and skin remains under the armpits. These are referred to as “dog ears” and may warrant further minor surgery to improve.

Bottoming out – Due to the nature of the breast tissue and inherent heaviness, the natural breast tissue can continue to sag after surgery resulting in  very “bottom heavy” breasts with nipples sometimes pointing upwards. Dr Dona uses a number of advanced techniques to minimise this problem, however this can still occur.

Breast Tissue Softness and “Sagginess” – Whilst breast reduction surgery can reduce the volume and change the position of you breast tissue, it can never make “soft” breast tissue firm. Also, soft breast tissue does not maintain its shape as well as firm breast tissue. Therefore, maintaining a fuller upper half of the breasts in these situations is generally not possible.

WILL PRIVATE HEALTH INSURANCE COVER COSTS?

Reduction mammaplasty is an elective surgery but is often carried out for health reasons, to ease the physical symptoms caused by excessively large breasts. Some of the fees may be covered by Medicare and your health fund; Dr Dona will advise whether this applies to you.

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