Breast Reduction
Breast reduction is one of the most rewarding surgeries for both the surgeon and the patient.
Read on to learn more about the procedure and whether or not it may be suitable for your unique situation.
Why do women seek to have their breast size reduced?
Women with large, heavy breasts seek to have breast reduction to improve their quality of life. The benefits of this procedure include:
Physical benefits
- The relief of back, neck and shoulder pain
- Less weight on the chest helping to create an improved posture
- Less tension on bra straps which can cause discomfort and grooves on the shoulder
- Rectifying the droop to the breasts which can also worsen pain and posture
- Lessening of the sweat or a rash under or in between the breasts
- Less pain, weight and movement of the breasts that can often affect physical activities or the ability to play sports
- Find bras that fit more comfortably
Mental benefits
- Relief from chronic pain that affects mental health
References:
Saariniemi, K. M., Sintonen, H., & Kuokkanen, H. O. (2008). The improvement in quality of life after breast reduction is comparable to that after major joint replacement. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 42(4), 194–198. https://doi-org.ezproxy.surgeons.org/10.1080/02844310802098433
Hermans BJ, Boeckx WD, De Lorenzi F, van der Hulst RR. Quality of life after breast reduction. Ann Plast Surg. . 2005;55(3):227-31. doi:10.1097/01.sap.0000171444.79737.70
Gonzalez MA, Glickman LT, Aladegbami B, Simpson RL. Quality of life after breast reduction surgery: a 10-year retrospective analysis using the Breast Q questionnaire: does breast size matter?. Ann Plast Surg. . 2012;69(4):361-3. doi:10.1097/SAP.0b013e31824a218a
What is breast reduction?
Breast reduction, which can also be referred to as a reduction mammaplasty, is a surgical procedure that involves removing extra skin and breast tissue, reducing volume and reshaping the breasts. In many cases, this procedure also involves repositioning the nipple (a lift).
What is breast reduction?
Breast reduction, which can also be referred to as a reduction mammaplasty, is a surgical procedure that involves removing extra skin and breast tissue, reducing volume and reshaping the breasts. In many cases, this procedure also involves repositioning the nipple (a lift).
What bra cup size can I expect to achieve?
This is your decision; however, Dr Tan recommends that her patients aim for cup C (or more). The reason for this recommendation is that the breast can lose its shape if too much is removed. More importantly, adequate tissue must be left behind, particularly to keep the nipple-areolar complex and the remaining tissue alive, by maintaining the blood circulation. It is about keeping tissue alive whilst maintaining the shape of a breast.
It is important to note that cup size is only an estimate, and Dr Tan cannot guarantee a specific size.
Therefore, if you have heavy, size G cup breasts, and the nipples are looking down, it is very difficult to downsize to size C cup, without compromising some of the blood circulation. Not leaving enough tissue to support the nipple could lead to partial or complete nipple necrosis, or the nipple is more likely to become insensate or numb permanently.
Will the surgery leave scars?
Yes. There will be some scarring around the areola (usually reduced in diameter) that continues vertically below, in a ‘lollipop’ shape. In addition, there is usually a horizontal scar across the lower breast fold (inframammary fold/IMF).
The length of this scar depends on how much excess skin is excised from the breast. Patients with excess fat at the sides of the chest may have some liposuction from that area at the same time, and when the excess skin is removed, the resultant scar is in continuation with the breast reduction scar.
Will the surgery leave scars?
Yes. There will be some scarring around the areola (usually reduced in diameter) that continues vertically below, in a ‘lollipop’ shape. In addition, there is usually a horizontal scar across the lower breast fold (inframammary fold/IMF).
The length of this scar depends on how much excess skin is excised from the breast.
How long does the surgery take? Do I need to stay in the hospital?
The surgery usually takes between 2.5 to 4 hours, depending on how much of the breast needs to be removed. The hospital stay will be overnight or two nights in some cases to manage pain as the effects of local anaesthesia wears off.
Are there any risks involved?
All surgery is associated with some risk, both from the surgery itself and the given anaesthesia. There are general and specific risks related to the operation. Please click here for further details on the general risks that relate to all operations. Some of the risks may overlap.
So, what are the risks relating to breast reduction procedure?
- Asymmetry
- Excess skin (looks like protruding ‘lump’), usually at the sides
- Change in nipple and skin sensation- loss or diminished
- Nipple or areolar necrosis- uncommon, unless massive breast reduction; in some cases, nipple grafting is necessary. High in smokers and diabetic
- Areola will be smaller but size and shape may change with time (e.g. may enlarge if large amount of breast tissue is left behind or if the breasts regrow in size)
- “Lumpiness” or contour irregularity, sometimes from liposuction; often with patchy areas of firmness. Some could be due to fat necrosis,i.e. some areas of fat die and scar.
Are there any risks involved?
As with any other surgery, there are risks of complication, either from the surgery or from general anaesthesia. There are general surgical risks of complications such as bleeding, infection, and wound healing issues and specific risks relating to the reduction, repositioning of the nipple, and reshaping of the breasts.
Dr Tan will provide in-depth verbal and written information about all relevant risks.
How long do I need to recover?
The following recovery times are a rough guide as all patients experience different healing abilities:
- Minimum 2 weeks with limited physical activities
- 4-6 weeks of restraint from upper body exercises and manual work that involves excessive shoulder movements or heavy lifting
When will I see the final results?
It can take roughly 3-6 months for the swelling to settle down and the uplifted breasts to drop and look more natural.
It is also important to note that the appearance and feel of scarring will evolve with time and vary between individuals. In general, younger patients may have reddened and ‘lumpy’ scars (hypertrophic scars) that mature after six months. Scar maturation may take one year or longer in some cases.
What is the process of getting breast reduction surgery?
The first step with any procedure is a consultation with Dr Tan for approximately 45-60 minutes to discuss your situation and the issues you would like to target.
Dr Tan will ensure this is the right procedure for you and provide you with reading materials and a quote for surgery to take home. If you decide to proceed, a second consultation is required to answer any remaining questions, take “before” photos and schedule a date for surgery.
From there, the process is as follows:
- Pre-operating mammogram with or without ultrasound if you are aged 40 and above or have a family history of breast cancer
- Surgery followed by 1-2 nights hospital stay; post-surgery advice sheet is provided
- Recuperate at home for a minimum of 2 weeks
- Follow-up care after surgery around 7-10 days; 4-6 weeks; 3 months; 6 months; and a year
What can I do to prepare for the surgery?
We recommend that all patients do the following before surgery:
- Eat well with lots of protein (aim for at least 0.5g/kg per day); include colourful and green leafy vegetables
- Dr Tan will let you know what to avoid taking for at least two weeks before surgery
- Stay positive and keep calm
- Sleep well (at least 7 hours a night)
- No smoking for at least four weeks
- Arrange for support at home, at least for the first week after surgery
What can I do to prepare for the surgery?
We recommend that all patients do the following before surgery:
- Eat well with lots of protein (aim for at least 0.5g/kg per day); include colourful and green leafy vegetables
- Dr Tan will let you know what to avoid taking for at least two weeks before surgery
- Stay positive and keep calm
- Sleep well (at least 7 hours a night)
- No smoking for at least four weeks
- Arrange for support at home, at least for the first week after surgery
What are the risks of surgery?
ALL Surgery is associated with some risk. There are general and specific risks related to the operation.
Understanding the Risks of Surgical Procedures: Every surgical procedure involves inherent risks, and it’s crucial for patients to be well-informed about these before deciding to proceed. Here, we outline not only the general risks associated with surgeries but also emphasize that specific procedures have their own unique risks.
General Surgical Risks: All surgical procedures can potentially lead to complications such as:
- Bleeding or hematoma formation
- Infection
- Healing issues, including slow/delayed healing or separation of the incision (wound dehiscence)
- Excessive or abnormal scarring, such as keloid formation
- Seroma (accumulation of tissue fluid)
- Deep suture extrusion that could lead to infection
- Fat necrosis (death of fat tissue)
- Pain- acute post-surgical pain; sometimes chronic pain
- Change in sensation (usually temporary but may be permanent)
- Allergic reactions to drugs or local anesthesia
- Deep vein thrombosis (blood clots in deep veins) that could lead to pulmonary embolism (clots travelling to the lungs)
- Pressure effect- excessive, unrelieved, or prolonged pressure on tissues can cause temporary or permanent damage. The risk of these complications is increased in lengthy operations and in the obese (BMI 30 or more), smokers, diabetics, and medically compromised patients. Great care is taken to minimize these risks during operations.
- Unsatisfactory result and need for revisional surgery
Informed Consent: Before any surgical operation, it is mandatory for all patients to read and sign informed consent forms. These documents are essential as they ensure that you have been provided with comprehensive information about the risks associated with your procedure. Dr. Tan and her team are committed to ensuring that you feel informed and confident in your healthcare decisions.
Procedure-Specific Risks: Each type of surgery carries additional risks that are specific to the procedure itself. During your consultation, Dr. Tan will provide a detailed explanation of these risks tailored to the specific surgery being considered. This information will also be included in the informed consent forms, which are discussed and thoroughly reviewed during your consultation. You are encouraged to ask any questions you may have during this time to ensure you fully understand all aspects of the procedure and its risks.
For breast reduction
- Asymmetry (the breasts are sisters and not twins…and they will remain sisters!)
- Excess skin at the bottom of the breasts
- Change in nipple and skin sensation- loss or diminished
- Nipple or areolar necrosis- uncommon, unless massive breast reduction; in some cases, nipple grafting is necessary. High in smokers and diabetic
Revision surgery is sometimes performed to remove any excess skin, and/or when asymmetry is significant, and/or more reduction in size is required. No out-of-pocket fee is charged unless there is a change of mind, for instance, the patient has decided to go smaller after surgery.
Book a consultation for a breast reduction review with Dr Tan today
With over fifteen years of experience in various areas of Reconstructive and Cosmetic Surgery, Dr Tan has a successful portfolio of improvement and the skills and knowledge required to create comfort and confidence for those with uncomfortably large breasts. Start your journey towards wellness today with Dr Beryl Tan. Patients can access Dr Tan at Brighton, Cabrini and PRSM in Donvale today.