What is breast reduction surgery?
Reduction mammoplasty, also known as breast reduction, is one of the most popular plastic surgery procedures in Australia. Many women opt for this procedure due to the discomfort and other symptoms caused by breasts that are too large for their bodies. (Gynecomastia surgery is the equivalent procedure for males.)
This surgery is usually performed on an outpatient basis and involves the removal of excess skin, fat and glandular tissue from the breasts to reduce their size. The surgeon also reshapes the remaining tissue and raises the nipples to create a perkier appearance.
By removing excess tissue and repositioning the breasts on the chest wall, breast reduction surgery can significantly improve or completely alleviate many physical discomforts related to disproportionately large breasts. These problems may include back, shoulder, and neck pain, bra-strap indentations, posture issues, skin irritation, rashes under the breast crease, and difficulty with other everyday activities (e.g. sports and exercise).
What are the pros and cons of breast reduction surgery?
- Breast reduction surgery can help you achieve more proportionately sized breasts relative to your body.
- This procedure can also help alleviate painful and irritating physical symptoms such as shoulder, neck, and back pain caused by large breasts.
- Research suggests that breast reduction surgery can improve self-esteem and overall quality of life.
- Areola reduction is often carried out during the same operation, which can make breasts look perkier, more youthful, and proportionate.
- Many individuals who have undergone breast reduction surgery report being able to exercise and play sports, with greater ease and enjoyment. They also note that they can now dress in a manner that better reflects their personal style and feel more confident as a result.
- Plan for at least a week to rest and recover, with some patients opting to take up to two weeks off work for more recuperation.
- Breast reduction surgery does involve some scarring. Incision lines typically fade over time but are still permanent. It is rare for patients to solely regret the surgery due to scarring.
- The technique used by your surgeon during breast reduction surgery may affect your ability to breastfeed. However, most plastic surgeons use methods that aim to preserve the ability to nurse.
- There is a possibility that you may experience some breast asymmetry after the procedure. Your surgeon will strive to create symmetry when visually looking at your breasts, but some variation in size and shape is not uncommon due to the way your skin adjusts.
In some women, the sensation in their nipples will temporarily reduce or even vanish, though most will regain the feeling within a year.
How much does a breast reduction cost?
Average Cost: $12,500
Range: $8,600 - $25,900
There are several factors that can impact the cost of your breast reduction surgery, including the experience and skill of your surgeon, your private health cover, and the hospital venue for the surgery. If you suffer from persistent back pain, skin irritation, infection, or other health issues, you may be eligible for Medicare rebates.
Is breast reduction safe what are the potential side effects and risks?
As long as the operation is conducted by a qualified and experienced plastic surgeon, breast reduction surgery is widely regarded as a safe procedure. A 2017 study, saw that only a small percentage (6%) of breast reduction procedures resulted in complications that needed revision surgery.
You may encounter the following risks and side effects during breast reduction:
- Post-surgery side effects commonly experienced after breast reduction include bruising, swelling, and scarring.
- As with all surgeries, there is a potential for complications such as adverse reactions to anesthesia, infection, and the formation of a hematoma.
- It is possible that some degree of asymmetry between the breasts may be present after the procedure, although surgeons will make every effort to ensure they are as symmetrical as possible. If the asymmetry is noticeable, revision surgery may be considered.
- Decreased sensation in the nipples is a temporary side effect of the surgery, with total feeling potentially taking up to a year to return.
What happens during a breast reduction?
Under general anaesthesia, breast reduction surgery is an outpatient operation. Normally, the procedure lasts 3 to 4 hours.
There are several different options available when it comes to breast reduction. The specific approach that is chosen will be based on your individual goals, physical assessment and personal circumstances. For instance, specific methods increase the likelihood that a woman will be able to breastfeed following surgery.
There are two surgical techniques typically used:
- The vertical or "lollipop" technique for breast reduction involves making an incision around the areola and a second incision that runs down from the base of the areola and stops at the breast crease. This method is best suited for those looking for a moderate reduction in size and sagging.
- The inverted-T or anchor technique for breast reduction starts the same, with an incision around the areola, a second incision that runs down from the base to the crease under the breast, and then an additional incision along the breast crease creating an upside-down "T” shape. This technique is often recommended for those needing a large size reduction or those who have significant sagging.
During reduction mammoplasty, the aim is to reshape and reduce the size of each breast by removing excess tissue, skin, and fat.
In the majority of cases, the nipple and areola will remain attached to the breast. However, in rare instances, doctors may need to be fully detached and reattached at a higher position on the breast (necessary, only if the breasts were particularly large).
Liposuction may also be utilized in some breast reductions. It is normally only effective for those with minimal sagging or drooping, as it will not provide significant lifting or tightening on its own. Additionally, removing fat independently can lead to sagging if the skin lacks sufficient elasticity.
After the surgery, you will be fitted with a surgical bra that may contain sanitary bandages or gauze dressing.
Your doctor may also set surgical drains, the size of drinking straws, on the edge of the incisions. These drains connect to a small collection reservoir and help to draw away blood and fluid that may accumulate within the breasts during the first 24-48 hours post-surgery.
Melon Tip: Patients can combine breast reduction surgery with a tummy tuck as part of a mummy makeover. While private health insurance and Medicare will likely not cover the cost of the tummy tuck, this can still be a more cost-effective alternative than having the procedures done separately as the anesthesia and facility fees are better utilised.
How long does it take to recover from breast reduction surgery?
Here is what to expect during recovery after a breast reduction:
- After undergoing breast reduction surgery, it is standard for patients to take at least a week off to allow for proper healing. If possible, it is best to take two weeks off to ensure that the recovery process goes smoothly.
- Your surgeon will likely use stitches that dissolve on their own and do not need to be removed. You will also have follow-up appointments with your doctor to monitor your progress.
- To support recovery, it is advised to wear the surgical bra for up to four weeks post-op, and after that a sports bra for an additional two to four weeks. Avoid wearing bras with underwires during this time, as they may irritate the incisions.
- You should be able to return to your normal activities, including exercise, within a period of four to six weeks.
- After completing breast reduction surgery, patients should be mostly recovered by the sixth to eighth week. Your breasts should feel soft, natural, and comfortable at this time with the swelling and inflammation subsiding by 50%.
- Some individuals may experience a temporary loss of feeling around the nipples following the surgery, but this is usually resolved as swelling declines. In some cases, however, it may take up to two years for the nerves to completely recover.
- The scars resulting from a breast reduction can take a whole year to fade. There are various treatments available, such as micro-needling or laser resurfacing, which may help to accelerate the fading.
What do I need to wear after breast reduction surgery?
For the first couple of weeks following your procedure, your surgeon will recommend that you wear a surgical or sports bra 24/7 except when showering. Avoid underwire bras during this time as the wire can put pressure on the breast crease incisions and cause irritation.
Due to swelling and bruising, it may be difficult to raise your arms above your head. To make dressing easier, prepare tops or pyjamas with front buttons for the first week or so.
Remember that your breast size will be entirely different after surgery, you will need to acquire new bras once your recovery is fully complete.
When will I see the final results of my breast reduction?
As soon as your surgery is completed, you will see a large instant reduction in the size of your breasts, though it may take 6 months to a year for swelling to die down before your final results are apparent.
How painful is breast reduction surgery?
During the first week after reduction mammoplasty, you may experience mild to moderate pain.
Over-the-counter pain medication like paracetamol is usually sufficient to manage the discomfort, but some patients may need prescription medication at the start.
Bruising and soreness are common after the procedure, and you may feel tension, tightness, or discomfort in the breast area for two to three weeks.
If liposuction was also performed as part of the breast reduction, the areas treated with liposuction will be quite sore.
Do you lose weight from undergoing breast reduction surgery?
During breast reduction surgery, spare tissue and fat are removed, which will result in minor weight loss.
The exact amount of weight you lose will depend on the amount of tissue removed during the procedure.
Even though the weight loss is minimal, others may still perceive you as having lost a significant amount of weight due to the improved proportionality of your breasts. Before the surgery, a large bust that did not suit may have given the impression of being overweight, even if you were not.
In addition to inducing weight loss, the surgery may also enable you to lead a more active lifestyle, which can contribute to further weight changes.
Can your breasts size still change after breast reduction surgery?
Breast reduction surgery will provide permanent results, but it is important to remember that your breasts may still be affected by your hormones, weight fluctuations, gravity, and the natural aging process. All these factors can cause your breasts to alter in size, shape, and potentially sag or grow over time.
While uncommon, breasts are able to regrow after reduction surgery. This may result from natural changes that occur during different phases of your life, or, in rare cases, rapid growth due to medical conditions is also possible, particularly in younger women.
There are several factors that can affect the size and shape of a woman's breasts over the course of her lifetime, such as pregnancy, hormone changes, menopause, and other weight changes. To help maintain your desired cup size after breast reduction, it is crucial to observe a healthy lifestyle and diet.
Moreover, gaining weight may increase the size of your bra due to the amount of fat in your breasts.
Consult your surgeon if you plan on losing a substantial amount of weight after your procedure. In order to avoid sagging skin, they may suggest waiting until you are closer to your ideal weight before having breast reduction surgery.
Can you still breastfeed after getting a breast reduction?
It is important to note that breast reduction surgery may impact your ability to breastfeed in the future.
While this is more likely to occur when a large amount of breast tissue is removed from the area under the nipple and areola, studies demonstrate that it is still possible to breastfeed in 75-100% of cases as long as the areola and nipple are mostly or fully kept intact.
It is rare, but there is a chance that during or after breast reduction surgery, part of the nipple or areola may be lost due to problems with blood flow to the area. This can occur if there is insufficient blood supply or if the blood flow becomes congested and unable to properly exit. Nipple and areola loss is also possible if the skin graft does not ‘take’.
Sources & Studies
Kraut, RY, Brown, E, Korownyk, C, Katz, LS, Vandermeer, B, Babenko, O, Gross, MS, Campbell, S & Allan, GM 2017, ‘The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies’, PLoS ONE, vol. 12, no. 10, viewed 10 January 2023, <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186591>.
Mello, AA, Domingos, NAM & Miyazaki, MC 2009, ‘Improvement in Quality of Life and Self-Esteem After Breast Reduction Surgery’, Aesthetic Plastic Surgery, vol. 34, no. 1, pp. 59–64, viewed 10 January 2023, <https://link.springer.com/article/10.1007/s00266-009-9409-x>.
Papanastasiou, C, Ouellet, JA & Lessard, L 2019, ‘The Effects of Breast Reduction on Back Pain and Spine Measurements’, Plastic and Reconstructive Surgery - Global Open, vol. 7, no. 8, p. e2324, viewed 10 January 2023, <https://journals.lww.com/prsgo/Fulltext/2019/08000/The_Effects_of_Breast_Reduction_on_Back_Pain_and.12.aspx>.
Riccio, Charles A, Zeiderman, Matthew R, Chowdhry, S, Brooks, Ronald M, Kelishadi, Shahrooz S, Tutela, J, Choo, J, Yonick, David V & Wilhelmi, Bradon J 2015, ‘Plastic Surgery of the Breast: Keeping the Nipple Sensitive’, Eplasty, vol. 15, viewed 10 January 2023, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492192/>.
Victoria State Government Department of Health 2022, Breast reduction for women, www.betterhealth.vic.gov.au, viewed 10 January 2023, <https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/breast-reduction-for-women>.
Winter, R, Haug, I, Lebo, P, Grohmann, M, Reischies, FMJ, Cambiaso-Daniel, J, Tuca, A, Rienmüller, T, Friedl, H, Spendel, S, Forbes, AA, Wurzer, P & Kamolz, Lars-P 2016, ‘Standardizing the complication rate after breast reduction using the Clavien-Dindo classification’, Surgery, vol. 161, no. 5, pp. 1430–1435, viewed 10 January 2023, <https://www.surgjournal.com/article/S0039-6060(16)30797-8/fulltext>.
Woodman, R & Radzyminski, S 2007, ‘Womenʼs Perception of Life Following Breast Reduction’, Plastic Surgical Nursing, vol. 27, no. 2, pp. 85–92, viewed 10 January 2023, <https://journals.lww.com/psnjournalonline/Abstract/2007/04000/Women_s_Perception_of_Life_Following_Breast.6.aspx>.