Through breast reduction surgery it is possible to raise, reshape and reduce large breasts.
The procedure removes excess fat, glandular tissue and skin from the breast, leaving the patient with a breast size which is in proportion with their body, alleviating the discomfort which can come with overly large breasts.
The self consciousness and emotional discomfort many women experience due to having large pendulous breasts is as important an issue as the physical discomfort and pain.
There are four important parameters that define the beauty of a breast:
- Location on the chest wall
- Proportions of the breast in relation to the torso
- Aesthetically pleasing shape
- Symmetry of both breasts in volume and shape
The challenge in breast reduction surgery is that all these parameters are affected and therefore need addressing to achieve an excellent result.
Breast reduction is a highly individualised procedure. To achieve a predictable and safe result a few key anatomical considerations need to be made.
This is the footprint the breast makes on the chest wall, similar to the outline a house makes on a parcel of land. The platform forms the basis or foundation of the overlying three-dimensional structure of the breast.
The goal of breast reduction surgery is to return the breast mound back to its original position higher on the chest wall.
This refers to the three-dimensional shape, projection and volume of the breast tissue on top of the breast platform. In building terms, this is analogous not only to the size of a building, but also the shape and form of the building.
In breast hypertrophy, the mound is too large and deformed. The breast mound needs not only a reduction, but also a lift and a reshaping.
My preference is to perform the breast reduction with an a superomedial pedicle, which just means that the blood supply to the breast mound and nipple come from a blood source above and to the midline of the chest wall.
After the breast mound has been reshaped and repositioned on the chest wall, the skin envelope needs reduction to fit the newly shaped breast mound. A skin envelope of appropriate quantity functions like a well-fitted bra, holding the breast tissue in an appropriate position.
Of the many different types of breast reduction operations available, my preferred skin envelope and therefore final scar is one that has a suture line around the areolar with an inverted T scar running vertically down and then across at the level of the inframammary fold. In my opinion this leads to the quickest healing, but more importantly the most predictable and therefore most reproducible results.
What are the potential risks and complications of breast reduction?
Some possible complications and risks specific to breast reduction surgery include:
- Surgical risks such as bleeding and infection
- Seroma accumulation under the breast. This fluid may need to be drained under ultrasound guidance.
- Visible and prominent scars including keloid and hypertrophic scars
- Swelling and bruising around the breasts which takes 2-3 months to settle
- Fat necrosis of the breast. This is a result of poor blood supply to the fat cells. These shows themselves as small firm lumps.
- Changes in breast and nipple sensation
- Temporary or permanent areas of numbness around the scars
- Asymmetry of the breasts
- Partial or total loss of the nipple and areola
- Need for further surgery to treat complications
- Revisional surgery to correct any unevenness between the two sides
- A blood clot in the legs (DVT), which can move to the lungs and may be life threatening
How much does breast reduction cost?
Breast reduction surgery is covered by private health insurance and carries an MBS code (45520). If your policy covers this item number, you are in luck as your insurance will cover a large chunk of your hospital and operation costs.
Unfortunately recent NSW Health guidelines has deemed breast reduction surgery as a cosmetic procedure and thus not able to be performed in a public hospital. I think this is a rather harsh stance as some women are very worthy candidates for reduction surgery in the public sector.
Costs associated with a breast reduction varies between $14,000-$17,000 depending on a number of factors, including:
- Anaesthetist’s fees
- Private hospital or day surgical facility fees
- Need for post-operative garments
- Your level of private insurance cover
- Surgical assistant’s fee
After our consultation my staff will give you an itemised account of the total cost.