What is a breast reduction?
The breast reduction 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 goals of breast reduction are to reduce breast volume, reshape breast tissue and reposition & lift breast tissue.
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 they can cause.
The breast platform is the footprint that 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. The breast mound 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. Dr Moradi's preference is to perform the breast reduction with a superomedial pedicle, which 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.
More About Breast Reduction
There are three important parameters that define the beauty of a breast, separate to achieving an aesthetically pleasing shape:
- Location on the chest wall
- Proportions of the breast in relation to the torso
- 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.
Is A Second Breast Reduction Possible?
Yes, but comes down to 2 main factors. How long it's been between operations, after a year there is no issue. And what nipple blood supply was used in the initial operation. Where possible it is best to use the same blood supply but sometimes this isn't possible because patients don't have access to their original operation report. You can use a different blood supply provided you have waited at least a year between operations.
Breast Reduction FAQs
Is there scarring after a breast reduction?
Regrettably you can't have a breast reduction without a scar burden. All scars take time to change colour as they heal. They start off red, then purple, then blue and finally white. This can take around a year.
The different patterns of incisions
1) Vertical or Lollypop
2) Inverted T or Anchor
Unfortunately, periareolar reductions just don't work with heavy breasts.
Can I breastfeed after a breast reduction?
Breast feeding after a reduction is possible, the best study addressing this question was published in Plastic and Reconstructive Surgery Journal. The authors selected around 150 patients who had a breast reduction and compared them to a matched group of 150 women of same age and weight who hadn't had surgery. After reviewing post-surgery, the results were the same in both groups: 1/3 could breast feed with no issues, 1/3 needed formula supplementation, 1/3 couldn't breast feed.
Breast Reduction Results
Breast Reduction Results & Recovery
Dr Moradi will use the cup size you want to be as a guide to achieve results as close to what you want as possible. No one can predict the cup size post-op because all bra manufacturers have different volumes for each size. As a general guide, each 150-200gm reduction equates to 1 cup size.
Around 3-6 months is when you'll start to notice the results. For the first 3 months, the breast is "boxy" and "flat" at the bottom. This always settles and takes a nicer shape around the 6 months mark, stay patient and trust the process.
Patients may need 1-2 weeks off depending on how they feel and what type of activity is required at work. Many patients go back to light-duty work after a few days. Heavy lifting or strenuous physical occupations may need adjustment and a little more time off on a case by case basis. Dr Moradi will give his professional recommendation on individual recovery times.
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Breast Reduction Cost
Costs associated with a breast reduction vary 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 consultation with Dr Moradi, his staff will give you an itemised account of the total cost.
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Dr Pouria Moradi - Your Sydney Specialist Plastic Surgeon
"I am a consultant plastic, reconstructive and aesthetic surgeon working as a visiting medical officer at Prince of Wales, Royal Women's and Sydney Children's Hospitals, and an associate lecturer at UNSW Medical School.
Having studied medicine at UNSW as a Sam Cracknell Sport and Academic Scholar, I was then awarded Membership of the Royal College of Surgeons of England in 2005 and Fellowship of the Royal Australasian College of Surgeons in Plastic, Reconstructive and Aesthetic surgery."