Many women with large breasts experience significant physical discomfort from the weight of their breasts. Common symptoms include:
- Neck ache
- Shoulder pain
- Rash and skin irritation underneath the breast
- Inability or difficulty to get clothes to fit correctly
- Indents in their shoulders from their bra straps
- Discomfort and difficulty with exercise
Things to consider before surgery
Patients with a high BMI have increased risks associated with the procedure and may be asked to lose weight before proceeding. Mr Hanikeri recommends waiting until patients have achieved a stable weight that they are happy with and a BMI under 32 before having breast reduction performed. The safety of the procedure is affected by smoking and Mr Hanikeri does not perform breast reduction in patients who are still smoking. Patients who have stopped smoking for at least 4 weeks are candidates for breast reduction.
Medicare rebates currently apply for breast reduction and so patients who have private health insurance will significantly reduce the costs associated with the surgery.
With breast reduction, excess breast tissue and skin are removed resulting in smaller and firmer breasts. The areola is reduced in diameter and the nipple is elevated to a new position. It is kept alive by a bridge of breast tissue called a pedicle. After removal of an appropriate amount of tissue, the remaining breast tissue is reshaped to create a smaller and more elevated breast.
The breast reduction method varies according to the patient’s breast size, their preference and their lifestyle demands, however the principle of all breast reductions is the same.
There are three main types of scars resulting from breast reduction surgery.
After surgery-what to expect
Patients will be mobile immediately and can resume driving, light activities and light exercise such as walking with two weeks. They can usually return to normal activities and exercise within four to six weeks. Most patients are recommended to take around one to two weeks off work after the operation depending on the physical demands of their job.
Whilst scars are not completely predictable, most are barely visible and easily concealed in time. They may appear pink and slightly thickened for a few weeks to months after the surgery but will usually fade to be pale and soft by around three to six months. Their final appearance may take up to eighteen months to achieve. Most patients experience very minimal scarring in the longer term.
Mr Hanikeri will usually recommend topical scar therapy such as silicone tape to be used from around the fourth postoperative week, until around three months after surgery
Breast reduction often makes a dramatic change in appearance as well as physical comfort.
Traditional ‘Anchor’ scar
This is the most common type of incision resulting from breast reduction. It results in a scar, starting around the areola, travelling vertically down and then horizontally across the fold under the breast.
Circumvertical scar (Lollipop scar)
Patients who are suitable for this technique end up with a scar around the areola and a scar that travels vertically down, but with no scarring underneath the breast. The vertical pattern is less effective for large breasts with significant droop or excess skin under the nipple. Also, because there is no excision of skin under the breast, the skin around the vertical scar can appear gathered or puckered for a few weeks after the operation. The appearance of this puckering will improve as the incision heals and the breasts settle into their new shape however, the final result may not be visible for up to one year after the procedure.
The only scar is from a circular incision is around the areola. This technique is only suitable when a very small amount of tissue needs to be removed such as when only one breast needs to be reduced to match the other breast for mild breast asymmetry.
Liposuction may be used to reduce breasts and to improve the contour on the side of the chest however some patients who are overweight may still have an excess of fat arising from their back which may become more visible after breast reduction.
Risks of breast reduction