Breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body. The procedure is designed to alleviate the discomfort associated with overly large breasts.

Breast reduction is a highly individualised procedure and may not be suitable for everyone. Always talk to your Specialist Plastic Surgeon before making a decision. Your Specialist Plastic Surgeon will assess your condition and general health, and plan the treatment that is best suited to you.

Before you decide on breast reduction surgery, there are some important issues to keep in mind:

• Surgeons generally recommend waiting until breast development, child birth and breastfeeding have stopped before undertaking breast reduction surgery
• Breast reduction surgery can interfere with some diagnostic procedures
• Ability to breastfeed following breast reduction surgery may be affected. Talk to your surgeon if you are planning to breastfeed a baby in the future
• Changes in the breasts during pregnancy, or significant weight loss or gain can alter the outcomes of previous breast reduction surgery
• Breast and nipple piercings can cause an infection
• Smokers are at increased risk of complications. If you are serious about undergoing surgery, you should quit smoking

Breast reduction may be a good option for you if:

• You are physically healthy
• You have realistic expectations
• Your breasts are fully developed
• You are bothered by the feeling that your breasts are too large
• Your breasts limit your physical activity
• You experience back, neck and shoulder pain caused by the weight of your breasts
• You have regular indentations from bra straps that support heavy, pendulous breasts
• You have skin irritation beneath the breast crease
• Your breasts hang low and have stretched skin
• Your nipples rest below the breast crease when your breasts are unsupported
• You have enlarged areolas caused by stretched skin

Remember that the shape and size of your breasts before surgery will influence the surgical procedure and the outcome.

Yes, breast reduction surgery is nearly always done under general anaesthesia. Modern anaesthesia is safe and effective, but does have some risks. Ask your Specialist Plastic Surgeon and anaesthetist for more information. Your surgeon and/or anaesthetist will ask you about all the medications you are taking or have taken, and any allergies you may have. Make sure you have an up to date list before the surgery.

Modern surgery is generally safe but does have the potential for risks and complications to occur.

Some possible complications and risks associated with breast reduction surgery may include:

• Risks of anaesthesia including allergic reaction or potentially fatal cardiovascular complications such as heart attack
• Surgical risks such as bleeding or infection
• Breathing difficulties due to general anaesthetic or the endotracheal tube which can cause swelling, noisy breathing and discomfort
• A blood clot in the deep veins of the legs (deep vein thrombosis), which can move to the lungs (pulmonary embolus) or to the brain and may be life threatening
• Fluid accumulation around the operation site(s)
• Allergic reaction to suture materials, tape adhesive or other medical materials and lotions
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent
• Fatty tissue deep in the skin could die (fat necrosis)
• Changes in breast and nipple sensation
• Temporary or permanent areas of numbness
• Asymmetry (unevenness) of the breasts
• Potential partial or total loss of nipple and areola
• Need for further surgery to treat complications

Depending upon your general health and the extent of the procedure, breast reduction surgery can be performed either as a day case or alternatively with a short hospital stay. Your Specialist Plastic Surgeon will advise on the best option for you.

You will also be asked to provide a complete medical history for your Specialist Plastic Surgeon including any health problems you have had, any medication you are taking or have taken, and any allergies you may have.

You may be advised to stop taking certain medicines such as non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and medicines that contain aspirin. You may also be asked to stop taking naturopathic substances such as garlic, ginkgo, ginseng and St John’s Wort as they may affect clotting and anaesthesia. Always tell your surgeon EVERYTHING you are taking.

SMOKING: Stop smoking at least two weeks before surgery. Smoking increases surgical and anaesthetic risk and delays healing of the surgical site.

You may be given medicines to take before the surgery, such as antibiotics.

Questions your surgeon may ask before the surgery include:

• Do you have an allergy or bad reaction to antibiotics, anaesthetic drugs or any other medicine?
• Do you have prolonged bleeding or excessive bruising when injured?
• Do you have a connective-tissue disorder such as rheumatoid arthritis, scleroderma, lupus erythematosis, or any other arthritis-like disorder?
• Do you have any long-term or recent illnesses?
• Have you previously had surgery for breast cancer, or radiotherapy to the breast?
• Have you had psychological or psychiatric illnesses?

Unless your surgeon advises differently, you will be able to continue taking most medicines that you have been taking.

Your surgeon will advise you if any other tests are required, such as blood tests, X-ray examinations or an Electrocardiograph (ECG) to assess your heart.

Prepare a “recovery area” in your home. This may include pillows, ice packs, a thermometer and a telephone within easy reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Someone should also stay with you for at least 24 hours after you return home.

Your surgeon should give detailed preoperative instructions. Follow them carefully.

While you are healing, you may experience some pain, bruising, swelling and numbness around the operated site. This is normal. Your Specialist Plastic Surgeon will prescribe pain relief as needed. If you have any problems or concerns, be sure to tell your surgeon.

After surgery, you will wear an elastic dressing or surgical bra to provide support for your breast. A plastic tube may be inserted into each breast to drain excess fluid. Other dressings may be changed or removed at this time.

Depending on the extent of your procedure, you may need to take a few days off work to rest. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports until advised by your surgeon.

SMOKING: Do not smoke. Smoking contributes to wound breakdown and delayed healing along with other health problems.

If you experience any of the following symptoms, notify your surgeon immediately:

• Temperature higher than 38ºC or chills
• Nausea, vomiting, shortness of breath or diarrhea
• Heavy bleeding from the incisions
• Leakage of blood or fluid beyond the first day after surgery
• Worsening and/or spreading redness around the incision sites
• Increasing pain or tenderness in either breast
• Any other concerns or problems regarding your surgery, particularly if it appears to be worsening

Your surgeon will give you specific instructions on post-operative care. These instructions may include:

• How to care for your surgical site(s) following surgery
• Medications to apply or take orally to aid healing and reduce the risk of infection
• Specific concerns to look for at the surgical site(s) or regarding your general health
• When to follow-up with your surgeon

Be sure to ask your surgeon specific questions about what you can expect during your individual recovery period, such as:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? If so, when will they be removed?
• Are stitches removed? When have they/will they be removed?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

Scars are an inevitable part of any invasive surgery. Your Specialist Plastic Surgeon will endeavour to minimise scarring and to keep your scars as inconspicuous as possible by locating the incisions in easily hidden sites. That way, scars will be along natural skin lines and creases. Scars may fade with time and become barely noticeable. If you are prone to scarring, you should advise your surgeon.

In most circumstances, breast reduction surgery does not need to be repeated. However, as with all surgical procedures, revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery. Prices for individual procedures can vary widely between Specialist Plastic Surgeons. Some factors that may influence the cost include the surgeon’s experience, the type of procedure used and the geographic location of the office.

Costs associated with the procedure may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anaesthesia fees
• Prescriptions for medication
• Post-surgery garments
• Medical tests

Breast reduction surgery is generally considered a reconstructive procedure and may be covered by private health insurance when it is performed to relieve medical symptoms. Many insurers define breast reduction surgery as reconstructive based on the amount of tissue that will be removed. However, pre-certification is required for reimbursement or coverage. Pre-certification is required for reimbursement or coverage. Insurance policies may vary greatly. Review your policy carefully to determine what is covered.

In this series of video’s Dr Kim Taylor answers all your questions on breast reduction surgery.

Click here to watch video’s

• Areola: Pigmented skin surrounding the nipple
• Excision: To remove the skin
• General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness
• Haematoma: Blood pooling beneath the skin
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax
• Local anaesthesia:A drug injected directly to the site of an incision during an operation to relieve pain
• Mammogram: An x-ray image of the breast
• Mastopexy: Surgery to lift the breasts
• MRI: Magnetic Resonance Imaging; a painless test to view tissue in a similar fashion to an x-ray
• Reduction mammoplasty: breast reduction, a surgical procedure that removes excess breast tissue to reshape the breast
• Sutures: Stitches used by surgeons to hold skin and tissue together

Visit the Plastic Surgery Glossary for more medical terms.