What is a breast reduction?
A breast reduction is a surgical procedure which aims to correct the problems associated with large breasts. It involves a general anaesthetic and generally you will be required to stay 1-2 nights in hospital or this can be done as a day case depending on your circumstances. The nipple and areolar are moved to the correct position, the excess skin, fat and breast tissue are removed and the breast is moulded into a more pleasing shape. It usually involves a scar around the areolar, vertically down to the fold under the breast and a scar in the fold itself. It aims to produce a breast with an attractive shape, which is of a size proportionate to the patients’ body shape. This can improve self-esteem, the ability to exercise and relieve many of the health problems associated with excessively large breasts. It is an operation, which has a very high patient satisfaction rate. The operation attracts an item number from Medicare and therefore some of the costs will be covered by Medicare and your Private Health Fund.
Our plastic surgeon, Dr Craig Layt, is highly experienced with this procedure. He would be happy to talk more with you about your goals during the initial consultation. It may be that a breast lift will be most able to achieve the aesthetic you desire.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified practitioner.
Who is a candidate?
Women who have large, heavy breasts, which may be the cause of breathing difficulties, back, shoulder and neck pain, poor posture, bra-strap indentations and chafing under the breasts, are potential candidates for breast reduction. Similarly, women with excessive breast size, causing a decrease in their sense of attractiveness and self-confidence or who find that their breast size limits their normal daily activities or exercise may benefit from a breast reduction.
Breast Reduction Photos
These before and after photos are of patients that have had surgery performed by Dr Layt. These patients have consented to the photos being shown. These are actual photos and have not been altered or digitally enhanced. Every patient is an individual and therefore final surgical results will vary from patient to patient.
What can you expect after the operation?
Your breasts will be taped with bandages for 24 – 48 hours after the operation. You will have a drain in each breast, which will usually be removed at 24 – 48 hours. These are to drain away any excess fluid, which collects after the operation. Once the drains are removed you will be fitted into a bra, which should be worn day and night for six weeks. There are usually no sutures to be removed as dissolvable sutures are placed under the skin. The breasts often have patchy areas of numbness during the early postoperative period. Tingling, burning or shooting pains indicate healing and should not alarm. Some asymmetry is normal after the operation as each breast swells to a different degree.
You should limit any strenuous activity during the first two weeks. Thereafter, you can steadily increase your activity level within the limits of discomfort. You should wear a firm-fitting bra during exercise.
What are the potential risks?
Modern surgery is safe. There is, however, no such thing as risk free surgery. The important thing is to understand any potential risks and minimise their occurrence. You will be fully briefed on pre and post-operative procedures to assist you with the best possible breast surgery experience, recovery phase and final outcome.
Specific Pre-Operative Instructions
Preparation for your breast reduction is a relatively simple process.
WASHING: Wash the evening prior to surgery and the day of surgery paying particular attention to the breast region. This decreases the bacterial count and should decrease the risks of infection.
PRODUCTS: Do not apply moisturisers, make-up, perfume/deodorant, nail polish or hair products after washing. Remove all jewellery.
CLOTHING: Wear loose, comfortable clothing and footwear. A shirt with a button or zipper opening is ideal for removal.
FASTING: You should have nothing to eat or drink for six hours before your operation. If you are required to take medication during this time please speak with your physician to check if this can be taken before the six hour fasting period or after your procedure.
MEDICATION: If you are having the operation as a day case, you will be given a script for antibiotics and pain relief tablets that you will need to purchase from the chemist and bring with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.
Certain over the counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. Do not take any medication containing or related to aspirin two weeks prior to your procedure. This includes NSAID’S, anti-Inflammatory medications, blood thinning medications. Please see your doctor regarding if and when to cease the medication. *This is not an all inclusive list*.
Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely effect anaesthetic drugs, prolong bleeding and impair healing after surgery. Please consult your physician before ceasing any medication.
SMOKING: Smoking increases the risks of complications significantly and should be ceased 6 – 8 weeks prior to surgery. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified practitioner.
ADMINISTRATION: Unfortunately, paperwork is a necessary evil. Each theatre complex has its own procedures. We have attempted to make it all easy by providing a simple series of steps to follow titled “THINGS TO DO FOR YOUR PROCEDURE” specific to the surgery complex you are attending.
Specific Post-Operative Instructions
POSITION: For the first week after surgery, try to sleep on your back, instead of your side. This will help reduce swelling. (It is more important for you to sleep than to rigidly adhere to this suggestion).
DRESSINGS & DRAINS: At the time of surgery, dressings and bandages will be applied around the chest. One drain will be placed in each breast at the time of surgery. These drains evacuate the fluid that accumulates after surgery and enable you to heal faster. The dressings and drains will be removed 1 – 2 days after surgery. You will then be fitted with a support bra, which you should wear day and night for two weeks after surgery. (You may, of course, remove it to shower and launder.) After two weeks, you may sleep without the bra. You should not go braless during the day for 4 – 6 weeks after surgery. Once the swelling has decreased you can buy new bras to fit your new size. This usually takes three months.
SHOWERING AND BATHING: If your procedure is a day procedure you should have “bird baths” until your drains are removed at 24 – 48 hours post operatively. If you are staying overnight your drains will be removed before you are discharged.
SUNLIGHT: Scars take at least one year to fade completely. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 15 at all times when in the sunshine. Be extremely careful if areas of your breast skin have reduced sensitivity.
SUTURES: Most sutures used in the operation are dissolvable and don’t require removal. Occasionally, some sutures around the nipple will require removal. You will have an appointment for these to be removed.
TAPE: Dr Layt advises taping the wounds with Fixomull initially then Siltape for 8 – 12 weeks after your operation for optimal scar healing. Our nurse will change these dressings one week after your operation. You will be given a sample pack of Siltape that will last approximately six weeks, after this you will need to purchase the Siltape yourself.
EXERCISE: You may take a gentle walk within a few days. Do not return to aerobic exercise for three weeks.
TED STOCKINGS: You may be required to wear TED stockings for compression to prevent DVT (blood clotting) post-operatively. If required these will be fitted at the hospital on your admission day. The nursing staff will advise you on how long you need to wear these for.
MEDICATION: Take your pain relief and antibiotic medication as directed. Any medication you ceased prior to surgery must not be taken after your surgery until you are completely healed or as directed by your physician.