Reduction Mammaplasty (Breast Reduction)

What is a breast reduction?

Also known as reduction mammaplasty, this is an operation intended to reduce the size of a woman's breasts and improve their shape and position.

Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation.

Inverted T-Scar or Anchor Scar

FREQUENTLY ASKED QUESTIONS:

Where are the incisions?

This is probably the most important topic that gets discussed in relation to Breast lift and Breast Reduction in my practice. Plastic surgery does leave scars and it is important that you see plenty of postoperative photos to understand the spectrum of scarring that can occur with breast surgery.

Dr Tavakoli specialises in all types of incisions techniques:

There are a variety of techniques for breast reduction (reduction mammaplasty) procedure. The techniques reflect a combination of differing skin incisions (scar pattern) and the methods used in shaping the breast substance.

1. Liposculpture - This technique is not commonly used. However, in patients who have large breasts that are mainly fatty in nature and do not exhibit droopiness (ptosis), liposuction can be quite successful with almost no scarring.
2. The European technique involving an incision around the areola (BENNELLI'S-GOES). This method is usually reserved for breast lifting and a very small breast reduction.
3. The French-Canadian breast reduction technique involves the extra incision between the areola and breast crease as well as the one around the nipple (lollypop scar, LE JOUR and HALL-FINDLAY). This is Dr Tavakoli's most favoured method of reducing small-moderate size breasts in generally younger patient (20-50 range). It produces remarkably perky breasts with excellent long term results.
4. The final technique involves the above incisions, plus the extra long incision within the crease under the breast (WISE pattern- most traditional). This is an "anchor-shape" or inverted "T" incision.  Dr Tavakoli still utilises this method in very large to gigantic breast reduction cases especially in the older age group (50-70).

Occasionally, especially with Breast lifting only, these incisions may be modified and more limited. Some operations may require only the incision around the areola.

Will Medicare & health fund pay for my surgery?

Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). When the excessive size causes functional problems, insurance will generally pay for part of the operations. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Mastopexy (uplift) is almost never covered by Medicare or the health funds.

What happens to the circulation and sensation of my nipple?

Generally, the nipple-areolar complex (brown part of the breast) is carried on some breast tissue to keep it alive. This usually preserves the nipple sensation and keeps it viable. However, for technical reasons, in extraordinarily large or bulky breasts, we sometimes remove the nipples completely and put them back as "free grafts." The sensory nerves are all cut, and even though a certain amount of sensation returns after healing, it will never be normal, with erotic sensation completely lost. The milk ducts are interrupted in this operation, so nursing would be impossible. You will be informed in advance if your breasts are in this category.

How long is the patient hospitalized?

lolly-pop Vertical Mastopexy scar

For a reduction mammaplasty, one day of hospitalization is usually needed if there are no complications. A Mastopexy can be done as an outpatient procedure requiring no hospitalization. Usually suction drains (plastic tubes) are left in place after surgery with breast reduction, and possibly with a Mastopexy.

What kind of anaesthesia is used?

A general anaesthetic is used on all reduction Mammaplasties and some Mastopexies.

Who is on the surgical team?

Dr Tavakoli will always perform the operation.

What can I expect postoperatively?

Discomfort, swelling, and discoloration of the breasts are to be expected for several weeks. Usually, our patients return to almost normal activity within two weeks. The scars at the incision lines typically become reddish, raised, and firm a few weeks after surgery, but after many months become pale and soft. After 8-12 months, the scars are relatively inconspicuous. The nipples and some areas of the skin may be numb or sensitive after surgery. Sensation frequently returns within a few weeks or months but may be diminished or overly sensitive.

Will the breasts start to sag again?

Gravity continues to have its effect, and there is a tendency for the skin of the breast to stretch over a long period of time. Women vary a great deal in this respect. In general, the smaller the breasts, the less tendency for sagging to recur. If the breasts sag further, excision of the skin on an outpatient basis can be used to correct the problem. If we try to lift heavy breasts without making them smaller at the same time, sagging will return soon. One key to a satisfying result is realistic expectations - a wide-based large breast will not look like a smaller, but firm, narrow-based breast.

What are my limitations in activity post-operatively?

You should plan to avoid activities which require much raising of the arms above the level of the head for 10 days after surgery. With great care, you can drive about 7 days after surgery. Patients can usually return to work in a few days unless their occupation requires particularly strenuous movements and lifting. In such cases, 2-3 weeks should be allowed.

• Walking can commence within days,
• Light jogging within 2 weeks,
• Gym & Pilates after 4 weeks and upper body weights 6 weeks.

Surgical risks may include: infection, bleeding, asymmetry, scarring, and nerve damage. Damage to the blood supply of the nipple-areolar complex, although uncommon, can occur.