All about Breast Reduction Mammoplasty Surgery

Is breast reduction mammoplasty surgery for you?

Do you have excessively large breasts and looking to undergo breast reduction mammoplasty surgery? Women with excessively large breasts often struggle with neck and back pain or struggle with normal activities like sports or light exercises. Some even struggle just to walk and move about – if that sounds a lot like you then you might make a good candidate for the operation.

Considering that it’s a major and highly invasive surgical operation not to mention the cost of surgery which can be fairly significant, patients need to fully appreciate the benefits and be well informed of everything that the procedure entails (risks, possible complications, recovery process, etc).

Consultation for a reduction mammoplasty surgery

Now if you are really keen on undergoing a breast reduction mammoplasty surgery, your first step would no doubt be to undergo a consultation with a breast surgeon. You can expect to be asked about your medical history to determine whether or not you are actually healthy enough for the procedure. This includes any relevant medical conditions that may affect the result of the surgery.

Patients need to remember that it’s important to be open and honest about your medical history throughout the consultation and why you are actually interested in the procedure on the first place. Expect to be asked about any issues that you’ve had to put up with concerning your breasts no matter how personal or uncomfortable it may seem and the results that you wish to have out of it. Doing so would help your breast surgeon set the right expectations and best understand your needs.

The consultation process for breast reduction mammoplasty surgery may also involve taking images of your breast and taking the required measurements. Your surgeon can also discuss exactly the amount of breast tissue that he intends to remove to accomplish the desired results.

You can expect an experienced and reputable breast surgeon such as our very own Dr Tavakoli to assist you with everything you need in preparing for the operation and planning for the recovery process. Call us on 1300 368 107 to get started and schedule a consultation.

Another thing that you can expect when undergoing consultation for breast reduction mammoplasty surgery is to be asked about your habits including any medications that you are currently taking and any vices that you currently have (smoking and drinking) which you’ll most likely have to abstain from to facilitate proper recovery. Anti-inflammatory drugs like aspirin, Aleve and Motrin are also something that you’ll have to avoid before and after surgery to further help avoid possible complications in breast reduction mammoplasty surgery.

Are you a candidate? Functional vs cosmetic indication

Patient suitability for breast reduction surgery is determined at a clinical consultation. The distinction between a functional and cosmetic indication is important because it determines whether your procedure may be eligible for a Medicare rebate under MBS items 45520 or 45523.

Functional indication

A functional indication exists where macromastia is causing documented physical symptoms that have not adequately responded to conservative management. Functional symptoms that support eligibility for a Medicare rebate typically include:

• Chronic neck, shoulder, or upper back pain attributable to breast weight
• Shoulder grooving or ulceration from bra strap pressure
• Recurrent or persistent skin rashes, infections, or intertrigo beneath the breast fold
• Restricted posture or postural deformity
• Neurological symptoms such as numbness or tingling in the fingers or arms related to breast weight
• Difficulty participating in physical activity or exercise due to breast size

To support Medicare eligibility, your GP referral and surgeon’s assessment should document these symptoms, their duration, and what conservative measures have been tried (for example, appropriate bra fitting, physiotherapy, or weight management where relevant).

Cosmetic indication

Where the primary motivation is aesthetic, the procedure does not attract a Medicare rebate under MBS items 45520 or 45523. It may still be performed as a private procedure, but it will be funded entirely out of pocket or through private health insurance for facility costs only.

Some patients present with a combination of functional and cosmetic motivations. Your surgeon will assess and document the functional component of your case, which determines Medicare eligibility regardless of any cosmetic goals.

Medicare eligibility for breast reduction

The two MBS item numbers relevant to breast reduction surgery in Australia are item 45520 (unilateral reduction mammaplasty) and item 45523 (bilateral reduction mammaplasty). Both require documented functional symptoms and a minimum tissue resection threshold to qualify for a Medicare rebate.

MBS item 45520: unilateral reduction

MBS item 45520 applies to reduction mammaplasty performed on a single breast. It is used in cases where macromastia affects one side only, or where clinical assessment determines that only one breast meets the resection and symptom criteria for Medicare eligibility. A minimum tissue resection of approximately 500g from the treated breast is the general clinical threshold applied, along with documented functional symptoms.

MBS item 45523: bilateral reduction

MBS item 45523 applies to reduction mammaplasty performed on both breasts in the same surgical episode. This is the more commonly used item number in clinical practice. The same functional symptom criteria apply, with a minimum resection threshold of approximately 500g from each breast. Where one breast meets the threshold, and the other does not, your surgeon will advise which item numbers apply.

How to get a GP referral

A referral from your GP is required before attending a surgical consultation for breast reduction surgery. During your GP appointment, describe your functional symptoms in detail, including how long you have had them, which treatments or measures you have already tried, and how the symptoms affect your daily life and ability to exercise. Your GP may also document physical findings such as shoulder grooving or skin changes beneath the breast fold.

A strong GP referral that documents functional symptoms clearly is an important part of supporting a Medicare rebate claim. If your GP is uncertain about the referral criteria, they can refer to the MBS online for item numbers 45520 and 45523 and the associated eligibility notes.

For further information on navigating eligibility and what to discuss with your GP, the guide to considering breast reduction in Australia provides a detailed overview of the process from initial enquiry to confirmed booking.

Surgical techniques compared

Two primary incision techniques are used in reduction mammaplasty in Australia: the vertical (lollipop) technique and the anchor (inverted-T) technique. The appropriate technique for a given patient depends on the volume of tissue to be removed, breast anatomy, the degree of ptosis (droop), and the surgeon’s clinical assessment. The table below compares the key differences between the two approaches.

Vertical (lollipop) incision

The vertical technique uses two incision lines: one circumscribing the areola (periareolar) and one running vertically from the bottom of the areola to the inframammary fold. The resulting scar pattern resembles a lollipop. This technique is well-suited to patients with mild to moderate macromastia who require moderate tissue removal and for whom a shorter total scar length is a priority.

The vertical technique produces a rounder, more projected breast shape and avoids a horizontal scar along the fold. It requires a surgeon experienced with the technique to achieve consistent results, as the breast shape is determined by internal tissue reshaping rather than a wide base of skin excision.

Anchor (inverted-T) incision

The anchor technique adds a horizontal incision along the inframammary fold to the periareolar and vertical components, creating a T-shaped scar pattern. This additional incision allows for greater tissue removal and more versatile reshaping, making the anchor technique the preferred approach for moderate to significant macromastia where larger volumes of tissue need to be removed.

The anchor technique has an extensive evidence base and is the most widely used approach for significant reductions in plastic surgery practice. The additional scar along the inframammary fold typically sits within or near the natural fold and becomes less visible as it matures over 12 months.

Which technique does Dr Tavakoli recommend?

The appropriate technique is determined at consultation based on a full assessment of your anatomy, the volume of tissue to be removed, the degree of ptosis, and your individual goals. Neither technique is universally preferable. Each has specific anatomical indications and produces different outcomes in terms of shape, scar pattern, and volume reduction capacity.

At your consultation, Dr Tavakoli will explain which technique is recommended for your anatomy, why, and what the resulting scar pattern will look like. The decision is made clinically and communicated transparently before any consent is provided.

Recovery timeline

Recovery from breast reduction surgery involves a period of restricted activity while the surgical sites heal. The timeline below provides a general guide. Individual recovery varies, and your surgeon’s post-operative instructions take precedence over any general guide. A detailed breakdown of what to expect at each stage is available in the breast reduction recovery guide.

Frequently Asked Questions

Does breast reduction surgery qualify for a Medicare rebate in Australia?

Breast reduction surgery may attract a Medicare rebate under MBS item 45520 (unilateral) or 45523 (bilateral) where the procedure is performed to treat documented functional symptoms of macromastia. A rebate does not apply where surgery is performed purely for cosmetic reasons. Eligibility is determined by your GP and surgeon through a clinical assessment and documented referral process. For a detailed explanation of how eligibility works, see the guide to Medicare and private health cover for breast reduction surgery.

What is the difference between MBS items 45520 and 45523?

MBS item 45520 applies to reduction mammaplasty performed on one breast (unilateral). MBS item 45523 applies where both breasts are treated in the same surgical episode (bilateral). Both items require documented functional symptoms and a minimum resection threshold — typically 500g from the treated breast or each breast. Your surgeon will advise which item number applies to your procedure at the consultation.

What symptoms do I need to qualify for Medicare-covered breast reduction?

Documented functional symptoms typically required for Medicare eligibility include chronic neck, shoulder, or upper back pain; shoulder grooving or ulceration from bra straps; recurrent skin rashes or infections beneath the breast fold; postural problems; neurological symptoms related to breast weight; and restricted ability to exercise. Conservative management should have been attempted and documented. Your GP appointment is the appropriate place to begin recording these symptoms formally.

How long does breast reduction recovery take in Sydney?

Most patients return to sedentary desk work within one to two weeks. Light activities are typically resumed at two to four weeks, and full exercise at six to eight weeks, subject to the surgeon’s clearance. Scars mature progressively over 12 months. Recovery timelines vary based on the extent of surgery, individual health factors, and adherence to post-operative instructions.

Will private health insurance cover breast reduction surgery?

Private health insurance may contribute to hospital accommodation and theatre facility costs for breast reduction surgery performed under MBS item 45520 or 45523. The extent of cover depends on your level of hospital insurance and your specific policy. Most policies impose a waiting period for surgical procedures. Private health insurance does not replace the Medicare rebate component, and an out-of-pocket gap between the surgeon’s fee and the scheduled fee will typically apply. Confirm your policy details with your insurer before your consultation.

What is the difference between the vertical and anchor technique for breast reduction?

The vertical (lollipop) technique involves an incision around the areola and a vertical line to the breast fold, producing two scar lines. It is suited to moderate tissue removal. The anchor (inverted-T) technique adds a horizontal incision along the inframammary fold, allowing larger volumes to be removed and providing more reshaping capacity. The appropriate technique is determined at clinical assessment based on your anatomy and the degree of macromastia.

Can breast reduction surgery help with neck and shoulder pain?

For patients with documented macromastia, breast reduction is performed to relieve the physical symptoms caused by excess breast weight, which commonly include neck, shoulder, and upper back pain. Whether surgery is the appropriate intervention for your symptoms is a clinical determination made by your GP and surgeon. For further details on the relationship between macromastia and musculoskeletal symptoms, see the guide to how breast reduction can solve neck, shoulder, and back pain.

Discuss your Medicare eligibility with Dr Tavakoli: book a consultation

At your consultation with Dr Tavakoli, you will receive a thorough clinical assessment, a clear explanation of your Medicare eligibility based on your documented symptoms, a discussion of which surgical technique is appropriate for your anatomy and goals, and a fully itemised written quote covering all cost components.

Bring your GP referral letter and any documentation of your symptoms to your first appointment. To book, contact Dr Tavakoli’s team online or call 1300 368 107.