Reduction Mammaplasty

Breast Reduction


Breast Reduction surgery is performed for patients who have large breasts which cause back and neck pain, potential infections under the breast crease, poor self esteem and difficulty with wearing and/or obtaining certain clothes.

There are various surgical approaches in performing a breast reduction; the majority of these techniques involve placing a scar on the lower half of the breast and around the nipple areola complex. Dr. Bobby A. Kumar has found that three particular techniques provide long term excellent results. The Bennelli technique involves a scar around the nipple areola complex only and avoids a scar on the breast skin.

Click for Breast Reduction & Lift Images

The Bennelli technique is usually performed on breasts which require minimal lifting and minimal reduction of breast tissue. For moderate breast droop the Hall-Findlay technique is a better option to reduce and lift the sagging breast tissue. This technique results in better upper pole fill of the breast and a perky breast shape with less likelihood of “bottoming out” of the breast.

For women with significant and severe breast droop an anchor type incision is made, otherwise known as the Wise pattern. In this instance the surgeon is utilising the breast skin as a brassiere to help maintain the breast shape. With this technique the long term problem tends to be related to the breast “bottoming out” and ultimately the patient may require a secondary breast reduction procedure many years later.

The main aim of breast reduction surgery is relief of symptoms and reduction of the breasts to a manageable size and shape. Compared to a Breast Reduction the shape and appearance as well as size of the breast may not be as natural or aesthetic as expected. Consequently it is imperative that a realistic goal and understanding occurs during your consultation with your Cosmetic Surgeon.

The complications associated with breast reduction surgery are related to the placement of incisions and degree of reduction and lift required. As blood vessels are affected by a reduction mammaplasty bleeding acutely can be problematic. However, preserving vascular supply to the breast and the skin is important as a potential complication is loss of the skin and part of the breast pedicle. Likewise sensation of the Nipple areola complex and ability to breast feed can be adversely affected. Given that breast reduction surgery involves significant incisions Infections fortunately appear to be an uncommon problem.

For patients with very droopy or sagging breasts a free nipple graft maybe required as the viability of the Nipple areola complex cannot be guaranteed postoperatively.

Healing

Patients realistically take 3-6 months to heal with reduction in breast swelling and some return to sensation of the skin and possibly nipple areola complex. It usually takes most scars at least 1-1.5 years to completely settle and fade, patients are expected to use a silicone based gel to help with the healing process of the scars.

There are initial limitations on patients with regards to lifting, driving, and exercise. In general Dr. Bobby A. Kumar usually recommends approximately 6-8 weeks recovery with a gradual introduction of some or all of these activities. A support garment is worn for at least 3 months as it maintains the shape and lift of the breast during its healing process. Patients will have regular follow up visits and any issues will be managed during these visits. Occasionally patients may require adjustment or “touch up” procedures.

Medicare and health funds cover patients requiring a breast reduction for physical symptoms and signs; patients should discuss this at the time of consultation with Dr. Bobby A. Kumar.

Breast Lift (Mastopexy)

A Breast lift (Mastopexy) is performed for women who have “drooping” or “saggy” breasts and they essentially require little or no removal of breast tissue. Ultimately the aim of this surgery is to return the breasts to a more natural shape and volume.

The procedure is usually performed because of changes to the breast associated with age, after pregnancy and following significant weight loss. The surgery involves tightening the lax skin, and lifting the breast tissue to produce a more pleasing breast shape. Occasionally a breast implant is required to provide shape, fullness and support the breast tissues.

In the Sydney, NSW Mid North Coast (Port Macquarie & Kempsey) and Adelaide practices breast lift surgery is often combined with a Breast Augmentation as most women find that simply lifting the sagging empty skin will not adequately fill or provide projected breasts.

Breast Lift Diagram

Whilst it is ideal to perform the breast lift and augmentation procedure in stages, it is not uncommon to perform this procedure as a single stage operation. There are inherent risks to a single stage procedure and this is related to the pressure of the breast Implant on the nipple areola complex and potential for loss of the nipple skin and or break down of the scars/wounds. However, careful planning of the amount of skin removal and lift and the correct breast implant will reduce this risk considerably.

Incisions

Breast lift incisions are very similar to the breast reduction surgery incisions. Lifting can be achieved by a Periareolar incision such as the Bennelli type or an “ice cream cone” or “lollipop” incision resulting in a Periareolar scar as well as a scar on the lower pole of the breast. Finally an anchor scar similar to that used in reduction mammaplasty is used to produce a breast lift.

Once again these scars take approximately 3-6 months to improve and can take about 1-1.5 years to completely fade; the use of a silicone gel will help facilitate healing of the scar.

Complications

The complications once again are similar to those encompassed in breast reduction surgery. As mentioned the risk of skin or nipple loss warrants clear discussion with Dr. Bobby A. Kumar during your consultation.

Unfortunately due to the loss of the natural elastic tissue of the breasts and age related sagging of the skin, the breast over time will ultimately sag again. This is especially so if there is subsequent volume enlargement and then loss of the breast volume following the initial breast lift/reduction, such as occurs with pregnancy.

For reduction mammaplasty and Mastopexy surgery the rate of complication increases with patients who smoke and/or have underlying conditions such as diabetes. Medical conditions are to some extent manageable, however, patients are required to cease smoking at least 4-6 weeks prior to surgery. This may not absolutely reduce the rates of complication but will help.

However, the results following a Breast reduction and or lift are quite pleasing and typically patients are happy, experiencing relief of their symptoms.


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