Breast Reduction Sydney

Breast Reduction

Breast reduction, also known as reduction mammoplasty, reduces the size and weight of the breasts by removing excess breast tissue, fat and skin, and repositions the nipple so the breast sits higher and in better proportion. It is often sought for physical symptoms rather than appearance alone.

Women commonly describe neck, upper back and shoulder strain, grooving from bra straps, rash or irritation in the fold under the breast, difficulty running or exercising, and trouble finding clothes and bras that fit. Reduction removes the weight driving those symptoms, and relief in comfort and mobility is often noticed early.

There is no right or wrong time for this surgery. Breast size changes through life and differs between women: for some the concern begins in early adulthood, for others after pregnancy and breastfeeding, and for others after menopause or weight change. Dr Maryam Seyedabadi, Specialist Plastic Surgeon, MBBS FRACS, a female surgeon, consults on reduction mammoplasty in Paddington, Sydney.

Who it may suit

• Neck, back or shoulder strain you attribute to the weight of your breasts
• Persistent rash, chafing or irritation in the fold beneath the breast
• Difficulty exercising, or no bra that supports comfortably
• Deep grooves left by bra straps
• Breasts that feel out of proportion, or are noticeably different in size
• A stable weight, no pregnancy planned in the near term, and willingness to stop smoking

What reduction mammoplasty involves

Surgery is performed in hospital under a general anaesthetic, usually with an overnight stay. The incision pattern depends on how much tissue is removed and how far the nipple needs to move.

1. Markings are made while you stand upright, planning the new nipple position and the amount of tissue to remove.
2. Incisions are made around the areola and vertically down to the fold, sometimes with a horizontal extension along the fold, known as an anchor pattern.
3. Excess breast tissue, fat and skin are removed. The nipple and areola stay attached to a pedicle of tissue carrying their blood supply and, where possible, nerve supply. Removed tissue is usually sent for pathology.
4. The remaining tissue is reshaped, the skin is closed in layers, sometimes over a drain, and dressings with a supportive bra are applied.

Recovery

The relief from weight is often noticed immediately, while the breasts stay swollen and firm for some weeks. Timeframes below are approximate.

• A supportive, non-wired bra is typically worn day and night for around six weeks.
• Soreness is most noticeable in the first week or two and is managed with prescribed analgesia.
• Desk work is often resumed in about two weeks, while lifting and upper body exercise wait longer, commonly six weeks.
• Nipple sensation may be reduced or heightened at first and usually settles over months.
• Shape settles and scars soften over twelve months or more.

Risks and considerations

Risks include bleeding, infection, delayed wound healing, particularly where the incisions meet beneath the breast, fat necrosis, fluid collection, and asymmetry in size or nipple position. Scars are permanent and can be thick, wide or raised. Sensation in the nipple may be reduced, increased or lost. Partial or complete loss of the nipple and areola is uncommon but serious, and the risk is higher with very large reductions and in smokers. Anaesthetic risks include drug reactions and clots in the legs or lungs.

Breastfeeding may still be possible after reduction mammoplasty, since the nipple remains connected to breast tissue, but it cannot be relied on and some women find supply is reduced. Breasts also continue to change with weight, pregnancy and ageing, so size and shape are not fixed by surgery.

Your consultation with Dr Maryam

A referral from a registered medical practitioner is required before your consultation, and a GP referral is preferred. Dr Maryam examines and measures your breasts, records your symptoms, takes preoperative photographs, and may request breast imaging depending on your age and history. She will discuss how much tissue can reasonably be removed and what your scars are likely to look like.

Where clinical criteria are met, breast reduction may attract a Medicare item number and your health fund may contribute, though this is assessed individually and cannot be confirmed beforehand. Fees are quoted after consultation. A cooling-off period of at least seven days applies, and at least three months for patients under 18, who also need assessment by an appropriate registered health practitioner. Dr Maryam operates at St Luke’s Hospital in Potts Point and East Sydney Private Hospital. Call 1300 067 668 to arrange an appointment at 2c Heeley Street, Paddington.