Breast reduction surgery is a surgical procedure to raise, reshape and reduce large breasts. The procedure in short removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.
The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.
There are four important parameters that define the beauty of a breast:
1) Location on the chest wall,
2) Proportions of the breast in relation to the torso,
3) Aesthetically pleasing shape, and
4) Symmetry of both breasts in volume and shape.
The challenge in breast reduction surgery is that all these parameters are affected and therefore need addressing to achieve an excellent result.
Breast reduction is a highly individualised procedure, to achieve a predictable and safe result a few key anatomical considerations need to be made.
This is the footprint that the breast makes on the chest wall, similar to the outline a house makes on a parcel of land. The platform forms the basis or foundation of the overlying three-dimensional structure of the breast.
The goal of breast reduction surgery is to return the breast mound back to its original position higher on the chest wall.
This refers to the three-dimensional shape, projection and volume of the breast tissue on top of the breast platform. In building terms, this is analogous not only to the size of a building but also the shape and form of the building.
In breast hypertrophy, the mound is too large and deformed. The breast mound needs not only a reduction but also a lift and a reshaping.
My preference is to perform the breast reduction with an a superomedial pedicle, which just means that the blood supply to the breast mound and nipple come from a blood source above and to the midline of the chest wall.
After the breast mound has been reshaped and repositioned on the chest wall the skin envelope needs reduction to fit the newly shaped breast mound. A skin envelope of appropriate quantity functions like a well-fitted bra, holding the breast tissue in an appropriate position.
Of the many different types of breast reduction operations available my preferred skin envelope and therefore final scar is one that has a suture line around the areolar with an inverted T scar running vertically down and then across at the level of the inframammary fold. In my opinion this leads to the quickest healing but more importantly the most predictable and therefore most reproducible results.
What are the potential risks and complications?
Some possible complications and risks specific to breast reduction surgery include:
- Surgical risks such as bleeding and infection
- Seroma accumulation under the breast. This fluid may need to be drained under ultrasound guidance
- Visible and prominent scars including keloid and hypertrophic scars.
- Swelling and bruising around the breasts, that takes 2-3 months to settle
- Fat necrosis of the breast. This is a result of poor blood supply to the fat cells. These shows themselves as small firm lumps
- Changes in breast and nipple sensation
- Temporary or permanent areas of numbness around the scars
- Asymmetry of the breasts
- Partial or total loss of nipple and areola
- Need for further surgery to treat complications
- Revisional surgery to correct any unevenness between the 2 sides
- A blood clot in the legs (DVT), which can move to the lungs and may be life threatening
Breast reduction surgery is covered by private health insurance and carries an MBS code (45520). If your policy covers this item number then you are in luck as your insurance will cover a large chunk of your hospital and operation costs.
Unfortunately recent NSW Health guidelines has deemed breast reduction surgery as a cosmetic procedure and thus not able to be performed in a public hospital. I think this is a rather harsh stance as some women are very worthy candidates for reduction surgery in the public sector.
Costs associated with a breast reduction varies between: $9000-$14000 depending on a number of factors:
- Anaesthetist’s fees
- Private hospital or day surgical facility fees
- Need for post-operative garments
- Your level of private insurance cover
- Surgical assistant’s fee
After our consultation my staff will give you an itemised account of the total cost.
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The below links will take you to relevant reviews left on the third party review system RealSelf. These are un-coerced reviews from patients of Dr Moradi.