Reduction Mammoplasty (Breast Reduction)

what is a breast reduction ...

Large, heavy breasts can contribute to a range of physical symptoms, including discomfort, restricted movement, and challenges with posture or physical activity. These concerns may affect day-to-day activities such as clothing choice, exercise, or sleep. For some individuals, these challenges may begin in adolescence and continue into adulthood.

Breast Reduction surgery (Reduction Mammoplasty) is a procedure that may be considered to address physical symptoms associated with breast size.

types of breast reduction surgical techniques ...

Wise-Pattern (Anchor) Technique: The anchor incision (also known as the Wise pattern or inverted-T incision) is typically used in cases involving significant excess skin and tissue. This approach allows for comprehensive reshaping and repositioning of the breast. The technique involves three incisions:

  1. Around the areola: to allow for repositioning and, if necessary, resizing of the areola.
  2. Vertically from the bottom of the areola to the breast crease: enabling removal of excess skin and access to underlying tissue.
  3. Horizontally along the inframammary fold (breast crease): to assist with reshaping and achieving a desirable size.

Once the incisions are made, excess breast tissue, fat, and skin are removed. The remaining tissue is reshaped into a more proportionate size. The nipple-areola complex is typically moved to a higher position on the chest wall, maintaining its connection to underlying nerves and blood supply when possible. The areola may also be reduced in diameter for increased balance.

This technique provides significant control over breast shape and skin removal, making it suitable for individuals with considerable breast volume, skin laxity, or asymmetry. While the anchor incision does result in more visible scarring compared to other methods, scars generally fade over time and are typically positioned so they can be concealed under clothing and undergarments.

Vertical (Lollipop) Technique: The vertical/lollipop technique is typically used when individuals are seeking a moderate reduction in breast size with reduced scarring compared to traditional methods. This technique involves two key incisions:

  1. Around the areola: to facilitate repositioning and, if required, resizing of the areola.
  2. Vertically from the bottom of the areola to the inframammary fold (breast crease): allowing for removal of excess tissue and skin, and enabling reshaping of the breast.

Unlike the anchor incision method, the vertical technique does not involve a horizontal incision along the breast crease. This reduces the overall length of the scar while still permitting a significant reshaping of the breast mound and elevation of the nipple-areola complex.

During the procedure, excess glandular tissue, fat, and skin are carefully removed, and the remaining breast tissue is reshaped. The nipple-areola complex is typically repositioned to a more central, elevated position while preserving its vascular and nerve supply. Final results depend on individual anatomy, healing characteristics, and the extent of tissue removal required.

Peri-Areolar (Donut) Technique: The peri-areolar breast reduction, also referred to as the donut or Benelli technique, is a breast reduction approach involving a single circular incision around the edge of the areola. This method allows for:

  • Removal of excess skin in a concentric ring around the areola.
  • Repositioning of the nipple-areola complex, when necessary.
  • Mild to moderate reshaping and lifting of the breast.

During the procedure, a ring of skin is excised around the areola. The surrounding tissue is then tightened and sutured to the outer edge of the areola, effectively reducing the skin envelope and allowing for repositioning. Because the incision is confined to the areolar border, scarring is typically limited to this area, which may fade over time and is often camouflaged by the colour transition between the areola and breast skin.

This technique may be suitable for individuals seeking a moderate reduction in breast volume with limited skin excess or for those requiring nipple-areola complex repositioning without significant reshaping of the breast tissue.

While the peri-areolar technique is less invasive than vertical or anchor methods, it does have limitations. It may not be suitable for individuals requiring removal of a larger amount of breast tissue or those with significant breast ptosis (descent of breast tissue).

types of concerns a breast reduction may address ...

Every person is unique, and the potential benefits of surgery will vary depending on individual circumstances, body proportions, medical history, and personal goals. While outcomes differ from one patient to another, potential benefits may include:

  • Relief from physical discomfort: Including back, neck, and shoulder pain that may be associated with larger breast volume.
  • Support for postural alignment: The redistribution of weight may assist with a more balanced posture.
  • Ease of movement: Some individuals find it more comfortable to engage in physical activities or exercise.
  • Reduced skin irritation: The procedure may help address issues such as chafing, sweating, or rashes under the breast fold.
  • Proportional appearance: The breasts may be brought into alignment with overall body proportions.
  • Less strain from bra straps: Heaviness in the breasts can contribute to grooving or discomfort from bra straps.
  • Adjustment of size differences: In cases of noticeable asymmetry, breast reduction surgery can help increase symmetry.

am I a suitable candidate ...

Breast Reduction surgery may be considered by individuals who experience physical symptoms or functional limitations related to breast size, like those mentioned above. Other factors that may indicate suitability include:

  • Being in good general health, with no medical conditions that could affect healing or surgical outcomes.
  • Being a non-smoker, or willing to stop smoking well before and after surgery.
  • Understanding the risks, potential complications, and limitations of surgery.
  • Having completed childbearing, pregnancy, and breastfeeding can affect the outcome.
  • Being at or close to a stable weight that has been maintained for at least six months.
  • A commitment to maintaining a balanced lifestyle, as significant weight fluctuations after surgery may impact results.

Breast Reduction is performed under general anaesthetic in a fully accredited hospital. The following steps are typically involved:

  • Pre-operative markings: While the patient is standing, your surgeon will mark the breasts to plan the agreed incision pattern and guide tissue removal, taking into account breast position and proportions.
  • Anaesthesia: A qualified anaesthetist administers general anaesthesia. Local anaesthetic is also used in the surgical area to assist with post-operative discomfort.
  • Tissue removal and reshaping: The chosen surgical technique (discussed and agreed upon before surgery) is used to remove excess skin, glandular tissue, and fat. The remaining tissue is reshaped and repositioned to change proportions and breast position.
  • Nipple repositioning: In most cases, the nipple-areola complex is repositioned to a higher point on the breast while maintaining its blood and nerve supply. For patients requiring a significant volume reduction, a free nipple graft may be necessary.
  • Drains: Small surgical drains may be placed temporarily to assist with fluid removal and support the early healing process. These are typically removed within a few days.
  • Support garment: A post-surgical compression bra is fitted at the end of the procedure to assist with swelling and support the breast throughout the healing period.

Yes, you will require a GP referral. As of 1 July 2023, AHPRA (Australian Health Practitioner Regulation Agency) requires all patients to obtain a referral from a GP (General Practitioner).

Recovery following Breast Reduction surgery is a gradual process that will vary between individuals. Factors such as your general health, the extent of the procedure, and the specific technique used all influence healing time. Your surgeon will provide clear post-operative guidance tailored to your needs and will remain involved throughout the recovery journey.

Early Recovery (First 1–2 Weeks)

  • Mild to moderate swelling, bruising, and discomfort are to be expected in the early days and are typically managed with oral pain relief.
  • Drains (if used) are usually removed within the first 1–2 days.
  • A post-surgical bra or compression garment is worn continuously to help reduce swelling and support the breasts during the early stages of healing.
  • It is important to rest with the upper body slightly elevated, avoid lifting or stretching, and begin with slow walks to support circulation.

Ongoing Recovery (Weeks 3–6)

  • Most patients feel more comfortable by this stage and may resume light daily activities or return to desk-based work.
  • Swelling gradually subsides, and external dressings may be removed or replaced with scar-supportive tape depending on your surgeon’s advice.
  • Physical activity remains limited, particularly any exercise that involves the upper body.
  • Follow-up appointments will allow your surgeon to monitor healing and address any concerns.

Later Recovery (After 6 Weeks)

  • Many patients can return to full activities, including travel, exercise, and more active work duties, between weeks 6 and 8. This will depend on individual recovery and medical clearance.
  • Scars continue to mature and may soften and lighten in appearance over several months.
  • It’s recommended to continue wearing supportive bras and to protect healing skin from sun exposure.

As with any surgical procedure, a Reduction Mammoplasty involves potential risks. During your consultation, your surgeon will discuss possible risks and complications as part of the informed consent process. Visit our Risks and Complications page for more information. Risks and complications can include, but are not limited to:

  • Infection or wound healing issues: Particularly in larger reductions or patients with certain medical conditions.
  • Changes in nipple sensation: Some patients experience temporary numbness or, in rare cases, permanent loss of sensation.
  • Asymmetry: Differences in size, shape, or nipple position may occur and may require revision.
  • Bleeding or haematoma: Rare but can require intervention.
  • Poor scarring: Some patients may develop thick, raised, or pigmented scars, particularly if prone to keloid formation.
  • Inability to breastfeed: While most techniques preserve breast function, breastfeeding ability may be reduced.

As per AHPRA guidelines, exact fees cannot be published online. A comprehensive quote will be provided during your consultation with your surgeon, based on your needs and any eligibility for rebates.

Surgical fees can vary depending on several factors, including:

  • The complexity and duration of the procedure
  • The hospital chosen for the surgery
  • The type of anaesthetic and who administers it
  • Whether drains, garments, and follow-up visits are included

Some patients may be eligible for Medicare or private health rebates if their Breast Reduction is ‘medically necessary’. In this case, an item number may apply.

Will I lose nipple sensation after breast reduction surgery?

Some patients experience a temporary change in nipple sensation following Breast Reduction surgery, including numbness or hypersensitivity. In most cases, sensation gradually returns over a period of months. However, for some individuals, reduced sensation may be long-lasting or permanent. Our surgeons use techniques that aim to preserve nerve pathways as much as possible.

Can I breastfeed after having a breast reduction?

Breastfeeding after reduction surgery is possible for many women, especially when the nipple remains attached to the underlying tissue (pedicle technique). However, the ability to breastfeed may be affected depending on the surgical technique used and individual anatomy. This is an important topic to discuss during your consultation with your surgeon if you plan to have children in the future.

At what age is it appropriate for a breast reduction surgery?

Breast Reduction can be considered once breast development has stabilised, which typically occurs in the late teens. While there is no strict age limit, our surgeons usually advise delaying surgery until breast growth has ceased for long-term stability of results. For older adults, general health and healing capacity are more important than age alone.

Will my breast shape change over time after surgery?

Yes, like all body tissue, breasts will continue to change over time due to ageing, weight fluctuations, hormonal factors, and gravity. Breast Reduction surgery does not stop these processes. Wearing supportive bras and maintaining a stable weight can help preserve your results.

What type of bra should I wear after surgery?

Following surgery, you will be fitted with a supportive, non-underwire compression bra, which helps reduce swelling and supports the healing tissue. Our surgeons typically recommend wearing this garment day and night for the first month, then during the day only for an additional two months. You’ll be guided on when to transition to regular bras.

Is breast reduction surgery also suitable if I have asymmetrical breasts?

Yes, breast reduction can be an effective way to help address breast asymmetry, especially when one breast is significantly larger or shaped differently. During your consultation, your surgeon will evaluate your specific concerns and recommend a technique that achieves increased balance and symmetry.