Introduction

Breast reduction surgery, also known as reduction mammoplasty, is a surgical procedure that removes excess fat, tissue, and skin from the breasts. It is commonly performed to reduce the size of breasts that are considered to be overly large, which can cause discomfort, pain, and other physical and psychological problems. In addition to reducing the size or volume of the breasts, breast reduction surgery also improves the shape of the breasts by lifting the nipples and breast tissue higher on the chest wall (this part of the surgery is called a breast lift or “mastopexy”)

What is Breast Reduction Surgery?

Breast reduction surgery is a common surgicalprocedure. It is performed under a general anaesthetic. Typically, the surgery takes two to three hours to complete, depending on the extent of the work being done. During the procedure, the surgeon will make incisions around the areolas and the creases under the breasts. Excess skin and fat will then be removed, and the breasts will be reshaped and lifted.

Using A/Prof Marucci’s techniques, patients are able to go home the same day, although most opt to stay in hospital for one night.

Types of Breast Reduction Surgery

There are two main types of breast reduction surgery:

• Traditional reduction mammoplasty (Wise pattern breast reduction) This is the most common type of breast reduction surgery. It involves making incisions around the areolas, straight down the front of the breasts and in the creases under the breasts. This is called a “Wise pattern breast reduction”, after the plastic surgeon who developed the technique.
• Vertical reduction mammoplasty: This type of breast reduction surgery is less common than traditional reduction mammoplasty. It involves making an incision in the centre of the breast from the areola to the crease under the breast. A/Prof Marucci uses this technique for patients with good skin quality who need more of a “lift” and less of a “reduction”. It is a good option for younger patient without too much excess skin or breast tissue.

Benefits of Breast Reduction Surgery

Breast reduction surgery can offer a number of benefits, including:

• Reduced breast size and weight
• Relief from physical discomfort and pain
• Improved posture
• Decrease the incidence of intetrigo (the name given to the rash that can develop in the fold underneath the breast)
• Easier to find clothes that fit

Who is a Good Candidate for Breast Reduction Surgery?

Good candidates for breast reduction surgery are patientswho are:

• In good overall health
• Have realistic expectations about the outcome of the procedure
• Are bothered by the physical and/or psychological effects of their large breasts

Before and After Photos

Here are some before and after photos of some of A/Prof Damian Marucci’s breast reduction patients.

You can see more of A/Prof Damian Marucci’s before and after results by clicking here.

What to Expect Before, During, and After Breast Reduction Surgery

Before Breast Reduction Surgery

During the consultation with A/Prof Marucci, he will take a full medical history from you, in particular any history of breast surgery, allergies, medications, smoking and alcohol intake and any family history of breast surgery or breast cancer. A/Prof Marucci will then perform a standard breast examination including the glands in the armpits, to make sure there are no suspicious masses that might need further investigation. A/Prof Marucci will then analyse the shape of your breasts, the symmetry and the relative position of the nipple to the fold underneath the breast. If the nipple is below the level of the fold (as it most commonly is in patients seeking breast reduction), this is called “ptosis”. One of the goals of the surgery then become to elevate the position of the nipple on the chest wall to correct the “ptosis”. Investigations such as breast ultrasounds and mammograms may be ordered depending on a patient’s age and risk factors. If you are requested to have a mammogram, please make sure it is done at least 2 weeks prior to surgery, so that A/Prof Marucci will have the written report well in advance. A/Prof Marucci will discuss your goals for the procedure and the risks and benefits of breast reduction surgery. He will give you handouts on what bras to buy before the surgery. Essentially, you will be asked to buy two bras with no underwire that do up in the front. You will be asked to be holding one of these bras in your hand as you go in for the operation (don’t pack it in your bag). A/Prof Marucciwill show you before and after photos of previous patients he has treated. Often two consultations are undertaken before surgery. After a thorough explanation of the potential risks and complications, A/Prof Marucci will take you through the consent form and a full written outline of the costs involved will be provided.

During Breast Reduction Surgery

You will be told when to stop eating and drinking before the surgery and when to turn up at the hospital. Make sure you have the bra with no underwire with you. On the day of the surgery you will be checked into the hospital. You will meet the anaesthetist. A/Prof Marucci will draw the surgical plan on you before you go into the operating theatre. Your bra will be collected at this point and you will go into the operating theatre for the procedure.

The surgery is performed under general anaesthesia – you will be completely asleep. In addition to that, A/Prof Marucci will put local anaesthetic into the wounds to make everything numb for many hours after the surgery.

All the removed breast tissue is sent off to the lab to make sure there is no disease. All the wounds are closed with dissolving sutures. Paper tape is placed on the wounds and you are then placed into the bra. You will then be taken into recovery and later to the waard.

After Breast Reduction Surgery

Once you have woken up you can get out of bed and walk around. Some patients stay in hospital one night and others go home the same day. If a drain is used (a hollow tube that drains away fluid), it is normally removed the day after surgery.

The local anaesthetic will last for many hours. You will be given a script for stronger painkillers to be used when the local anaesthetic wears off

You can remove the bra and shower NORMALLY the day after surgery. The paper tape can get wet. Pat it dry after your shower.

Wear the bra day and night for the first two weeks. Then, for the next two weeks wear the bra when you like. Four weeks after the surgery you can start wearing bras with underwires again as you are comfortable

If there is any bleeding from the wound put firm pressure on for at least 10 minutes with clean tissues. This should stop 99% of all bleeding. Look at the clock and make sure it is a full 10 minutes. If the bleeding hasn’t stopped after 20 – 30 minutes of pressure, let the rooms or A/Prof Marucci know

If there is spreading redness/ increasing pain/ signs of infection, please let the rooms or A/Prof Marucci know

It is common for there to be bruising of the breasts. Initially the skin is purple, then it goes green/yellow

Risks and Complications of Breast Reduction Surgery

Major complications after breast reduction surgery is rare, but there are some risks and complications to be away of, including:

• Bleeding
• Infection
• Scarring
• Loss of nipple sensation
• Changes in breast shape
• Unsatisfactory results

For a more complete A-Z list of the potential complications of breast reduction surgery, click here.

Recovery from Breast Reduction Surgery

Most people are able to return to work or school within two weeks of breast reduction surgery. However, it may take several weeks for your breasts to fully heal. During this time, it is important to avoid strenuous activity and protect your breasts from the sun. You can shower normally the day after your surgery, and most of A/Prof Marucci’s patients are driving withing a week

Finding a Qualified Breast Reduction Surgeon

It is important to choose a qualified and experienced surgeon for your breast reduction procedure. Look for a surgeon who is a Fellow of the Royal Australasian College of Surgeons (FRACS) and is a member of the Australian Society of Plastic Surgeons (ASPS) as well as the Australasian Society of Aesthetic Plastic Surgeons(ASAPS). A/Prof Marucci has a FRACS in Plastic and Reconstructive Surgery. He is on the Education Committee of ASPS and is on the Board of ASAPS. A/Prof Marucci is registered a specialist in plastic and reconstructive surgery with AHPRA.

Conclusion

Breast reduction surgery is a routine surgical procedure that can improve the physical and psychological well-being of people who are bothered by the size or appearance of their breasts. If you are considering breast reduction surgery, be sure to consult with a qualified surgeon, like A/Prof Damian Marucci to discuss your goals and expectations.