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He was able to settle my nerves, he provided me with clear instructions and he was keen to see me well again. I actually enjoyed the experience – and I hate hospitals.

- Julie

Breast reduction surgery involves a combination of skin and breast tissue removal and reshaping. The surgery aims to reduce the size and weight of large breasts by lifting the breasts off the lower chest and upper abdomen. The objective is to leave the breasts smaller and lighter, sitting higher on the chest and closer to the body.

Physical symptoms impacting on health and wellbeing can include breast pain, shoulder, neck and upper back pain, breathing difficulties, exercise limitations, skin irritation and possible infections. Women who have disproportionately large breasts may also experience psychological distress, and this can significantly impact on daily functioning.

With age, pregnancy, breastfeeding, and weight fluctuations, breasts may continue to enlarge, progressively sitting below the breast fold and resting on the lower chest and upper abdomen. Consequently, the breasts become longer and sit further away from the body making exercise and sometimes sleeping difficult without a supportive bra.

Breast reduction surgery may help you to address physical limitations and discomfort

Breast reduction surgery addresses the size and heaviness of the breasts as well as their shape and position, creating or restoring breasts that sit higher on the chest. The goal of breast reduction surgery is to have the breasts sitting above the inframammary fold, close to the chest, correcting the tendency of the breast to elongate, and creating a breast size that is in proportion to the rest of the chest and body.

During breast reduction surgery, the nipple and areola generally remain attached to the breast despite the appearance of the scar around the areola (appearing as though it has been removed and replaced higher up on the breast). The areola itself is often reduced, as it tends to enlarge as breast size increases. Reducing the areola brings it back into proportion with the new smaller breasts.

Breast reduction surgery may be suitable for any woman with symptoms related to large breasts, with a wide age range for women typically seeking this procedure.

After breast reduction surgery, women may notice improvements in their posture, ability to exercise, and have a wider range of clothing options than before.

At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us. You can discover some of our wonderful patients' journeys here.

Wherever you are on your personal journey, we would like to assist you. Dr Avery will listen to your concerns and what you want to achieve with surgery. Dr Avery will assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.

Procedure

There are several techniques used in breast reduction surgery depending on the existing breast tissue, the need for future breastfeeding and the desired aesthetic outcome.

These are some of the common surgical techniques used for breast reduction:

Anchor Incision

This is the most commonly used technique, where incisions are made extending around the areola, down the midline of the breast, and across the lower crease of the breast.

Vertical Incision

This incision extends around the areola and down the midline of the breast, without the incision underneath.

Free Nipple Graft

A free nipple graft incision removes the nipple and relocates it higher up on the breast. Scarring in this case may be similar to an anchor incision.

The scars from the incisions made during breast reduction surgery are placed around the newly sized areola, and continue from the lower part of the areola, down the front of the breast to the breast fold and then possibly along the breast fold for a variable distance.

This surgery can take anywhere between 2-4 hours, depending on the amount of breast tissue being removed and the amount of breast reshaping needed. Your individual anatomy and expectations will determine the best surgical technique for you and will be discussed at your consultation with Dr Avery.

Consultation

There are two main pathways to a consultation with a Specialist Plastic Surgeon. Your GP or another health practitioner can make a referral to Dr Avery. Alternatively, it is possible to refer yourself for a consultation. This decision may be made after talking with family or friends, or following your own research into plastic surgery and Dr Avery.

Plastic surgery is a varied specialty with a number of surgeries to treat a variety of conditions or concerns. A unique feature of plastic surgery is the ability of the surgical procedures to produce physical changes that can also impact psychological functioning in a positive way.

The purpose of your initial consultation with Dr Avery is to discuss both your concerns and your goals. It is an opportunity to openly communicate what you want to change, alleviate, improve, restore, enhance, or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.

When you arrive at Avery, you will check in with our front-desk team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation process.

The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are and then decide if having the surgery is a safe and appropriate choice for you as an individual.

After your consultation, our support team will be there to talk through any further questions you have including the cost of the surgery.

Plastic surgery procedures generally impact both physical appearance and your psychological response to the new changes in your body. Besides all the advantages to having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes possible complications and what can be done if these occur. Dr Avery and the Avery team will be available to answer all of your questions.

Recovery

Generally, one or two overnight stays are required post-surgery to aid with recovery. Depending on the complexity of the surgery, up to two weeks off work may also be recommended.

If you have undergone another surgery in addition to the breast reduction, a longer stay in hospital might also be necessary for recovery. As with any operation, you will need to organise somebody to drive you home. We encourage our patients to have another adult stay with them during the first night after surgery.

After breast reduction surgery, you will be required to wear a compression garment for 4–6 weeks to provide support and reduce post-operative pain or swelling, which generally subsides about two weeks after the surgery.

A customised pain relief program will be created for you and issued before you leave the hospital. If circumstances change at any stage during the recovery period, we can adjust the pain medication accordingly.

Breast Reduction FAQs

What do the scars look like after a breast reduction?

The scars from the incisions look like a thin line, initially a bit raised above your skin. Their appearance will vary depending on the technique used to reduce the breasts and your genetics. There are people more prone to hyperpigmentation and hypertrophic scars or keloids.

As the scars heal, they will flatten and eventually fade and they will not be visible in clothing.

Will my nipples retain their sensitivity after the surgery?

Most women retain normal nipple sensation after surgery. Generally, the chance that there will be a change in nipple sensation increases with the extensiveness of the surgery.

Some women may experience a reduced sensation in the nipples that can be temporary or permanent. They may also find their nipples hypersensitive for a short time after surgery.

Will my nipples be removed during breast reduction surgery?

Despite the appearance of the scars around the entire areola, the nipple and areola remain attached to the breast at all times. The size of the areola is usually reduced. In some rare cases, the nipples are removed and replaced on the breast, but this would be discussed with you prior to the surgery.

Will breastfeeding be affected by a breast reduction?

For most women, it is generally possible to breastfeed following breast reduction surgery. Typically, the nipple and areola will remain attached to the breast tissue maintaining the pathway from the milk-producing part of the gland to the milk ducts in the nipple.

Is there an age restriction for a breast reduction?

Breast reduction surgery is generally performed after 18 years of age up to any age depending on individual symptoms. In some cases, if the severity of symptoms warrants surgery, and if the breast growth has stabilised, surgery can be considered around 16 years of age.

How long will it take for the swelling to go down after surgery?

Most of the swelling from surgery will be gone by about 6 weeks post-surgery. Beyond this time, there can still be some changes in the breast size, but they will be less obvious. The breasts will continue to remain responsive to weight fluctuations, as they did prior to surgery.

Can I have a second breast reduction?

A second breast reduction is possible. This is often chosen by women who have had an initial breast reduction earlier in their life. The same benefits and risks apply to the second reduction, although the risk of wound healing challenges are increased because of the altered blood supply from the initial operation particularly in regards to the nipples.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Dr Avery is a member of the two leading professional associations for plastic surgeons in Australia, ASAPS and ASPS. Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.