Breast Reduction

A breast reduction (the medical term is reduction mammoplasty) is an operation to reduce the size and weight of the breasts by removing breast tissue, fat and skin, then reshaping what remains. It’s an operation we perform for women whose breast size is causing physical symptoms that have built up over years and that aren’t responding to conservative measures like supportive bras, weight loss or physiotherapy.

Reduction is one of the more substantial operations in breast surgery, with a recovery period that’s longer than augmentation and with a specific set of considerations around scarring, sensation and the ability to breastfeed in the future. It’s also one of the most consistently rewarding operations from a symptom-relief perspective, and many patients describe the symptomatic improvement as significant within the first few weeks of recovery.

Women with very large breasts often live with a set of physical symptoms that develop progressively over the years and become part of daily life in a way that’s easy to underestimate until the breasts are reduced and the symptoms ease. Upper back, neck and shoulder pain are the most common, often present from the time the patient gets out of bed and worsening through the day. Grooves cut into the shoulders by bra straps can become permanent skin changes. Skin irritation and recurrent infection in the fold beneath the breast are common, particularly in summer or in patients with active lifestyles.

Postural changes from carrying weight at the front of the chest are often visible to family and friends before the patient notices them, and can contribute to longer-term issues with the spine. Difficulty exercising or finding clothing that fits properly is a common complaint, and many patients describe limiting activities they would otherwise want to participate in. Reduction surgery is performed to address this set of physical symptoms, and the assessment we do at consultation focuses on documenting these symptoms and planning surgery to deliver meaningful improvement.

Several different techniques exist for breast reduction, and which one is most appropriate for any individual patient depends on how much tissue needs to be removed, where the nipple is sitting in relation to the breast fold, the quality of the breast skin, and other individual factors that we'll work through at consultation.

Breast reduction is performed under general anaesthesia in an accredited hospital. The operation usually takes between two and four hours, depending on the size of the reduction and the complexity of the reshaping. Most patients stay in hospital for one to two nights, with the second night often reserved for larger reductions where pain control or fluid balance need ongoing observation.

Drains are sometimes used and are typically removed before discharge or at the first follow-up appointment. A surgical bra is fitted at the end of the operation and worn continuously through the early recovery period.

Most patients describe moderate discomfort for the first week, settling steadily after that. The pattern of recovery is influenced by the size of the reduction, your individual healing characteristics, and what you do for a living. A surgical bra is worn for several weeks, and lifting, vigorous exercise and overhead activity are restricted for around six weeks while the wounds and the reshaped breast tissue heal.

Sedentary work is usually possible again after two to three weeks, and patients in physically demanding roles need longer. Final breast shape continues to develop over several months as swelling settles and the tissues mature, and scars take 12 to 18 months to reach their final appearance, going through a phase of being more pink or red before fading.

We’ll provide specific recovery instructions based on your operation and your individual circumstances, and we follow up at scheduled intervals through the first year to monitor healing.

Breast reduction is a major operation. The recognised risks include:

Breast reduction may attract a Medicare rebate where specific clinical criteria are met. Eligibility depends on factors including documented physical symptoms over a defined period, the amount of tissue planned for removal in proportion to body size, and other criteria set out in the Medicare Benefits Schedule. Not every patient qualifies, and qualification is assessed individually rather than assumed based on breast size alone.

We’ll assess your likely eligibility at consultation and provide a written quote covering all costs, including the gap between Medicare and private rebates and our fees if a rebate does apply.

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545