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Breast Reduction
Health Guide
Excessive breast enlargement (mammary hypertrophy) causes a number of medical problems:
  • back and neck pain
  • strap marks and shoulder strain
  • poor posture
  • skin irritation and infections (intertrigo)
  • shortness of breath
  • difficulty participating in recreational activities
  • difficulty fitting bras, swimming costumes and clothes
  • social/sexual embarassment / harassment

    Women with extremely large breasts may become very self-conscious about their appearance and will go to the extent of camouflaging their body shape by wearing baggy clothing, and avoiding social and recreational activities. In some severe cases, women become introverted, reclusive and depressed.

    Breast reduction surgery, also known as reduction mammaplasty, is a commonly performed operation, designed to make large breasts smaller, lighter, symmetrical and more proportionate to the rest of the woman's body. In most cases the darker skin around the nipple is reduced in size and the nipples are elevated to a normal position at or just above the level of the fold where the breast meets the chest.

    Breast tissue is a mixture of glandular tissue and fatty tissue. There is more glandular tissue and less fat in young women's breasts and less glandular tissue and more fat as women get older. Liposuction can be used to remove some of the excess fat but it is invariably necessary to cut out the excess glandular tissue and skin. The breast tissue is carefully examined afterwards to make sure it is healthy.

    As a result of surgery there will be scars on the breasts but these are carefully placed so that they are relatively inconspicuous once they fade and are hidden by a bra or swimwear.

    This information has been written to give you the basic facts about breast reduction. There is a separate sheet detailing the costs of the operation. If you decide you would like to know more about breast reduction please make an appointment at St Marks Breast Centre. Please write down any questions you wish to ask the surgeon.

    The vast majority of breast reductions are done for legitimate medical reasons rather than for cosmetic improvement. There is a dramatic improvement in musculoskeletal symptoms following the operation and women find they can exercise more easily.

    It is one of the most gratifying plastic surgical procedures. Many of our patients after breast reduction say "It is the best thing I have ever done".

    The Best Candidates For Breast Reduction

    Breast reduction is usually performed for physical relief rather than simply cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort.

    In most cases, breast reduction isnít performed until a womanís breasts are fully developed; however, it can be done earlier in the teenage years if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results.

    All Surgery Carries Some Uncertainty And Risk

    Breast reduction is not a simple operation, but itís normally safe when performed by a qualified surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anaesthesia. An "invisible mending technique" using dissolving stitches is used to close the breast skin - occasionally one or two of the buried knots may irritate or inflame the overlying skin but can be easily trimmed by the Breast Nurse or treated with antibiotic cream. The great advantage of this stitching technique is that you do not have to suffer the pain and discomfort of suture removal. The scars that result are of very high quality. You can reduce your risks of developing complications by closely following your surgeon's advice both before and after surgery.

    The procedure does lea
    Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. The surgeon should also explain the anaesthesia he or she will use, the facility where the surgery will be performed, and the costs. (Some insurance companies will pay some of the costs towards breast reduction if itís medically necessary; however, they will require a supporting letter from your surgeon beforehand.) Southern Cross Healthcare currently provide an ex gratia payment up to $3200 for Regular/Supercare policyholders and $4000 for Ultracare. The criteria are as follows:

    1.The ex gratia payment will only be paid in the event of approval being sought and given prior to surgery.

    2.The patient will have been a member for at least three continuous years. Surgicare policyholders, however, will not be covered, if the problem predates their joining.

    3.The Medical Referee must satisfy himself that surgery is proposed for medical reasons and will consider the relevance and severity of contributing medical conditions.

    4.The Medical Referee may at his discretion require an independent pre-operative opinion as to the medical necessity from a specialist medical practitioner nominated by Southern Cross.

    Preparing For Your Surgery

    If you are over the age of 30 your surgeon may recommend that you have a mammogram (breast x-ray) before surgery. Youíll also get specific instructions on
    how to prepare for surgery, including guidelines on eating and drinking, stopping smoking and taking or avoiding certain vitamins and medications. Some surgeons suggest that their patients lose a certain amount of weight before the operation.

    Breast reduction rarely requires a blood transfusion. If your blood count is low you should take iron supplements before and after surgery.

    While youíre making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

    Where Your Surgery Will Be Performed

    Breast reduction is generally done in a hospital, as an inpatient procedure. The surgery itself usually takes two to four hours, but may take longer in some cases. You can expect to remain in the hospital one to two days.

    Type of Anaesthesia

    Breast reduction is nearly always performed under general anaesthesia. Youíll be asleep through the entire operation.

    The Surgery

    The techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areolar into their new position. He or
    she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.

    In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are extremely large or pendulous, the nipples and areolas may have to be completely removed and grafted in a higher position. (This will result in a loss of sensation in the nipple and areolar tissue).

    Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.

    After Your Surgery

    After surgery, your breasts will be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small suction drain may be placed in each breast to drain off blood and fluids for the first day or two.

    You may feel some pain for the first couple of days - especially when you move aroLink to St Marks Breast Centre Online

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