Breast procedures

During a breast reduction procedure, the surgeon removes excess breast tissue and skin, resulting in smaller and firmer breasts. Most breast reduction surgery begins with the nipple, which is lifted into a new position and kept alive on a pedicle (tube) of tissue. Excess skin and breast tissue is then removed, and the remaining breast tissue is reshaped to create a smaller and more elevated breast.

The methods of reduction and reshaping vary and depend upon the patient’s breast size, wishes and individual needs. While the principle of all breast reductions remains the same, different techniques do result in different types of scarring.

Traditional ‘anchor’ technique

The most common and traditional type of breast reduction uses an anchor-type incision, also known as an inverted-T. This technique results in an anchor-shaped scar, starting around the areola, travelling vertically down and then horizontally across the breast crease.

After the surgeon has removed excess breast tissue, fat, and skin, the nipple and areola are shifted to a higher position. The areola, which in large breasts has usually been stretched, is also reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour under the arm. Usually, the nipples and areolae remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breastfeed may also be preserved by this method, although this cannot be guaranteed.

Circumareolar technique

In a circumareolar breast reduction, the only scar is from a circular incision around the areola. This technique is suitable when only a small amount of tissue needs to be removed or when only one breast needs to be reduced to match the other breast, as in the case of breast asymmetry.

• Breast reduction often makes a dramatic change in appearance as well as physical comfort.
• Many patients experience increased confidence and greater choice when selecting clothing, particularly swimwear and underwear.
• The level of patient satisfaction from breast reduction is among the highest of any plastic surgery procedure.
• Significant complications from breast reduction are infrequent.
• It is often possible to return to work within one or two weeks, depending on the level of activity required in the patient’s job.
• Resumption of most normal activities, including some form of mild exercise, is often possible after several weeks.

• Every surgery carries some risk. Potential complications include reaction to anaesthesia, bleeding, infection and poor healing.
• Pregnancy and breast-feeding affects the size and shape of a woman’s breasts so it is recommended that patients undergoing a breast lift procedure do so after completing their family.
• Patients may be instructed to wear a postoperative compression garment/support bra for a few weeks, until the swelling and discolouration of the breasts diminish.
• Diminished sensation in the nipple and areola areas usually is temporary; however, it may take weeks, months or even more than a year before sensation returns to normal. Permanent loss of sensation in the nipples or breasts may occur rarely.
• Incisions will initially be red or pink in colour, and will remain that way for a number of months following surgery before fading to white.
• Incision lines will be permanently visible, more so in certain individuals than others. The incisions for breast reduction are in locations easily concealed by clothing.
• Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time, but patients should remember that natural breasts usually show some variation.