Your breast reduction questions, answered.

breast augmentation

Here are some of the most common questions ladies ask me about Breast reduction.

WHAT IS BREAST REDUCTION?

Breast reduction is a kind of surgery designed to reduce the size of excessively large and symptomatic breasts.

WHAT ARE THE BENEFITS OF BREAST REDUCTION? 

Reducing the size of breasts with breast reduction surgery can help alleviate the symptoms of large breasts. It can allow a woman more freedom to exercise and embrace an active lifestyle. And can help a women feel good about herself, feel more comfortable in her clothes and feel more confident. 

WHAT ARE THE RESULTS OF BREAST REDUCTION? 

Breast reduction surgery will result in smaller more shapely breasts, but that comes hand in hand with scars and potential side effects. While most women are extremely satisfied with the improvements seen with breast reduction surgery. But it is important to discuss the benefits and risks of breast reduction surgery with your plastic surgeon, to help you to make a well-informed decision that is right for you.

WHAT KIND OF OPERATION IS DONE TO REDUCE ENLARGED BREASTS? 

There are two major types of breast reduction scars – either the wise-pattern anchor incision or vertical lollipop incision. A nipple areolar lift is safe to do at the same time as the reduction, but in very very large breasts a technique called a free nipple graft is sometimes needed.

WHO CAN DO BREAST REDUCTION SURGERY? 

Plastic surgeons are trained and qualified to perform breast reduction surgery. Make sure to check that your plastic surgeon is registered with the HPCSA – Health Professions Council of South Africa or APRASSA the Association of Plastic Reconstructive and Aesthetic Surgeons of South Africa.

HOW LONG DOES BREAST REDUCTION SURGERY TAKE?

Breast reduction surgery takes approximately two and a half hours.

WHERE CAN BREAST REDUCTION BE DONE? 

It can be done by a plastic surgeon in a Private hospital or in a State hospital.

WHAT DOES IT COST? 

The cost of breast reduction varies from hospital to hospital and is in the range of R50,000. 

WILL MY MEDICAL AID PAY FOR BREAST REDUCTION?

Some medical insurance companies do cover breast reduction as part of their benefits, but it does depend on the plan you are on. Others totally exclude breast reduction. It is helpful to check the small print of your medial insurance contract, or to contact them directly to enquire about breast reduction surgery. Your plastic surgeon will provide you with a motivation letter for your medical aid which will include the estimated volume of breast tissue to be removed. Using the Schnur sliding scale for breast reduction to calculate the ratio of breast tissue to be removed in relation to your total body surface area, is useful in motivating medical funders to cover breast reduction surgery.

CAN I FINANCE MY BREAST REDUCTION? 

There are the number of financing companies which offer a personal loan facility specifically for medical and surgical procedures which may help you to realize your surgical goal.

WHAT ARE THE PROBLEMS AND SYMPTOMS OF LARGE BREASTS? 

Large breasts can be very troublesome for some women. Symptoms of macromastia (large breasts) include shoulder pain, neck pain and back pain which is not improved by physiotherapy or anti-inflammatory medication. The breasts may be painful (mastalgia). 

Bra straps can often cut into the shoulders and cause shoulder grooving. Breasts rashes called intertrigo can occur within the folds of the breast causing bad odors. In incredibly fast growing breasts the breast skin can develop ulcers because of lack blood supply. Many women struggle to find well fitting bras and clothing that they feel confident in. Large breasts can negatively affect a woman’s self-esteem and self-confidence. 

WHAT CAUSES ENLARGED BREASTS?

Breast hypertrophy, macromastia and gigantomastia are all names for the phenomenon of out-of-proportionately large breast size.  The real cause for breast hypertrophy is not well understood, but it often runs in families. Hyper-sensitivity to sex hormones and growth hormones may be the underlying culprit. Puberty or pregnancy can trigger dramatic breast growth. Certain medications can play role. But very often there is no explanation. 

CAN ONLY ONE BREAST BE ENLARGED?

Breast  overgrowth (hypertrophy) most commonly affects both breasts, but in some cases only one breast can be affected. It’s important to make sure that there is no underlying disease causing breast enlargement especially if it occurs only in one breast. 

CAN I BE TOO YOUNG FOR A BREAST REDUCTION? 

A woman’s breasts will continue to grow up to the age of 18 and even beyond, as she matures. There is a risk that breasts may grow again after a breast reduction particularly if the breast growth has not stabilized (stopped growing). Extremely heavy breasts can have a very negative effect on a young woman’s development and self-confidence. And surgery in teenaged women is carefully considered on a case-by-case basis. 

WHO IS NOT A GOOD CANDIDATE FOR BREAST REDUCTION SURGERY?

Breast reduction is major surgery and if you have underlying health problems that are not well controlled this can put you at increased risk of complications during and after surgery. Obesity is a relative contraindication to surgery. Smoking is associated with increased risk of complications. You should stop smoking for at least six weeks before breast reduction surgery. 

SHOULD I HAVE A BREAST REDUCTION IF MY FAMILY ISN’T COMPLETE? 

The changes that take place during pregnancy and breastfeeding may negatively affect the appearance of your breasts. Unless your symptoms are very problematic, it may be prudent to delay breast reduction surgery until after your family is completed. 

WILL BREAST REDUCTION STOP MY BREASTS FROM DROOPING? 

Your breasts will always be under the influence of gravity and ageing changes, and overtime your breasts will start to sag out again, despite a breast reduction. 

ARE THERE NATURAL WAYS TO REDUCE BREAST SIZE?

Weight loss can help to reduce the size of the breasts in some women. That being said extremely large breasts do make it very difficult to lead an active lifestyle. Enlisting professional help from a dietitian or nutritionist is a safer way to lose weight than following new fad diets. 

There is to the best of my knowledge no scientific evidence to suggest that creams, lotions or over-the-counter supplements can reduce the size of the breasts. 

WILL LIPOSUCTION WORK?

Liposuction is only an option to reduce the size of breasts for women with moderately enlarged breasts with little or no drooping or sagging of the breasts. Occasionally liposuction is combined with breast reduction surgery to improve fatty deposits in the tail of the breast or the side of the chest.

HOW LONG WILL I BE IN HOSPITAL?

Usually you will stay in hospital for one night after your surgery.

HOW LONG DOES RECOVERY TAKE? 

By three to four weeks you can get back to light exercise and by six weeks you should be back to all your normal activities.

WHEN CAN I GET BACK TO WORK?

Depending on the kind of work you do, you should feel well enough to return back to work two weeks after your surgery. 

WHAT ARE THE SIDE EFFECTS OF BREAST REDUCTION? 

Breast reduction surgery is a major surgery performed under general anesthesia and side-effects can occur. Scarring, bruising, bleeding, swelling and changes in sensation are potential side effects. Problems such as infection or wound healing complications can also happen. Serious side-effects like losing a part of the nipple due to loss of blood supply can rarely occur. Aesthetic complications include asymmetry and poor scarring may need revision surgery.

CAN I BREASTFEED? 

Breast reduction surgery removes milk producing glandular breast and fatty breast tissue. This can reduce the ability to breastfeed. The rule of thumb is that 50% of woman will be able to breastfeed and 50% of women will need to add some kind of supplementary formula feeding for their baby.

IS IT PAINFUL?

The surgery is done under general anesthesia and does require the regular use of prescription pain medication for the first two to three weeks after surgery. 

WILL I HAVE SENSATION? 

Sensation is usually reduced to the nipple area after breast reduction surgery. The sensation on the scars are also reduced. Some women with extremely large breasts have a reduced sensation of their nipples because of the excessive breast weight which stretches the nerves. For these women, breast reduction surgery can result in an improvement in sensation. 

IS THERE A WAY TO IMPROVE MY RESULTS AND RECOVERY AFTER BREAST REDUCTION SURGERY? 

My advice is to be healthy, fit and at your ideal body weight before undergoing breast reduction surgery. Stop smoking at least six weeks before your surgery. Make sure to discuss all your health issues and prescription medications with your plastic surgeon. Be open and honest with yourself and your plastic surgeon about your needs and expectations of breast reduction surgery. 

Follow the post operative after care instructions and recommendations from your plastic surgeon and attend your follow up appointments as scheduled. 

And remember to be in touch with your plastic surgeon if you have any questions before or after your breast reduction.

If you have any other questions you would like answered – feel free to get in touch with Dr Clare Neser Plastic Surgeon.

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