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Breast Reduction – reduction mammaplasty

reductionBreast reduction surgery, or reduction mammaplasty as it is known in the medical field, is one of the most commonly performed cosmetic surgical procedures in the world.

It is often assumed that this surgery is only for women with extremely large breasts, but in fact can be performed for any woman wanting to reduce the size of her breasts.

We commonly reduce women from D cup breasts right through to a J cup!

Women with large, pendulous breasts  experience a variety of very real medical problems caused by the excessive size and weight of their breasts . Others just really want to be smaller and have their breast position more natural.

Every breast reduction procedure is performed in such a way that it will lift the nipple position and give more fullness to the breast.

Some of the problems that women wanting breast reduction complain of  include back and neck pain and skeletal deformities caused by the weight of the breasts, and the fact that naturally large breasts don’t sit against the bony rib cage, but pull forward and distort the natural posture.

Problems also include skin irritation under the breast. This is due to  breast tissue sitting on the upper abdomen and an excess  moisture build up causing rashes, and in severe cases, non-healing ulcers or sores.

All women with large breasts complain about indentations in their shoulders caused from their bra straps. Not to mention the fact that thay have to wear a bra at all times – including in cases of really large breasts (F cups and above) having to wear a bra to bed!

Very large breasts can make a woman, and in particular young girls feel extremely self-conscious. It is not uncommon to perform breast reduction on girls of 18  – 20 years of age. In Queensland doctors are prohibited from performing cosmetic surgery on minors. However, in cases of extremely large breasts in a young girl causing problems, discuss the problem with your general practitioner. If they think that your problem warrants treatment outside of these guidelines, they can refer you onto Dr McGovern to discuss your problem in more detail.

The Procedure
Breast reduction surgery procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give you smaller, better-shaped breasts in proportion with the rest of your body.

Breast reduction can reduce your chance of successfully breastfeeding by about 25%. However many women do successfully breast feed. See the letter at the end of this information page from one of our very happy clients who has successfully breast fed 2 children! These risks will be discussed with you at consultation with Dr McGovern

There are quite a few different techniques employed by qualified plastic surgeons when performing breast reduction surgery. Dr McGovern generally performs a Robbins style breast reduction for large breasts. For smaller breasts he may choose a McKissock or Bennelli  breast reduction technique. He will discuss with you the procedure that will  best suit you.

Qualifications of Your Surgeon
It is imperative that you choose a qualified plastic surgeon to perform your breast reduction surgery. If you are not aware of the reason to not choose a “cosmetic surgeon” then you have not done enough research in this matter and should refer to the “Qualifications ” information on this website.

We are constantly fixing problems caused by “cosmetic surgeons” performing breast reduction surgery. Those problems are real people with wound problems requiring further surgery. This costs these women more  money – surgeons fees, hosital fees and anaesthetic fees to put things right. It also costs them time as they have to  go through the surgery again and the recovery period. Not to mention the time and emotional anxiety they have had to go through living with the problems created by not doing their homework thoroughly.

Caveat Emptor!  Buyer be ware!

Scars
Breast reduction surgery will  leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit.  The actual pattern of scars will depend on the type of breast reduction performed by Dr McGovern. The Robbins breast reduction leaves an anchor shaped pattern of scars, and is the msot common type of breast reduction performed by Dr McGovern.

Dr McGovern will utilise internal, slow dissolving sutures to create support for your scars whilst in the maximum  healing phase (the first 6 – 12months). We also ask that you keep your scars taped for 3 months following surgery to help support the scars and prevent them from becoming wide spread.

Part of the reason to choose a qualified plastic surgeon to perform your breast  reduction is to ensure the very best scar quality. Scars are inevitable and will fade after 18 months or so, but will always be there. Choosing the right surgeon, and following his post-operative instructions carefully, will ensure that your scars remain as fine and short as possible.

Please note that if you smoke you are at greater risk of problems. Poor healing can result in longer recovery times and  wider scars. Dr McGovern does not perform breast reduction surgery on smokers. You must quit (permanently) at least 3 weeks prior to breast reduction surgery.

Assymetry of the Breasts
Every person on the planet is asymmetric in their make-up. Almost every woman has asymmetric breasts, or one breast larger or smaller than the other. Women’s breasts can be completely different in their poistion and in their shape, this is quite normal. One of the aims of breast reduction surgery is to even up any obvious asymmetries. Of course it is impossible to make 2 breasts exactly the same – we are humans – not machines, but Dr McGovern will aim at improving any asymmetry with breast reduction surgery.

Loss of Nipple Sensation
Approximately 5% of women undergoing breast reduction surgery will experience a permanent loss of feeling in their nipples or breasts, or areas of numbness. This may be apparent in both breasts, or may be in just one. Dr McGovern will discuss this with you at more length  at your consultation with him.

Costs for Breast Reduction
You will have 4 sets of fees for breast reduction. They are:
Surgeon’s fees – including your initial consultation and  the cost of the surgery itself. Please call our rooms, or make an appointment to see one of our nurses for a free consultation  to explain your costs in detail. This will depend on the type of breast reduction procedure you require.
Anaesthetic fees – we use a qualified anaesthetist to perform your surgery – not a GP! His fees are paid prior to your surgery. You will need to call the anaesthetic group to confirm these fees. Again these will vary according to the type of breast reduction  you have.
Hospital fees – you may choose to have breast reduction as a day procedure (most commonly), or stay overnight in hospital. Day procedures are performed at the Sunshine Coast Day Surgery, and overnight stays at the Sunshine Coast Private Hospital. Costs vary between the 2 hospitals.
If you are privately insured you may have all of your hospital fees covered. This will depend on your level of health cover. Again our nurses can help you to demystify this at the time of consultation.

Will I Get Any Rebates on Breast Reduction Surgery?
Medicare & health insurance funds will contribute towards breast reduction  surgery.

Call our helpful staff on 18000 80001 to make an appointment for a free consultation with one of our nurses. They will spend 45 minutes with you explaining breast reduction and everything you could possibly want to know about the procedure, in detail. They will take you through a power point presentation which includes lots of before and after photos of Dr McGovern’ s patients. We have deliberately tried to include photos of women of different ages, sizes and races, so that you will find someone that looks similar to you, and you can get an idea of the types of results that you may achieve.

Letter from Patient – Successful Braest Feeding Following Breast Reduction Surgery

Dear Dr McGovern,
I am writing to thank you and let you know of the successful breast feeding of my two children since my reduction back in 1999.  My first baby I fed for 12 months and the second for 10 months and neither required supplementing with formula.  All nurses and doctors involved with my children’s development have been suitably impressed and I felt it fitting to express my gratitude and thank you for the wonderful job you did 13 years ago.

Regards,

Rachael Still (nee Broman)

surgeryYour surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. While 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.

Breast reconstruction usually involves more than one operation. The first stage, whether done at the same time as the mastectomy or later on, is usually performed in a hospital, and involves at least an overnight stay. Follow up procedures may also be done in the hospital, usually as a day procedure (allowing you home the same day).

The first stage of reconstruction, creation of the breast mound, is almost always performed using general anesthesia, so you’ll sleep through the entire operation. Follow-up procedures may require either local anaesthesia with sedation or general anaesthesia.

If your surgeon recommends the use of an implant, you’ll want to discuss what type of implant should be used. A breast implant is a silicone shell filled with either silicone gel, a saltwater solution known as saline, or a solid rubber called cohesive gel. (click here for more information on breast augmentation )

There are many options available in post mastectomy reconstruction. Those suited to your circumstances will be discussed at consultation.

Tissue expansion: The most common technique combines tissue expansion and the subsequent insertion of an implant. Following mastectomy, your surgeon will insert a balloon expander beneath your skin and chest muscle.

Through a tiny valve mechanism forming part of the implant, he will periodically inject a saltwater solution to gradually fill the expander over several weeks or months. After the skin over the breast area has stretched enough, the expander may be removed in a second operation and a more permanent implant will be inserted.

Some expanders are designed to be left in place as the final implant. The nipple and the dark skin surrounding it called the areola, are reconstructed either at the second operation or at a subsequent procedure.

A few patients do not require preliminary tissue expansion before receiving an implant. For these women, your surgeon will proceed with inserting an implant as the first step.

Flap Reconstruction: An alternative approach to implant reconstruction involves creation of a skin flap using tissue taken from other parts of the body, such as the back or abdomen.

In one type of flap surgery, part of the tissue remains attached to its original site, retaining its blood supply from the armpit or upper abdomen. The flap, consisting of the skin, fat, and muscle with its blood supply, are tunneled beneath the skin to the chest, creating the breast mound itself, without need for an implant. Sometimes, especially with the latissimus flap, an implant is used for extra volume.

Another flap technique uses tissue that is surgically completely removed from the abdomen and then transplanted to the chest by microsurgically joining the blood vessels to new ones in that region. This procedure involves additional risks specific to microvascular surgery and in particular involves a risk of losing the entire new breast.

Regardless of whether the tissue is tunneled beneath the skin on a pedicle or transplanted to the chest as a microvascular flap, this type of surgery is more complex than skin expansion. Scars will be left at both the tissue donor site and at the reconstructed breast, and recovery will take longer than with an implant. On the other hand, when the breast is reconstructed entirely with your own tissue, the results are generally more natural and there are no concerns about a silicone implant. In some cases, you may have the added benefit of an improved abdominal contour.

Follow-up Procedures: Most breast reconstruction involves a series of procedures that occur over time. Usually, the initial reconstructive operation is the most complex. Follow-up surgery may be required to replace a tissue expander with an implant or to reconstruct the nipple and the areola. Many surgeons recommend an additional operation to enlarge, reduce, or lift the natural breast to match the reconstructed breast. But keep in mind, this procedure may leave scars on an otherwise normal breast.

recoveryYou are likely to feel tired and sore for a week or two after reconstruction. Most of your discomfort can be controlled by medication. Depending on the extent of your surgery, you’ll probably be released from the hospital in two to five days. Many reconstruction options require a surgical drain to remove excess fluids from surgical sites immediately following the operation, but these are removed within the first week or two after surgery. Most stitches are absorbable.

It may take you up to six weeks to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone. If implants are used without flaps and reconstruction is done apart from the mastectomy, your recovery time may be less.

Reconstruction cannot restore normal sensation to your breast, but in time, some feeling may return. Most scars will fade substantially over time, though it may take as long as one to two years, but they’ll never disappear entirely. The better the quality of your overall reconstruction, the less distracting you’ll find those scars.

Follow your surgeon’s advice on when to begin stretching exercises and normal activities. As a general rule, you’ll want to refrain from any overhead lifting, and strenuous sports, for three to six weeks following reconstruction.

Chances are your reconstructed breast may feel firmer and look rounder or flatter than your natural breast. It may not have the same contour as your breast before mastectomy, nor will it exactly match your opposite breast.

But these differences will be apparent only to you. For most mastectomy patients, breast reconstruction dramatically improves their appearance and quality of life following surgery.

If you have further questions, write them down and ask your surgeon and his friendly staff at your consultation.