Breast Reduction Surgery - All your questions answered

Undertaking any elective operation, despite what you read on social media or the internet is still a tough, stressful decision to make.  Especially if you do not understand the process and what the operation will be like.   

If you have ever been curious about breast reduction surgery and whether or not it may be an option for you, read on as we answer some of the most common questions about the procedure.   

What is breast reduction surgery and what has changed in the last 10 years? 

Breast reduction surgery is one of the most common plastic surgery operations performed.  More than any other plastic surgery operation, it consistently improves patient confidence and well-being with almost all patients saying it is one of the best decisions that they have made.  Most patients state that they wished they had had the surgery performed a long time ago.  This is because the operation eliminates back pain and neck pain which almost invariably accompanies large breasts.  The surgery itself is relatively painless in that most patients report the pain as being either a 0/10 or at most a 1/10.  The other important thing to understand is that the surgical technique has changed considerably over the last 10 years with almost all surgery now being able to be performed using a “lolly pop” or vertical scar technique.  It is very uncommon for us to now use an anchor shape scar (in which there is an additional horizontal scar along the entire lower pole of the breast).  This means that almost all the scarring can be confined to the breast.   

In all breast reduction surgery, there are 3 main aims to surgery – to centralise the nipple within the breast, to eliminate any sag or ptosis of the breast making the breast more perky and upright, and finally, to reduce the size of the breast making them smaller, narrower and lighter. 

What is involved in a breast reduction? 

Breast reduction is performed under general anaesthetic in a licensed accredited hospital.  The surgery normally takes somewhere between 90 and 120 minutes and would involve you being admitted to hospital overnight.  All the sutures used are dissolvable meaning you don’t need to have any sutures removed after surgery.  We routinely use fine smooth soft silicone drains which are left in your breasts overnight before being removed just before your discharge.  Because the nipple and areola are left attached to your breasts, it is possible to breast feed after breast reduction surgery and in almost all situations your nipple sensation is preserved.   

The 15 most common questions after breast reduction surgery   

 

1. When can I exercise?  

You should be resting for the first 3 weeks post-op. The best way to remember what exercise you can do is remember the numbers 3, 6 and 12.  In the first 3 weeks you need to rest and not undertake any exercise at all.  At 6 weeks you can begin walking and you can undertake lower body exercise.  At 12 weeks you can undertake upper body exercise. 

2. How long do I need to wear tapes? 

Brown surgical tape has been shown to be the most effective device to minimise the scarring associated with your breast surgery.  There is no clear-cut answer as to timing but the studies show that wearing tape for a minimum of 6 weeks improves the nature of your scar.  Additional studies have shown that wearing tape at 12 weeks has a benefit over 6 weeks. However, sometimes people develop an allergy to the tape over time and the area under the tape becomes itchy.  If this happens, you should stop wearing the tape. 

3. Are there any other scar management products such as Bio-Oil, or Vitamin E that I should use? 

Products such as Bio-oil or vitamin E have not been shown to be as effective as the brown tape. They are significantly more expensive. With no additional benefit we would not recommend their routine use.  The only very expensive product which has been shown to be equal to the brown tape is Silicone strips, but as these strips cost somewhere between $100 and $150, and brown tape is under $10… We would recommend you use brown paper tape.   

4. When can I get my wounds wet? 

You must keep your suture line and the bandages dry for 2 weeks. After the white gauze dressings that were used at the time of surgery have been removed, and you simply have brown tape on your suture line, you are able to have a shower and bath as per normal.  However, after showering it is important that you towel dry the tape and if is still wet, you should use a hair dryer on a low setting to dry it out.  

5. How often do I need to change the tape? 

We would recommend that you change the tape weekly.  Please be careful when you remove the tape. Do not remove the tape aggressively as it may tear the underlying skin.   

6. When can I wear a bra? 

When you see our nursing staff they will advise you on the best time to wear a bra.  It is not straight forward, as we need to ensure we support, but also mould your breasts post operatively.  You need to be aware that the incision line at the lower part of the breast is vulnerable to being damaged. As almost all bras have underwire or gusseting in this area,  you need a wear a bra with extreme care.  One tip that we found to be very useful is to insert a ‘make up’ gauze removal pad inside your bra -in between the bra and the scar at the bottom part of your breast. This pad will provide protection and absorb any moisture, particularly if you are exercising. If you have been advised that you are now able to wear a bra, we would recommend the bra as much as possible with the above precautions. Wearing the bra overnight improves your breast shape.   

7. I have noticed that I have what looks like a small pimple arising in the suture line, is this normal? 

This is almost certainly a reaction to the dissolving sutures used to close your wounds.  These sutures should slowly dissolve over 3-6 weeks after surgery.  During this process, a suture may force its way through the overlying skin and result in a small area of redness and a small white area of dissolving suture containing white paste.  This is not an infection but never the less can be quite tender. I recommend that you keep the area dry and frequently apply Betadine directly to the area to help dry out the skin and inflammatory reaction.    

8. When can I go swimming? 

Swimming, (as all exercise), should follow the same rules of 3, 6 and 12 weeks described above.  Gentle bathing, that is, where there is no exercise involved, can be undertaken from 3 weeks on, but more aggressive swimming such as doing laps in a swimming pool, involves upper body exercise and therefore can be undertaken from 12 weeks.   

9. When can I do more aggressive exercise such as surfing or boxing or golf?   

Surfing, boxing and golf involve the upper body and hence should not be started until 12 weeks after surgery.   

10. When can I do yoga or Pilates? 

Yoga or Pilates involves a combination of lower body exercise, core strength exercise and upper body exercise.  As above, some parts of yoga or Pilates (like stretching) class could be undertaken as early as 3 weeks after surgery, but other more aggressive exercises such as those involving planking, core strength and the upper body should be delayed until 12 weeks. 

11. My nipple sensation is different, and in particular one nipple is more sensitive than the other? 

This is very common and we find that it is not uncommon for the nipple sensation to return in an uneven way -where one nipple is more sensitive.  You may find that in the early stages after surgery that your nipples may be incredibly sensitive. Over time your nipple sensation will settle all by itself with no further treatment.  

 12. I have noticed underneath my breast at 6 o’clock there is small area of fullness.  

This is normal.  The area of fullness underneath your breast is called a “dog ear” and normally settles all by itself without any surgical treatment. 

13. How often do I need to come back to the rooms for follow up reviews? 

Patients would normally return to our rooms 10 days after surgery, 3 weeks after surgery and 6 weeks after surgery.  Follow up appointments after that, would normally be at 3 and 6 months.  This is assuming that everything is progressing smoothly, and your breasts are healing exactly as we would expect.   

Obviously if you have any concerns, or were worried about any aspect of your care, we would see you more frequently. Our rooms are able to see you at any time.  We are open from Monday 8am through to Friday 4pm.  Mark is available on his mobile phone 24 hours a day, and there is a 24/7 nursing call service to answer any questions that you may have about your dressings or about any changes in your breasts about which you are concerned.   

Please be respectful of this service. 

 14. I live in the country, it’s a 4 hour drive, can’t my GP manage my postoperative care? 

Unfortunately no.  

We must see you at you day 10 appointment and your 3 week appointment. This is when we monitor the wound healing of your breasts and coordinate the fitting of a bra to help mould your breast. This is not straightforward. We need to see you. 

 15. What is the most common thing people do wrong? 

That is an easy one. People don’t give their bodies time to heal and try to continue on with their busy lives without slowing down and resting. You must allow time to recover. Be kind to your body. 

If you’re looking for a trusted Melbourne plastic surgeon to perform a breast reduction procedure, or if you simply want to find out more, book an appointment with Dr. Mark Ashton today. 

 

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