FAQs

Eat a normal diet. You can do all your normal activities right up until the day of the procedure.

No special supplements are required.

We will discuss any medication you are on and advise you if we need to change this in any way.

Please avoid taking any herbal or other vitamin supplements for 2 weeks prior to the procedure, unless you have checked with us first.

If you need to take pain medication for a headache or any other reason, please take Paracetamol (Panadol) based medicines only. Please avoid aspirin and/or Ipobrufen/anti-inflammatory type (Nurofen) medications for 10 days prior to surgery as these can affect your blood clotting and lead to much greater bruising after surgery if you have taken them at any time in the 10 days prior to surgery. If in doubt please check with us first.

Most woman will be able to do almost any activity after 4 weeks. Some women are able to go back to non physical type jobs at 2 weeks or less. If you work, or can work from home, then you may be able to do some or all of your work earlier. The answer to this question often requires individual guidance based on your personal specific needs. You would be surprised how much individual thought is required.

You might do an office type job but if you have a 2 year old at home who needs to be lifted up 10 times work might be a small issue for consideration but you might need to consider whether you need help around home. Alternatively if your children are older or you don't have children but you are a passionate horse rider again work may be a minor consideration but who looks after your horse for you might be something we need to talk through. (I have had at least one lady back horse riding at 4 weeks).

This is why  considering breast reduction is a collaboration between you and your surgeon. Everyone's life is different and you will need to talk about your individual needs.

See Dr Burt Video response.

All stitches used are beneath the skin so you will not need to have any sutures removed. The stitches dissolve slowly over 4- 6 weeks following the surgery. You will have special tapes over the suture lines placed at the end of the procedure.

You will have soft supportive crop top garment for support. You can remove this each day and shower normally. You will be able to shower from the first day after surgery.

There is no hard rule as to when you may be too old to consider breast reduction. Currently it is uncommon for women over 65 years to choose to have a breast reduction.

Accepted age limits for all medical treatments are constantly being revised as more and more people are living very long healthy lives. Most people (particularly women) don't seem to realize how long they are going to live. Currently a female child born in Australia is likely to live to 84 years but more relevantly a woman who reaches the age of 65 years in Australia is likely to live to be 90 or beyond (and these figures are getting better much quicker than the statisticians predict).

The standard approach in assessing any person for any medical procedure in Australia is no longer age based (and has not been for a long time now). No one is denied surgery for any problem based purely on their age. So if you are a 68 or 70 year old healthy active woman and your breasts are a significant source of difficulties you are absolutely entitled to come along and talk about your individual situation and consider breast reduction as an option.

It is important to note ultimately you make the decision about whether you proceed. The doctor's role is to give you high quality information so you can make and informed decision.

It is also important to understand that there is some evidence to suggest women who have a breast reduction significantly reduce their risk of breast cancer. In the over 50 age group the risk reduction may be up to 40%.

See also Dr Burt video response.

Your general recovery will progress through stages over a few weeks following the procedure (on average 4 weeks is a good rule of thumb). You will be eating and drinking normally within hours of surgery. There is no dietary restrictions after surgery.

You can shower as soon after surgery as you wish as often as you wish. If you feel anxious about showering we can advise you on alternate strategies.

Sleeping can be the trickiest bit depending on your normal sleeping habits before surgery. If you, by habit, sleep on your back you are in luck because this is the most comfortable position to sleep in for the first few days or weeks. If it is your habit to sleep on your front then you will have to readjust and sleep on your back for the first few nights. You will slowly get more comfortable and get back to normal over 3-4 weeks. You cannot cause any complications by rolling onto your tummy or side in your sleep it just may be uncomfortable and wake you up.

There are lots of ways to minimise scarring.

1. Choice of technique

You can elect a minimal scar technique. These techniques are; a) liposuction alone or b)"vertical " breast reduction techniques.

All these choices are open to you but the key is to understand how appropriate those choices may be for your individual needs. For instance a decision about liposuction is influenced by age (younger women's breast have more dense glandular tissue and are therefore more difficult to reduce with liposuction) and how much drooping of the breasts is present. If you have significant drooping you may need your nipples repositioned upwards as well as the weight of your breast reduced  which may not be able to be achieved by liposuction alone. Everyone is different and you need individual assessment and advice.

2. Scar management

Before and after a reduction procedure you will routinely get advice on scar management techniques to get any scarring produced to settle as favourably as possible.

It is important to understand that for most women who decide to have a breast reduction the severity of their symptoms (usually neck, back and shoulder pain, etc.) mean any scars resulting from the breast reduction procedure they choose  are acceptable to them as a trade off for being symptom free.

This is the key decision in considering whether breast reduction is right for you.

See also Dr Burt Video response

You will have a graduated return to normal activities. When you return to work very much depends on the demands of your job. If your job mainly involves telephone and email correspondence which can be done from home you may be able to do part or all of your duties within days of the surgery. If you do a heavy physical job like nursing, personal care attendant, paramedic, hospitality or outdoor work (gardening, construction, manufacturing) you may need up to 4 weeks off work. Most women are able to get back to work in around 2 weeks. One of the goals of your consultation will be to understand the individual demands of your life and give you specific advice on when you will likely be able to resume your normal activities.
Most women can resume driving by around 7-10 days post surgery.

Exercise will be a graduated process. You are strongly encourage to walk from the first day following surgery. This can be increased as tolerated. In most cases the skin wounds will be healed in 10 days. After this you can resume most activities as you feel comfortable. As you would understand activities where you get a lot of bouncing action (jogging, aerobics, dancing) are the activities it takes longest to get back to often around 4 weeks. 

Fortunately significant infection is very rare after breast reduction. If you were to have a breast reduction procedure you would be given intravenous antibiotics during the procedure.

It is very rare to see a significant infection after the procedure. As a guide I have never had to readmit a patient to hospital for infection problems after a breast reduction. Nothing is impossible but it would certainly be a rare occurrence.

See Dr Burt Video response.

Yes. If you are over 40 years of age we recommend you have a mammogram before proceeding to any breast procedure. 

You will be able to resume your normal mammogram sequence following surgery. If you are over 40 we suggest you have a mammogram performed one year after your breast reduction. This becomes a snapshot of the new internal appearance of your breast to assist with your future screening.

Increasingly mammography is a tool used hand in hand with ultrasound. The ability to perform an ultrasound exmination of your breasts will also be unaffected after breast reduction.

In the future it may be that MRI becomes the imaging modality of choice. The ability to perform an MRI is unaffected by having had a breast reduction.

No one can guarantee that you will be able to breast feed after a breast reduction procedure.

There is a lot of misunderstanding about breast feeding. 

The research data published in regards to breast feeding after breast reduction suggests if you have had previous success breast feeding earlier children you will likely be able to feed if you chose to after reduction. The success rates for these women is 75-80%

If you have not had the opportunity to have children prior to breast reduction the most important factors dictating successful breast feeding after surgery are having a supportive obstetrician and access to skilled support and advice from a lactation consultant (breast feeding expert).

Only 15% of women (who have not had a breast reduction) breast feed exclusively for 6months which is the World Health Organisation recommendation. There are multiple reasons why this is the case.

Yes. You will have permanent scars. There are 2 common scar patterns depending on which technique procedure you choose. Most women have scars around the nipple/areola and a vertical scar below the nipple towards the fold under your breast. In addition depending on the size of your breasts and your choice of technique you may have a further long scar in the fold under your breast. If you choose to have your breast size reduced by liposuction alone you will have multiple very small scars (3 or 4 scars 5mm each in length). Liposuction by itself will not usually address significant droopiness of the breasts (ptosis).

Liposuction can also be difficult in younger women because at a young age much of the breast tissue is glandular tissue and is too dense to be able to be removed by liposuction. As you get older a greater amount of the breast tissue is fatty tissue which is amenable to liposuction. The irony of course, is that as you get older the droopiness (ptosis) is likely to be greater. So young woman may not be candidates for liposuction alone because their brests are composed of very dense tissue and older women may not be candidates for liposuction alone because of the severity of the droopiness. We will need to discuss and assess these factors if we meet.

Yes, for most women the results are permanent. However, if you experience significant weight loss or gain your breasts will change in size in proportion to their new size.

No one escapes gravity so over time (particularly if you have further pregnancies) you can expect some further drooping (ptosis) of the breast tissue. Because your breasts will be much lighter this is likely to be proportionately less than the case if the reduction had not been performed.

Breasts can regrow if you are extremely unlucky. It is most uncommon. If a further reduction is required this can (in most cases) be safely performed but it is a very uncommon occurrence. I have performed 2 repeat breast reductions in my career. In both cases I did not perform the original surgery. In one case the original surgery was performed 34 years prior in the other case 30 years prior. Both women had been very happy with the outcome of their original procedure but experienced considerable further breast growth after menopause associated with generalised weight gain. In both cases a further reduction was performed without complication and achieved the outcome desired by the patient.

1. If your concerns about your breasts are purely cosmetic. Women who have breast reduction surgery have large, heavy breasts causing physical symptoms (neck ache, back ache, shoulder pain). Due to the scars resulting from breast reduction it is not a procedure commonly perfomed for cosmetic concerns. Breast reduction is restorative surgery. It restores body proportions. It is not cosmetic surgery. Unless your breasts are significantly out of proportion to body it should not be considered.
    
2. If you have a strong family history of breast cancer you may wish to avoid any elective breast surgery. Breast reduction if anything reduces your risk of breast cancer but if your family history is significant you need to seek specific individual advice about your situation.This is very important. Unfortunately breast cancer is a common disease. If you have a family history (specifically, if your mum and/or sisters have had breast cancer) you should make it your business to get that advice. Normally the doctors who have treated your relative are more than happy to assist you. If you find yourself in this situation please see your GP or one of these doctors.
    
3. If you have a personal history or family history of making unsightly, raised, red or ugly scars (medically we call these hypertrophic or keloid scars) then breast reduction is not likely to be a procedure for you. Often the scars for breast reduction are extensive so if you are likely to make bad scars it can be a significant issue. Fortunately this is rare. Liposuction may be an option as a compromise if you fall into this category.
    
4. If you will be very distressed if you could not breast feed your babies breast reduction should be deferred until you have completed your family.
    
5. If you have a personal or family history of bleeding or blood clotting problems or you are taking particular blood thinning medications then breast reduction may not be appropriate.

If you are overweight not all the tissue on your chest is breast tissue (particularly tissue on the sides of your chest wall is often fatty tissue). This gives your chest a broader width and breast reduction results in wider, less projecting, less shapely breasts. The risk of complications such as wound healing difficulties, infection, loss of nipple sensation and damage to the blood supply of the nipples is also increased. It is far better to lose weight prior to a procedure and maximise the benefts where possible.

You should not be actively smoking if you are preparing for this procedure. This is a completely elective procedure .You should give up smoking first and consider breast reduction after this has been achieved. Smoking increases the risk of having a complication from the surgery. In particular it increases your risk of a wound healing problem and damage to the blood supply to the nipple.

You must not smoke for at least 4 weeks prior and 2 months after surgery.

You may require a simple blood test to check your blood count (haemaglobin levels) and basic blood chemistry. Sometimes menstruating women can be anaemic (have a low blood count) without knowing it. If you are going to have an anaesthetic and surgery we want to know about these things beforehand. It is part of caring for you properly. Most often preoperative tests will be completely normal and even if your blood count is low it is easily correctable over a couple of weeks with some iron supplements.

Yes. I realise this is a sensitive issue. Photographs will not be taken until you have made a firm decision about whether you wish to proceed to surgery. At that point photographs become a necessary part of your medical record. Photographs will be taken at the office visit prior to your surgery. This allows the photos to be used for planning your operation. It is also usually more private and less stressful to have photos taken at the office and not at the hospital.

On the day of surgery at the hospital you will be a little anxious (this is normal for any person) and if the photos are already taken it is one less stress to deal with.

The cost of breast reduction depends on a number of factors such as whether you have private hospital insurance. We have tried to give you a transparent idea of what the likely costs are. Click this link  and it will take you to our Costs information page.

Do I require private health insurance? No, you do not require private health insurance you can self fund the hospital costs of the procedure. The hospital costs however, are a substantial part of the overall costs .

What is the difference between having private cover or not? We have tried to make this clear on our costs information page Click here

Yes. A breast reduction incorporates a breast lift.

Do you charge more for the lift? No it is all the one procedure.

There is no hard rules which suggest how big you need to be before you consider breast reduction. It is really all about how severe your physical symptoms are. This determines if considering breast reduction makes sense for you. Women who decide to have breast reduction are suffering pain (neck, shoulder, back pain and associated symptoms). If you are not experiencing symptoms such as these breast reduction is not for you.

In the perfect world you would be at your ideal body weight when you had a breast reduction perfomed. Breast reduction is restorative surgery. The goal is to restore your breast proportions to your body proportions. It makes sense then that if you are at your preferred proportions at the time of surgery you are more likley to get the optimal outcome. In the real world sometimes that is not going to be the case. If you are within a reasonable range of you ideal BMI (Body mass index) then the operation can be perfomed safely (BMI<30). If you are way over weight your risk of complications increases substantially and it is best to lose weight before considering surgery.

Try this BMI calculator

Yes you can have liposuction. We can talk about that. Whether you ultimately choose liposuction will depend on your personal circumstances. In broad terms liposuction removes fat cells from the breasts. Once the fat cells are removed, the breast is made lighter. The hope is that once these fat cells are removed the skin will be elastic enough to shrink up and therefore contribute to the overall reduction of your breast size. When you think about this there are several questions we need to answer before deciding if liposuction alone will be the correct technique for you.

1. Is your breast tissue mostly fatty tissue (usually the case after you have had your children) or is your breast tissue dense breast glandular tissue (often the case in young women and those who have not breast fed).
2. Is your breast skin elastic, free of stretch marks or is it thin and saggy with obvious stretch marks? (Is my skin part of the problem or part of the solution?)
3. Do I have large breasts but my nipples sit up high at or close to the breast fold (within 4 cm would be good) or do i have a major problem with sagging? These are some of the issues we would talk about and work through in our decision making discussions.

This is totally dependent on your symptoms. Breast reduction in terms of weight of tissue removed range over a very broad range from 250 grams to 2.2kg each breast in my experience. An "average" reduction would be upwards of 700 grams each side (i.e. upwards of 1.4kg in total). The most common situation is a reduction of over 1kg each side (total bilateral reduction of over 2kg).

In terms of cup size it would be uncommon to consider breast reduction if your breasts were less than DD cup.

For reasons which we do not understand often the breasts do not substantially reduce in size as you lose weight. Of course the actual size of the breast is only part of the problem adressed by breast reduction. In my experience all women having breast reduction have ptosis (sagging) of their breast as well as increased weight of breast tissue. Losing weight does not improve this and sometimes makes it worse. The symptoms caused by your breasts are in large part due to the excess weight but the more saggy the breasts are the more they pull on you shoullders, neck and back.

Having said that, weight loss is unlikely to solve your breast problems. Weight loss is really important if you wish to get the best outcome from any planned breast reduction procedure.

If you are not, at or near as possible to your ideal body weight it is difficult or impossible to get the best size and shape for you at the time of surgery.

Body mass index is a suggested way of classifying a person's weight compared to their height. It is not a perfect method of classifying weight but it is widely used and gives a reasonable guide.

BMI is calculated by the formula Weight (kg) / {Height (m) x Height (m)}

For example If you weigh 82kg and are 175cm (1.75metres) the calculation looks like this.
BMI = 82/(1.75x1.75) = 82/3.0625 = 26.78

Try this BMI calculator

Liposuction is the closest thing to a scarless breast reduction. You have multiple small (~5mm) scars so it is not totally scarless.

Whether liposuction is the best option for you will depend on several factors. The breasts of younger women who have not had children have dense breast tissue composed of gladualr tissue which is not able to be removed by liposuction. In addition if you have a significant problem with droopiness (ptosis) liposuction alone may not be able to achieve repositioning of the nipple and areola.

That is not really how it works. I am not aware of any surgeon, myself or anyone else, who will guarantee you a particular cup size after a breast reduction procedure. There are a number of reasons for this.

The first is there is no consistency in the cup sizes manufactured by the bra companies and most women will tell you they may be a D cup in one brand and a C cup or DD in another brand. The main reason cup size is not our primary focus is that this procedure is about restoring proportion rather than trying to make your body "fit" an arbitary cup size. 

The "average" breast reduction  is greater than 700 grams each side (1.4 kg in total). The reality for almost every woman is that if you have 1.4kg or more removed from the front of your chest and out of your bra the practical improvement to your day to day life is so great that cup size is irrelevant. 

Research studies suggest that as little as 250 g removed each side can make a significant improvemnt in neck, back and shoulder pain. Considering most women have much greater amounts of tissue removed the relief of day to day neck, shoulder and back pain is the real reason breast reduction is so highly rated by patients.

If you really believe you would not be happy unless you wee a particular cup size you should not have the procedure performed. This is not a cosmetic surgery procedure it is about symptoms relief. If you are more concerned about size than symptom relief there is a risk you will be dissatisfied.

You will have bruising and swelling of your breasts in the immediate post procedure period over 2- 4 weeks. During this time your nipple, areola and skin of your breasts may be numb. After this for most women the sensation of the nipple returns. 

There is a risk however, of permanent numbness of one or both of your nipples and areola from this procedure. The skin of the breasts adjoining any scars (the scar pattern can vary from patient to patient depending on your decisions about which procedure you choose) can have areas of numbness. These may slowly resolve but they can also be permanent in some cases.

In most cases the rashes woman experience in the fold under the breasts will resolve after surgery.

If you have minor skin lesions like skin tags they can be removed during the procedure as long as you discuss this with us well before the operation day.

You will definitely feel lighter on your front. This is the key positive outcome from breast reduction surgery.

You will notice less dragging on your neck and shoulders too.

You will not lose your balance .

There are 2 population based studies (from Canada and Scandanavia) which suggest your risk of breast cancer is reduced after breast reduction particularly in the over 50 age group.

Breast reduction does not in any way lessen the need for you to perform regular self examination and have regular mammograms once you turn 50 years of age.

Most women choose to stay in hospital overnight but the procedure can be performed safely as a day case if you prefer. You will be bruised and swollen for 2- 4 weeks but will be able to progressively do many activities. 

When can I return to work? It will depend on the type of work you do and the type of breast reduction you have chosen to have. As a general rule if you do desk based work you may get back in 2 weeks if you do heavy physical work you may prefer to take 3 to 4 weeks off work.

When can I drive? Usually within 7-10 days. 

Can I lift the laundry basket? It is safe to lift the laundry basket. The hardest thing to do after breast reduction is put your hands up over your head so you may not want to peg the washing on the lne for 2- 4 weeks.