While many believe that undergoing plastic surgery is solely for cosmetic purposes, this is not always the case. For example, breast reduction, or mammoplasty, has been developed to provide women with oversized breasts a surgical solution to rectify their discomfort.

Breast Reduction

While many believe that undergoing plastic surgery is solely for cosmetic purposes, this is not always the case. For example, breast reduction, or mammoplasty, has been developed to provide women with oversized breasts a surgical solution to rectify their discomfort. These problems can vary from chronic neck and back pains to respiratory difficulties and severe skin irritations.

Breast reduction surgery is designed to vastly improve the quality of these patients’ lives, and I find this operation one of the most gratifying cosmetic surgery procedures.

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Who Would Benefit From A Breast Reduction?

Ideal candidates for mammoplasty are women who have reached maturity and suffer from overly large painful breasts. Chronic neck and back pain experienced by women can be linked to the size and weight of their breasts. Women with severe skin irritations in the breast fold will also benefit from a breast reduction. Not only do large breasts lead to poor posture and constant discomfort but can also result in low self-esteem.

Most of these patients also experience psychological problems, and some find that the size of their breasts affects many of their normal activities in life. In most cases breast reduction isn’t performed until a woman’s breasts are fully developed, however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. We are however seeing more conscious teenagers in our practice, as they are more aware of the possibilities around having a breast reduction surgery to improve their discomfort self-esteem.

What To Expect From Your Breast Reduction?

Once you’ve undergone mammoplasty, aside from the boost in self-confidence, you won’t experience any more pain or discomfort in your back or neck. Another advantage is that certain clothing will fit you better. If you’re smaller in stature and had breasts that looked disproportionate to the rest of your body, you can expect everything to look proportional after your surgery.

The results of a mammoplasty can last for several years. Although, it’s important to know that your breasts may increase in size once again, should you gain a considerable amount of weight.

Are There Any Risks Involved?

If you’ve had your mammoplasty performed by a qualified plastic surgeon, like myself, post-op complications are rare. However, with any surgery, there is always a certain amount of risk that can be incurred both during the procedure and while you’re recovering.

Potential complications include:

  • Bleeding
  • Infection
  • Negative reactions to anaesthetic medication

It’s also possible that your breasts may not be perfectly symmetrical and nipple height may vary slightly between the two. However,  it’s worth noting that natural breasts also show some variation. It’s also rare, but not unheard of for a permanent loss of sensation to occur in both the nipple and breast tissue.

At first, scarring will be prevalent, however, over time they will fade, depending on how quickly your skin heals. Dr Nerina Wilkinson does everything she can to cause as minimal scarring as possible. In the unlikely event of damage to or loss of the nipple and/or areola, these can be reconstructed using skin grafts.



Prior to your consultation, it’s important to conduct your own research, to ensure you put your own mind at ease and know as much as possible about your procedure. Upon your initial examination, Dr Nerina Wilkinson decides on the best course of action to take based on your general health.

She discusses your desired breast size and other improvements you may want to be made during the procedure. It’s here that she will be able to give you an idea of how realistic and achievable your goals are, and advise you accordingly. She then examines, measures and photographs your breasts and take note of the size, shape, skin quality and nipple and areola placement.

During your first consultation, you’ll be asked to disclose your full medical history including conditions, drug allergies, medical treatments, current medication and previous surgery. It’s also important that you discuss the following during your consultation:

  • Weight loss – If you plan on losing a sufficient amount of weight, she may advise you to book the procedure once you’ve achieved your goal weight.
  • Pregnancy – If you’re considering having children and breastfeeding after you’ve undergone a breast reduction, it’s important to discuss this with her during your consultations. During the surgery, some of the milk ducts are removed, which might make it difficult for you to breastfeed.
  • Smoking –  you will be advised to stop smoking if you are a smoker as smoking could be detrimental to the blood supply of the nipple-areola complex that is moved during a breast reduction.
  • Mammograms – It is possible that Dr Nerina Wilkinson may recommend that you undergo a mammogram before the procedure is booked, especially in cases where there are risk factors for breast cancer such as a family history.

The preferred breast reduction technique is restricted to over-sized bosoms. Therefore, if you do not meet the criteria, you might have to opt for a different type of mammoplasty i.e mastopexy.

The entirety of a mammoplasty is usually done within two to four hours while you’re under conscious sedation and involves:

  • Incisions – The most common breast reduction technique requires three incisions. One around the areola, another from the nipple to the underside of the breast, and the final in the bottom creases. Dr Nerina Wilkinson always attempts to minimize the extent of the scars and succeed in most breast reductions to use the short scar, otherwise known as the lollipop incision  (around the areola and extending down to the breast crease.) Only in extremely large breasts would she use the traditional anchor incision that extends along the distance of the breast crease.
  • Removal and repositioning – Excess fat, glandular tissue, and skin is removed from both breasts to make them smaller and firmer. Next, the nipple-areola complex is repositioned to the desired location and, if necessary the size of the areola can be reduced for cosmetic reasons. In some cases, liposuction of the underarm region is performed to reduce excess fat deposits that tend to bulge over the bra.
  • Finishing touches – The remaining breast tissue is reshaped with internal sutures and the skin wounds are sutured with dissolvable sutures. The incisions are then covered with a light dressing, and in most cases, drainage tubes may be inserted. These will need to be removed after 2-3 days, depending on the measurements of your drainage.

Dr Nerina Wilkinson recommends that most of her patients overnight in the post-operative recovery ward, following their mammoplasty, when they’re advised to wear a surgical bra. This serves to maintain symmetry during the initial healing period. While you may experience some discomfort initially, you can expect this to decrease on a daily basis. Oral medication can be used to manage discomfort or pain. You can also expect the scars to fade between six and 18 months.

In most cases, it’s possible to resume work within two weeks, unless the nature of your job is excessively strenuous. You may also resume exercise, starting slowly, within a few weeks. It’s normal to experience periodic and mild discomfort, but severe pain must be reported immediately.

After your procedure is completed, the recovery period is projected to around 12 days, during which no strenuous activity should be undertaken. Once the time has passed and the swelling has gone down, you can enjoy not being hindered by overly large breasts.

You can resume normal sexual activity after a minimum one week period, but you’re advised to handle the breasts gently for the following six weeks. If you have any concerns or questions regarding specific activities and time frames, check with your surgeon.

If you want to do further research into what you can and can’t do after your breast reduction, consult our full recovery guide.

Dr Nerina Wilkinson has more than 18 years of experience in breast surgery and attends regular breast surgery meetings and seminars internationally and locally. She has established herself by utilizing revolutionary technology and techniques.

Contact the practice today to find out more about breast reduction surgery with Dr Nerina Wilkinson.



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The Cosmetic Surgery Team

About Dr Nerina Wilkinson FCS (Plast SA)

What sets her apart is her in-depth surgical precision and knowledge combined with a delicate artistic eye. Her philosophy is using art and science to deliver on the signature natural look.

She specialises in Breast Rejuvenation & Restoration

Dr Nerina Wilkinson is an extremely distinguished plastic surgeon and known as one of South Africa’s leading breasts specialists. Over 2 decades of surgical experience instills confidence in patients seeking minimal scar Breast rejuvenation surgery

“Firstly , thank you for the wonderful work that you and your team have done on my breasts. Thank you for the friendly Anelda and the stunning Lorna. You all have improved my life”

J.J. Cook, Breast Surgery

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