Written by Dr. Nerina Wilkinson – Plastic Surgeon
In my practice, the most common reasons for patients wanting breast surgery are cosmetic reasons, for example, to increase their breast size (breast augmentations) or to enhance the appearance of sagging breasts (breast lifts). However, there is a large proportion of women who receive cosmetic breast surgery for corrective reasons. These patients are those with overly large breasts requesting a reduction of their breast size to improve associated medical conditions of back and shoulder pain as well as painful breasts.
Table of contents:
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- SMALLER BREASTS CAN BE LIFE-CHANGING
- WHAT IS THE NEW SHORT SCAR BREAST REDUCTION?
- WHO IS A GOOD CANDIDATE FOR BREAST REDUCTION SURGERY?
- AT WHAT AGE CAN ONE HAVE SHORT SCAR BREAST REDUCTION SURGERY?
- SHORT SCAR BREAST REDUCTION: FROM CONSULTATION TO RECOVERY
- WHICH PROCEDURES ARE INCLUDED IN A SHORT SCAR BREAST REDUCTION SURGERY?
- DOES A SHORT SCAR BREAST REDUCTION LEAVE SCARS?
- BREASTFEEDING AFTER BREAST REDUCTION SURGERY
- WILL I STILL HAVE NIPPLE SENSATION AFTER BREAST REDUCTION SURGERY?
- WILL EXERCISING BE EASIER AFTER BREAST REDUCTION SURGERY?
- CAN BREASTS “GROW BACK “AFTER BREAST REDUCTION SURGERY?
- CAN BREAST REDUCTION SURGERY IMPROVE MY SELF-ESTEEM?
Smaller breasts can be lifechanging
As much as some of us ladies (who were not given the gift of a bountiful bosom) often wish to have more volume and cleavage, most women with overly large breasts struggle to have a “love” for their breasts due to the challenges of the discomfort associated with this.
For this reason, I am seeing an increasing number of young patients requesting breast reduction surgery, not wanting to wait until they are older to become more comfortable in their bodies. I remember a lovely patient of mine who underwent breast reduction surgery when she was 75 years old. Her relief after the surgery was life-changing and her message to me was “I wish I had achieved the confidence I have now 50 years ago”.
Cosmetic surgery is not about creating a “different look”, cosmetic surgery is about creating harmony, and breast reduction surgery is one of the cosmetic procedures that truly creates a more harmonic appearance in many patients.
What is the new short scar breast reduction?
A traditional breast reduction is typically done using a large “anchor”-type incision which goes around the nipple, up and down on the breast, and across the entire bottom of the breast. The scar across the bottom of the breast is most noticeable in clothes – it may be visible in the cleavage area with a low V-neck shirt or gown, or on the sides of the breasts in a bikini.
The new short scar breast reduction (also known as the lollipop technique) is more than just a change in the scar. It is a change in the philosophy of how breast reduction is performed. Rather than using the skin to hold up the breast, the breast tissue is completely remodelled, creating an internal bra so that the breast sits in a higher position without the help of the skin. The breast tissue that remains is never disconnected from the nipple, which optimizes the possibility of breastfeeding in the future. Breasts without stretch marks and with good skin elasticity are perfect for lollipop scars.
Who is a good candidate for breast reduction surgery?
Any healthy patient wanting smaller, firmer breasts is a good candidate for breast reduction surgery. For most patients, breast reduction surgery is a truly life-changing procedure! One of my younger breast reduction surgery patients recently said to me, “Being able to wear string tops and finding a swimming costume that is classified as pretty and not functional was the best gift ever“.
You are a candidate for a short scar breast reduction if:
- You have reached maturity and suffer from large painful breasts that contribute to poor posture.
- You suffer from chronic neck and back pain due to the size of your breasts.
- You experience skin rashes in the fold under your breasts.
- Your breasts restrict normal and sporting activities in your life.
At what age can one have short scar breast reduction surgery?
In most cases breast reduction isn’t performed until a woman’s breasts are fully developed which is usually around the age of 21, however, it can be done earlier if large breasts are causing serious physical discomfort. In my practice I see many patients younger than 20 years old requesting a short scar breast reduction.
The best candidates for breast reduction surgery are those who are mature enough to fully understand the procedure and have realistic expectations about the results and the possibility of visible scars. We are however seeing more conscious teenagers in our practice, as they are more aware of the possibilities around having breast reduction surgery to improve their discomfort and self-esteem.
Short scar breast reduction surgery: from consultation to recovery
Most patients will consult me 2-3 times before their final breast reduction surgery day. We ensure each patient has ample time to discuss and plan the size/shape of their breasts, incisions/scars, and the possible side effects associated with surgery.
Breast reduction surgery is then performed at The Cosmetic Surgery Institute under conscious sedation. I recommend for comfort that my patients spend a night under specialized nursing care in the postoperative recovery unit. Recovery is usually uneventful with follow-ups to remove drains and sutures during the 10 days postoperative.
After breast reduction surgery, you’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and about within 12 to 24 hours. Most of your discomfort can be controlled by the medication prescribed. Within 2 – 4 days, the Elastoplast dressings and drainage pipes will be removed, and you will start to wear a surgical bra supplied by us; you should wear it 24 hours a day for 6 weeks.
You may also experience a burning sensation in your nipples for about two weeks, but this will subside as the bruising fades. Although the stitches are dissolving there will be 4 little knots that need to be removed 10 – 14 days after surgery, but the swelling in your breasts may take four to 6 weeks to disappear. Your final breast shape will only be determined after 3 months.
Which procedures are included in short scar breast reduction surgery?
Breast reduction surgery removes fat, glandular breast tissue, and skin from the breasts, making them smaller, lighter, and firmer. Liposuction is performed to reduce the excess tissue that often extends to under the armpits. During a breast reduction, we can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to achieve smaller, naturally-shaped breasts which are in proportion to the rest of the body.
Does a short scar breast reduction leave scars?
The expectation from many patients is often that there will be a scarless result. The reality is that every person heals uniquely, depending on many factors (including genetics). Even though a short scar breast reduction makes use of techniques to reduce the size of the scar, it will still leave a scar. It will, however, be a much shorter one than with the traditional inverted T-scar used in older breast reduction surgery techniques.
At first, the scar will be slightly raised, and the skin will be discoloured. Once it has healed, the scar will flatten and change colour. Most scars will mature over 3 – 6 months post-surgery and fade over time. It can take almost a year post-surgery for scars to completely fade and soften.
While it may not be possible to prevent the scars, there are steps a person can take to help prevent the development of raised scars or keloid scars. All my patients are placed on a strict scar management protocol to assist with the healing process and improve the resultant scar which, in most of my patients, becomes a thin line.
Breastfeeding after breast reduction surgery
Large research studies have shown that nearly 90% of women are able to breastfeed after a breast reduction surgery. In my practice too, most patients have had good success with breastfeeding after a short scar breast reduction. It is important to remember, however, that there is no guarantee that a breast reduction patient will be able to breastfeed after surgery, so if this is extremely important to you, you should have this discussion with your surgeon before proceeding with surgery.
Do you lose nipple sensation after breast surgery?
A change in nipple sensitivity is always a consideration for many of my patients undergoing a short scar breast reduction procedure. It is vital for me to understand how important nipple sensation is to each individual patient. I have found that generally, most patients are not too concerned about the impact on the sensation of their nipples as they are more concerned about the discomfort, they are experiencing from having overly large breasts. Statistically, a recent study has shown that on average, 19% of patients experienced a reduction in sensation, and 7.3% experienced an increase in sensation.
Will exercise be easier after breast reduction surgery?
It definitely will, and we see it all the time! A 2018 study published in the Journal of Science and Medicine in Sport showed that people with large or hypertrophic (excessively large) breasts don’t exercise as much or with as much intensity as people with small- and medium-sized breasts due to the size of their breasts.
What I love to see is patients returning for their 6 monthly surgery follow-ups dressed in active wear sporting their newer slimmer shape due to the fact that they are able to exercise with greater ease after a short scar breast reduction surgery.
Can breasts “grow back” after mammoplasty?
Since breasts are partly made up of fat tissue, it makes sense that if there is weight gain after breast reduction surgery, you’ll see an increase in your bra size. On the other hand, if you plan on losing a significant amount of weight, it is best to delay your surgery until you are able to achieve your desired weight. This will ensure that there are not too many fluctuations in breast size once the surgery has been completed.
Hormonal changes are also known to affect the size of your breasts either by stimulating the breast tissue to increase, resulting in larger breasts. In other patients, breast tissue diminishes with ageing and hormonal changes (often an effect of the contraceptive pill or other hormonal supplements). When consulting my patients, it is important for me to understand the hormonal changes and phases my patients are in to determine the ideal way to proceed with breast reduction surgery in order to achieve the best results.
Can breast reduction surgery improve my self-esteem?
The breast certainly symbolizes femininity and is closely linked to a patient’s self-esteem. As a woman develops, her breasts become a symbol of sexuality and are often seen as an organ of female power. I therefore definitely see a transformation in most of my patients after breast reduction surgery, leaving them more confident in their personal and often also their professional lives.
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