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Weighing In

Dr Sawjin Tew

Very large or heavy breasts can cause the patient to suffer shoulder, neck and back pain, and excoriations under the breasts and in the shoulder areas related to bra straps. Teenagers with abnormally large breasts, women whose breasts have grown with weight gain and post-menopausal women whose breasts have sagged may desire breast reduction surgery. Large breasts tend to run in families.

How is the surgery done?
The most common technique leaves the nipple-areola complex attached to the underlying breast tissue. The excess gland, fat and skin is excised, and the nipple-areola complex repositioned higher than its original position.

The scars from the surgery are around the nipple-areola complex, which settles naturally as it is at the junction of the dark areola skin and pale breast skin. There is a vertical scar from the nipple/areola complex to the fold under the breast, which is unavoidable. Finally there is a horizontal scar along the fold under the breast, and the length of this scar can vary, depending on the amount of skin that needs to be removed.

Some women are keen to avoid scars, and are interested in liposuction as a technique. Not everyone is suitable for it and the patient will need to have realistic expectations if breast reduction is performed by liposuction.

Will it cure shoulder and back pain?

Breast reduction surgery is about comfort. Reducing the size, and therefore the weight of each breast definitely helps to relieve back and shoulder pain.

Is breast reduction permanent?

Yes, it is a permanent change in the size of the breast. Women who have had the surgery are generally happy with the smaller breasts after the surgery.
What are the risks of breast reduction? 

The risks can be grouped into general risks associated with any surgery, such as bleeding, infection, scar problems, and risks specific to breast reduction, such as asymmetry, especially if the patient starts off with breasts of different sizes, changes in nipples sensation, just to name a few. Then there are anaesthetic risks to consider.

What are the long term side effects? 

Nipple sensation will be different, sometimes it is more sensitive, sometimes less sensitive. If the patient gains or loses weight, then breast shape and size may change again, so it is best if the patient achieves a stable weight before going through breast reduction surgery.

Can women breast feed after breast reduction surgery?

Because the nipple-areola complex is still attached to the underlying breast tissue, there is no reason why women can’t breastfeed after breast reduction surgery.
Can women have mammograms after breast reduction surgery?

For the older women, a baseline mammogram before breast reduction surgery is recommended. Once recovered from the surgery, she will be able to have mammograms from about 6 months after breast reduction, to allow time for the scars to settle.

Fast facts

Cost: $4,500 to $9,500
Time in hospital: 1 to 2 nights
Time off work: 3 to 4 weeks.

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