BREAST Reduction
Professor Mark Ashton
MB., BS. MD. FRACS (Plas)
Specialist Plastic Surgeon
Professor Mark Ashton is a Melbourne-based plastic surgeon who specialises in breast reduction procedures. He is chair of plastic and reconstructive surgery at Epworth Freemasons Hospital, and former head of plastic and reconstructive surgery at Royal Melbourne Hospital (2001 – 2016) and Royal Women’s Hospital (2000 – 2016).
The following information is designed to help you understand our process for breast reduction surgery, including assessment and suitability, and will emphasise essential information to consider before proceeding with surgery.
AHPRA registration number – MED0001135718
WHAT IS BREAST REDUCTION SURGERY?
Breast reduction surgery, also known as reduction mammoplasty, removes excess fat, breast tissue and skin from the breasts. This surgical procedure is performed to reduce the size and weight of overly large breasts, while also addressing asymmetry, sagging and nipple position.
Breast reduction surgery is commonly sought after by people who experience physical discomfort or pain due to excessively large breasts, medically termed macromastia or breast hypertrophy.
CONSULTATIONs
Our aim is to provide a comprehensive, informative and personalised patient experience. During the initial consultation process, you will have the opportunity to meet Prof Ashton, our dedicated nursing and administration staff, and our practice manager.
We encourage every patient to seek a second opinion with a qualified specialist plastic surgeon, before proceeding with any surgical procedures.
INITIAL CONSULTATION
Your initial consultation with Prof Ashton will require a valid referral from your general practitioner (GP), or other qualified healthcare provider. It is preferable that your referral is from your usual GP, as they will ensure all relevant medical history is included in your referral.
During your consultation, you and Prof Ashton will discuss your treatment objectives, and with your written consent, clinical photos will likely be taken for medical purposes. Prof Ashton will assess your medical history to ensure that all suitable and relevant treatment options are thoroughly discussed with you.
Our nursing staff and practice manager will also provide additional information regarding the procedure discussed, to ensure you are well-informed and you understand your choices. You will be afforded adequate opportunity to address any remaining questions prior to leaving our rooms, we are always happy to answer questions you may have.
SECOND CONSULTATION
After having reviewed the information provided to you during your initial consultation, if you decide to progress with your surgery, you will then have a second consultation with Prof Ashton for further discussion. During your second appointment, you will also meet with one of our nurses again to discuss the necessary surgical documentation, including the initial preoperative and postoperative care instructions.
Whilst you may be enthusiastic to schedule your surgery as soon as possible following your second consultation, if your procedure is determined as purely cosmetic – thus not eligible for an item number, there is a mandatory 7-day cooling off period in accordance with the current AHPRA guidelines. Following this cooling off period, you will have the ability to secure a surgical date and pay the required deposit.
COMMUNICATION
Communication is one of the most important aspects of your breast reduction consultation process and surgical planning. It allows you and your surgeon the ability to ensure your concerns and the related surgical options have been adequately discussed.
Our bodies are all unique and no two people will have the same results. In our practice, we find most patients invariably have a pre-determined result in mind. Therefore, it is critical you are always afforded a platform to openly and clearly communicate with your plastic surgeon, to ensure they understand the results you are hoping to achieve, prior to your surgery.
We find one of the most effective tools to communicate your wishes is via images. We encourage you to bring screenshots or photos to your initial consultation to articulate this.
WHAT YOU MUST KNOW BEFORE CONSIDERING BREAST REDUCTION SURGERY
POTENTIAL RISKS
It is important to understand the risks involved with any surgery. The choice to undergo any surgical procedure, elective or urgent, should be based on the comparison of the potential risks to the potential benefits. Although most patients do not experience severe surgical complications, you must always discuss the risks versus the benefits with your surgeon, to ensure you understand all the possible consequences of your planned surgery.
There are risks associated with any surgery, and a breast reduction is not immune to these risks. Some risks are common to all forms of plastic surgery, and others are specific to breast reduction surgery. If any complications arise, it may be necessary to bring you back to theatre to address and resolve these concerns.
Some of the potential risks relating to breast reduction surgery are:
- Differences in the symmetry between the right and left sides of the breasts
- Wound breakdown and slow healing
- Seroma – the build-up of inflammatory fluid
- Haematoma – a collection of blood
- Nipple Ischaemia
FURTHER RISKS
INFECTION
The risk of infection can occur despite using antibiotics in the post-operative period. It appears to be more common in patients who continue to smoke post operatively, or who have comorbidities such as diabetes. There are other specific risks associated with surgery that you should always discuss with your surgeon prior to consenting to any surgery.
GENERAL ANAESTHESIA
General anaesthesia is commonly used, however, there is an array of potential complications which can occur during or after general anaesthesia. These complications can be as major as death or brain damage, or as minor as muscle soreness or pain at the site of your cannula. The most common complications are nausea, vomiting and sore throats, and all specialist anaesthetists are trained to avoid and manage complications as they arise.
One of our anaesthetists will be in contact with you the week prior to your surgery to confirm your health status, and answer any questions you may have regarding the anaesthetic and post operative pain management.
SMOKING
As cigarette smoke constricts the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems. In particular, smokers are much more likely to develop wound breakdown and infection. For this reason, it is critical to stop smoking 2 weeks prior to surgery and for 6 weeks postoperatively.
DEEP VENOUS THROMBOSIS AND PULMONARY EMBOLISM
During surgery, there is a risk that blood may accumulate in the veins of the lower legs. Post-surgery, these clots can dislodge from the vein walls of the calves and travel to the lungs, resulting in problems with breathing or even death.
Some medications can increase the risk of deep venous thrombosis. It is essential you discuss your current medications with your surgeon and your anaesthetist prior to surgery.
Please be aware this is not an exhaustive list of potential risks. Every patient responds differently to general anaesthesia and surgery. Please ensure you always discuss the surgical risks with your surgeon prior to moving forward with any surgery.
IF I DECIDE TO PROCEED, WHAT CAN I EXPECT WHEN I UNDERGO BREAST REDUCTION SURGERY?
HOSPITAL AND ADMISSION
We perform all our surgeries at Epworth Freemasons Private Hospital in East Melbourne.
Each of our patients have a private room with an ensuite, and at Epworth Freemasons there are 12 state-of-the-art operating theatres with the latest anaesthetic machines and theatre equipment. There is also 24 hour onsite medical emergency care, with an onsite Intensive Care Unit.
You will need to fast prior to your surgery, usually from midnight the night prior. Your admission paperwork will be provided to you a minimum of 3 to 4 weeks prior to your operation so that any questions you may have can be answered well before your admission.
SURGICAL PROCEDURE
Breast reduction surgery is only performed on our patients by Professor Ashton, a qualified specialist plastic surgeon, and is carried out under the administration of general anaesthesia by one of our accredited specialist anaesthetists.
In addition to your general anaesthesia, local anaesthetic is infiltrated to the breast tissue, which aids in minimising blood loss,
POSTOPERATIVE CARE
Following breast reduction surgery, you will spend time in the Post Anaesthetic Recovery Unit until you are wide awake and your pain is adequately managed, at which time you will be transferred to your room for the night.
You will be reviewed by Prof Ashton prior to being discharged from hospital, and the nursing staff will ensure your dressings are intact, and your discharge medications, usually antibiotics and pain medications, are ready for you.
You will be provided an information bag to take home which contains our after hours details, as well as the dates and times for your follow up appointments with our nursing team and Prof Ashton. During your post-operative period, we will monitor your recovery and progress, and provide precise guidance on the level of activity or exercise you should engage with during your recovery.
Recognising each patient’s healing process is unique, our post-surgical care is tailored to accommodate individual needs. We will address any concerns you or we may have, and you will receive thorough post-surgical care from Prof Ashton and our dedicated team throughout your recovery.
BREAST REDUCTION MELBOURNE
COMMON REASONS PEOPLE CONSIDER BREAST REDUCTION SURGERY:
- Back, neck and shoulder pain due to the weight of the breasts
- Difficulty in finding clothing that accommodates large breasts
- Shoulder indentations from bra straps
- Skin irritation in the crease below the breasts
- Limited or restricted daily activities and exercise due to large breasts
WHAT IS INVOLVED WITH BREAST REDUCTION SURGERY
Breast reduction surgery takes between 90 to 150 minutes depending on the size of the breasts. All incisions are sutured with dissolving stitches which don’t require removal. Fine, soft drains are placed in your breasts for 24 to 48 hours post operatively, and are usually removed prior to leaving hospital.
The breast tissue removed will be weighed and sent for histopathological testing. The results of the tissue testing will be provided at your post-operative appointment.
RECOVERY FROM BREAST REDUCTION SURGERY
We encourage you to rest, and have recognised from our experience, patients who are able to take this time to rest for the initial few weeks following breast reduction surgery, are more likely to experience less complications.
It is critically important that you involve a support person such as your partner, close friend, or a family member, in your recovery process. You will need someone to assist you with your children, to do the washing, meal preparation, shopping and errands around home. Your total recovery time is dependent upon this support.
RETURNING TO WORK AFTER BREAST REDUCTION SURGERY
If you have a job which is not physically demanding, or a role in which you are able to minimise your contact hours, most patients are able to return to work within 4 weeks. However, this varies depending on the physicality of your employment, which we will discuss with you at length prior to your surgery.
THINGS YOU SHOULD KNOW ABOUT BREAST REDUCTION SURGERY
- BREAST CANCER DETECTION
Although breast reduction surgery does not alter your risk of developing breast cancer, we may recommend having a mammogram prior to your breast reduction surgery. We will discuss this with you in detail during our consultations.
- NIPPLE SENSATION
Your nipple and areola sensation may change after surgery. Most commonly, your nipple/areola sensation may increase for a period of 6 to 8 weeks. Alternatively, one or both of your nipples may have decreased sensation. Usually by 2 to 3 months following breast reduction surgery, your nipple sensation will have returned to normal.
BREAST REDUCTION FAQ
WHAT IS INVOLVED - CAN YOU LIFT MY BREASTS AS WELL?
Yes. Breast reduction allows us to reduce the size of your breasts, lift you breasts and make your areolae smaller.
HOW LONG DOES IT TAKE?
Breast reduction surgery usually takes between 90 minutes and 150 minutes.
DO I NEED TO STAY IN HOSPITAL?
You would usually stay in hospital for one night after surgery, going home the following day after being reviewed by Professor Ashton.
WHAT SCARS WILL I HAVE?
Do you use the lollipop technique? Yes. The older anchor or “wise pattern” scar technique is not commonly used anymore, unless your breasts are excessively large.
HOW MUCH TIME SHOULD I TAKE OFF WORK?
You should take a minimum of 2 weeks off work and avoid exercise for 6 weeks.
CAN I SHOWER AFTER SURGERY?
You must keep the dressings clean and dry until your post-operative appointment with our practice nurse, who will check your incisions and advise you further.
WHEN DO I WEAR A BRA?
Once we confirm you are healing as expected, one of our nurses with fit you for a bra.
CAN I BREAST FEED AFTER SURGERY?
Most women are able to breastfeed following breast reduction surgery, due to the surgical techniques in which the nipple-areola complex remains attached to the underlying tissue and blood supply during surgery.
IS BREAST REDUCTION COVERED BY MY HEALTH FUND?
You may be eligible for an item number for your breast reduction surgery. Applicability is determined during assessment by Prof Ashton.
If an item number is applicable and you have private health insurance, your hospital related costs may be covered, and you may also receive a rebate from Medicare. Please be aware, you will still have out of pocked costs associated with your surgery.
Interested In Breast Reduction Surgery?
