Macromastia
“Breast reduction surgery is one of the most fulfilling operations for me to perform as a surgeon. I may recommend it as part of treatment for breast cancer or to address macromastia symptoms.”
- Dr Ben Green
“While cosmesis is a huge consideration for breast reduction surgery, my primary concern is about improving function and quality of life.”
- Dr Beth Campbell
What is Macromastia?
Macromastia, or breast hypertrophy, is a condition characterized by excessively large breasts. It can cause physical discomfort and emotional distress. Women with macromastia often experience a variety of symptoms, including:
Physical Symptoms:
Chronic neck, shoulder, and back pain.
Posture problems and difficulty standing upright.
Grooves or indentations from bra straps due to the weight of the breasts.
Skin irritation or infections beneath the breast folds.
Difficulty with physical activities or exercise due to breast size.
Emotional Impact:
Feelings of self-consciousness or embarrassment.
Difficulty finding well-fitting clothes or bras.
Social or psychological stress related to body image.
What is Breast Reduction Surgery?
Breast reduction surgery, also called reduction mammoplasty, is a surgical procedure designed to reduce the size and weight of large breasts. This surgery not only improves physical symptoms but can also enhance the shape and proportion of the breasts, providing a more balanced appearance.
Who is a Candidate for Breast Reduction?
You may be a good candidate for breast reduction surgery if:
You have chronic pain or discomfort due to the size of your breasts.
Your large breasts limit your physical activity or make exercise difficult.
You experience skin irritation or infection beneath your breasts.
Your breast size causes emotional distress or affects your quality of life.
You have realistic expectations about the outcome of the surgery.
A breast reduction is suitable for breasts that are excessively large:
As the breast enlarges they usually drop and develop ptosis. Ptosis is the technical name for drooping of the breast. The degree of ptosis is measured on how far the breast sits below the infra-mammary fold (IMF). The IMF is the the line at the bottom of the breast where the breast lifts off the chest wall. Once the breast has fallen below this line you have ptosis. To obtain a Medicare rebate over 60% of the breast must be below this line.
Typically a lady considering a breast reduction has a large breast volume referred to as macromastia. Cup size above a D-cup are usually considered for a breast reduction. Please note that cup size is not uniform and no one cup size is a minimum for a breast reduction. If you feel your breast are excessively large and causing back and neck pain a breast reduction may be of benefit.
Who is suitable for a breast reduction?
A breast reduction is suitable for any patient who has a large breast volume that results in impairment to your quality of life. Large breasts can be very debilitating. The excess breast weight can result in significant back and neck pain. The larger breast volume can also impact on a lady’s ability to exercise resulting in weight gain and a general decline in fitness.
A breast reduction is not a cosmetic procedure if being performed for the reasons above. There are strict criteria that need to be met for a Medicare refundable breast reduction. These criteria for a breast reduction are listed below:
The criteria for a Medicare and health fund rebate are listed below - MBS Item No 45523
You must have a referral form your General Practitioner;
You must have had documented issues with back and neck pain or skin infections under the breast. These must be stated in the GP referral;
More than 60% of the breast volume must lay below the infra-mammary fold;
The nipple must be at the most dependant (lowest) aspect of the breast.
Breast reduction surgery may also be offered as an oncoplastic procedure in the setting of cancer or a breast lesion. This is referred to as a ‘therapeutic mammoplasty’ or reduction.
The Breast Reduction Procedure
Consultation: During your initial consultation, your surgeon will evaluate your breast size, shape, and overall health. They will also discuss your goals and expectations for the surgery. Preoperative photos will be taken.
Surgery:
The procedure is performed under general anesthesia and usually takes 2 to 4 hours.
The surgeon removes excess breast tissue, fat, and skin to reduce breast size.
The nipple and areola may be repositioned to achieve a more natural appearance.
What scars are involved in a breast reduction?
A breast reduction requires both removal of excess breast tissue and the surrounding breast skin. The usual pattern of a breast reduction is called a Wise Pattern or an ‘Anchor’ pattern. Whilst this does result in longer scars it allows control of the shape.
Many patients with enlarged breast have also developed enlarged/widened nipple areolar complexes. As part of the reduction the nipple is raised (mastopexy) into a higher more natural position and reduced to a size that matches the smaller volume.
The important thing to remember when it comes to scars is they will fade. Wide or raised scarring can always be corrected. Unfortunately, a poor shape is much more difficult to correct. With that in mind a breast reduction will usually favour larger scars for an improved appearance of the breast.
Recovery:
After surgery, your breasts will be bandaged, and you may have drains to remove excess fluid.
You will need to wear a special supportive bra during the healing process.
Most patients return to work and light activities within 1 to 2 weeks, but full recovery may take 4 to 6 weeks.
Scarring is a natural part of the healing process, but scars will fade over time and can be minimized with proper care.
Benefits of Breast Reduction Surgery
Relief from chronic pain in the neck, shoulders, and back.
Improved posture and the ability to engage in physical activities.
Reduction in skin irritation or infections beneath the breasts.
Enhanced self-confidence and body image.
Easier time finding clothes that fit properly.
Risks and Complications
Like any surgery, breast reduction carries risks, including:
Scarring, which is permanent but usually fades over time.
Changes in nipple or breast sensation (which may be temporary or permanent).
Breast asymmetry or irregularities in shape.
Problems with wound healing or infection.
Potential difficulty breastfeeding in the future.
Frequently Asked Questions
Will I need to stay in the hospital?
Breast reduction surgery usually involves a night or two in hospital.
How much smaller will my breasts be?
The amount of tissue removed varies depending on your body frame and desired breast size. Your surgeon will work with you to determine the appropriate reduction for a balanced, proportional look.
Will my insurance cover breast reduction surgery?
If macromastia is causing significant health problems, such as chronic pain or skin infections, medicare and many insurance companies may cover the procedure. However, coverage varies by provider and policy. Documentation of your symptoms and preoperative photos may be required for approval. There is often an out of pocket cost associated with the surgery.
When will I see the final results?
Initial results are visible soon after surgery, but swelling will take time to subside. Final results can be seen within a few months as your breasts settle into their new shape.
Conclusion
Breast reduction surgery offers significant relief for women suffering from the physical and emotional challenges of macromastia. It can improve your quality of life by alleviating pain and restoring confidence in your appearance. If you believe breast reduction surgery might be right for you, schedule a consultation with a surgeon to discuss your options.