Physical & Psychological Relief

Reduction Mammoplasty, commonly referred to as breast reduction, is probably one of the oldest procedures that have been sought by female patients to improve their shape. While many procedures were developed in the 1930s to reduce breasts, great strides were made in the 1960s and 1970s in improving the results with the most common procedures using the ‘anchor-shaped incision’. In the 90s, however, developments in reduction techniques have focused on creating the results with less scarring than was formerly necessary and acceptable.

The procedure basically consists of three major components:

1. Reducing the size of the breasts.
2. Creating nicely shaped breasts.
3. Reducing the size of the nipple and raising it to the normal position.

Who is a Candidate?

The basic problems that patients with large breasts (greater than size D or DD size) have are back strain, possible notching of their shoulders, a rash underneath their breasts and eventually a curvature of the spine, especially when they reach menopause.

There are 3 common age groups seeking breast reduction. These are younger women aged 16 to 25 years, women aged 35-45 years who have finished having their families and older women who gain weight after the menopause.

BEFORE

AFTER
breast reduction by Dr Hodgkinson

Newer Techniques Reduce Scarring

During the 1990s, the trend has been to even further reduce the amount of scarring from breast reduction surgery. This has been aided significantly by the use of liposuction to remove some of the tissues (in young women for example, 50% of breast tissue is actually fat) and then to reduce the skin thus reducing the size of the scars. The procedure, which has been championed by the European and South American surgeons in particular, is the “peri-areolar approach” which means around the nipple.

This procedure can only be used for breasts that require a reduction of up to half a kilogram each; hence reducing a breast from a D to a C and where the nipple only needs to be raised approximately 6 centimetres. It is an excellent procedure, reducing the scarring to just around the nipple without the traditional anchor shaped scars which actually run vertical and horizontal in the crease underneath the breasts.

In a very large breast, however, the vertical and horizontal scars still need to be used. But in the smaller breast reductions, the vertical and horizontal scars are completely discarded leaving only the peri-areolar incision. I, personally, have been working with this technique for the last 10 years and find it an extremely gratifying procedure for both the patient and surgeon. It is always my goal as a cosmetic surgeon to perform all surgery with the minimum amount of scarring possible.

Certainly, breast reduction is a very popular procedure – I perform about 75 breast reductions per year as opposed to about 175 breast augmentations. The breasts can still be left functional by maintaining the duct tissue to the nipple. The nipple is not cut off, as some people think – and by the newer techniques, women still have the possibility of breast feeding after the procedure.

Dr Darryl Hodgkinson