For many women, both young and old, their breasts can be problematic.
Mother Nature and particularly gravity can be quite unkind to some. Mother Nature firstly endows a woman with breasts of a very variable size. This is apparent early in a young woman’s life. Some women develop only very small breasts whilst others can develop large breasts right from the beginning of puberty. (One of my patients blames “The Boob Fairy” for this.)
Mother Nature then further affects a woman’s breast as time goes by. Pregnancy and breastfeeding can have significant impacts. Breasts obviously become larger during this period. Whilst smaller breasted girls may well enjoy this period of breast enlargement, for big breasted girls it can be very compromising. They may even struggle with being able to breastfeed. But Mother Nature is not finished there. When a mum finishes breastfeeding her breasts will change again. For small breasted women, they may well reduce back to their pre-pregnancy size, but, because of stretching of tissues during feeding they may appear to waste away somewhat (atrophy) and undergo a drop (ptosis). Large breasted women also undergo drop as their lactation wanes, but they may retain an increase in breast volume. So for some women their breasts can be a problem right from the beginning and for others can become problematic as time goes by.
The two problems we are talking about are drop and volume. Drop can be embarrassing or awkward, but it may also be a physical problem. Women can develop rashes under the breast, especially in the summer months. For those who are large breasted, the weight of their breasts adds extra difficulty in the form of shoulder neck and back pain. Physical activity can be limited and suitable bras hard to find. Weight loss can help but many women say their breast size does not reduce to any real degree.
How can we as Plastic Surgeons be of assistance?
Plastic Surgeons have been developing techniques to deal with the problems of breast drop and large breasts for many years now. At last count, there were about 30 techniques which have been used. In short they rely on tightening the skin and lifting the breast tissue. Where necessary, the volume of breast tissue is also reduced. For many women, these operations have been life-changing.
The simplest of methods is Liposuction. Liposuction primarily removes fat from the breast. In doing so it will reduce the volume of and, therefore, the weight of your breasts. It is a compromise, however, as the volume of the reduction is much less than in the other operations which involve cutting tissue away. I always consider it in young women as it does not cause scarring on the breast, it does not reduce nipple sensation and it does not compromise breast feeding. Because it reduces the weight of the breast, the breast may lift a little as well. This does rely on the skin and breast tissue having good elasticity however and it only suits a limited number of women.
Surgical breast lifting and the other forms of breast reduction involve cutting the tissues.
In breast lift operations, the skin is cut away und sewn back together to lift and tighten your breast. In many cases your breast tissue is also operated on to lift it and reposition it on your chest.
In breast reduction operations, the same techniques may be used, but in these cases some of your breast tissue is removed. Once again your breast tissue is lifted on your chest wall and your skin tailored to a tighter fit.
These operations change your breasts to a pert shape which is higher, tighter and more comfortable.
Many women ask if a breast augmentation is necessary as part of their lift. I believe, if you have enough of your own breast tissue, you should avoid it. Indeed, if you have significant breast drop, you will probably be best to have a breast lift first and consider having a breast augmentation at a second operation later on. Many women, who initially think they need a breast augmentation, are quite delighted by the lift alone and don’t want an augmentation once their breasts are lifted.
Breast lift and/or reduction are complex operations and you must understand this. Some operations will take two or more hours. Although complications are rare, they can occur and you must discuss them with your surgeon. You must not smoke for a period before and after your operation. Your recovery will depend on the extent of your surgery. Liposuction is quite quick, but more extensive procedures naturally take longer. I suggest you think four weeks off work and longer if your work is moderately physical.
As to whether the surgery is rebatable, that will depend on your symptoms, situation and examination findings fitting into the Medicare criteria.
Breast surgery is a major part of my practice. I have to say it is also extremely gratifying, because so many women are so happy after their surgery. So if your breasts are presenting you with problems, talk to a Plastic Surgeon about whether Plastic Surgery has anything to offer to improve your situation.