Breathe a Sigh of Relief
Not all women think having large breasts makes them more attractive. In fact, many women are eager to reduce the size of their breasts for a variety of reasons.
Reasons for treatment
- to ease the discomfort of heavy breasts
- improve posture and or back and neck pain
- to ease the anxiety, and in some cases embarrassment of heavy, big breasts
- for many women, just the thought of squeezing into tight clothing, dancing or playing sports can be a nightmare
Typically, women who seek a breast reduction are concerned about the effects the excess weight of their breasts will have on their upper body.
Treatment Options
Until recently, the only method of breast reduction available was a surgical procedure called Mammoplasty. This procedure involves cutting out a section of the breast, repositioning the nipple and elevating the whole breast. A mammoplasty involves undergoing major surgery that could take several hours and hospitalisation for several days. There is extensive recuperation, significant discomfort including bruising and pain, extensive scarring and risk of infection. The loss of nipple sensation can occur due to relocation and breast-feeding is usually not possible following a mammoplasty. However the advantages of a mammoplasty are that it is a reliable and more precise means of reducing the breast size, a more youthful shape can be obtained and it may sometimes be the only option for women with fibrous breasts.
Tumescent Liposuction is now a proven means for reducing breast size. Tumescent liposuction safely reduces breast size a few cup sizes (depending on fat content) with almost no visible scarring. Extremely small and thin micro cannulae are used for less trauma and smoother results. Breast Liposuction is a day procedure which has a faster recovery period than the more conventional mammoplasty. Bruising and swelling are present for approximately two weeks and lumpiness can persist for some months, however as the lumps are absorbed the breast size shrinks.
The Procedure
- the procedure is performed under sedation at an accredited day hospital
- the breasts are marked into sections with a marking pen.
- small incisions (about 0.5mm) are made in the crease of the breast base.
- tumescent fluid is infused into the breasts then gently sucked out with the fat through very fine micro cannulae. Dressings are applied to the tiny holes after the procedure.
- the procedure takes approximately 1.5 to 2 hours depending on breast size
- patients are discharged on the same day but have a nurse phone number for 24-hour support
- all patients are reviewed the following day at the clinic
Prior To Treatment
Tumescent Breast Liposuction Pre Operative Tests and Information
- Prior to surgery, a mammogram of the breast is requested. Dr Rich specifically requests the radiologist to define what percentage of fat within the breasts, in comparison to breast tissue, whilst also checking the breast for any abnormalities.
- Government funded breast screen xray is not sufficient for this information
- The breast size is measured through a dip test which involves immersing the breast in a vessel of water and measuring the amount of water displaced.
- A full history is taken to ascertain whether there is a risk or history of breast cancer, such patients will be referred to a specialist breast surgeon for assessment.
- Routine blood tests are taken and a breast examination is given by a doctor here at the clinic.
- Routine antibiotics are given prophylactically.
- It is important that both the patient and Dr Rich are sure of what is achievable and desirable.
- Breast liposuction can reduce breast size between one third and one half of the patients’ current size. Evidence has shown that older patients usually have larger amounts of fat in their breasts and therefore their size can be reduced to a greater degree. The amount of fat removed varies from about 200mls-1200mls of fat per breast and it is important that the patient and Dr Rich discuss the desired outcome in detail before the procedure.
- Larger breasts often have a fat pad, which continues under the arm, this can be also be removed at the same time. As the nipple is not repositioned as in mammoplasty (the surgical technique), the breast shape does not change. However, elevation of the breast usually occurs due to the weight and size of the breast being reduced. Studies in America have shown that the average nipple elevation following breast liposuction was 3.8cm with a maximum of 8cm. There is more elevation through the surgical alternative.
Recovery Process
It is essential that a compression garment is worn for two to four weeks following the procedure as instructed by Dr Rich. Tenderness, swelling and bruising around the breasts is normal and usually lasts two or more weeks. Because the tiny holes are left open it is normal for the tumescent fluid and a light staining of blood to seep from the holes for the first 24 – 49 hours following the procedure. These small nicks heal quickly and are virtually undetectable over time
Considerations
A major issue with both types of breast reduction is whether changes may occur in future mammograms, confusing scars from surgery with early detection of breast cancer. This is still under investigation, although studies in America have shown no long-term effects after six months. For this reason, we recommend repeating the mammogram six months after the procedure. This will give us an indication of changes and will become a guide for the patient’s future mammograms.
It is important to note that breast reduction by liposuction in women is a very new procedure and still in its developmental stage. As such, it is difficult to give guarantees as to the exact outcome of each procedure.
Risks And Complications
It is normal have a certain amount of bruising, swelling and pain following breast liposuction. The tumescent method of liposuction minimises these side effects and reduces the risk of infection due to the antibacterial action of the tumescent fluid used. All patients commence antibiotics prior to surgery to also minimise the risk of infection.
No guarantee can be given to the extent of skin contraction or nipple elevation each patient could expect. Or in fact to the sensation to the nipple, which may, or may not be altered. Long-term study results are not yet available however to date this has not been an issue. For larger, pendulous breasts, it may be necessary to have a second procedure or surgical intervention.
FAQs
What is the recovery time after a breast reduction via tumescent liposuction?
Most patients are back at work within a few days or a week of their procedure due to the less traumatic nature of the procedure compared with major surgery involved in a mammoplasty.
What is tumescent fluid?
Tumescent fluid is sterile saline solution, which is infused into the treatment areas. It contains a local anaesthetic, a vasoconstrictor and sodium bicarbonate. The local anaesthetic makes the breasts numb while the vasoconstrictor shuts off the small blood vessels in the fat layer to reduce bleeding. The sodium bicarbonate acts as an antibacterial, as well as breaking down the fat.
Will there be scarring?
Scarring is not significant with breast liposuction due to the tiny incisions made. These small nicks heal quickly and are virtually undetectable over time.
