The happiest group of patients I operate on are breast reduction patients, and this is also the most frequent operation I do.
Although large breasts may have appeal initially, this is soon overcome by the reality of neck, shoulder and back pain; bra straps cutting into shoulders; repeated and frequent headaches; sweating and rashes under the breasts; difficulties in exercising and playing sport; not being able to find bras that fit, support and don’t cost a fortune; fashionable clothing not fitting.
Over the last 20 years, I have done breast reductions for patients aged 15 to 78, with a level of satisfaction not matched by any other procedure. It is an operation where the likelihood of positive benefits is very high, and the possibility of significant adverse events is very low. I am still impressed by young breast reduction patients who seem little worried by the scarring associated with the surgery, but are thrilled with the functional and cosmetic benefits of the operation, which allows them to fit in with their peers with regards to sports, activities and fashion.
When I was a young surgeon it was standard dictum to encourage patients to first lose weight, and then have the surgery. Nearly all breast reduction patients, except for some young teenagers, are normal females and have been trying to lose weight at some point. My patients have had far more success at weight loss with me first doing the breast reduction, and then them losing the weight. I think two things happen. Firstly, after the breast reduction, the patient feels much better about themselves. The breast reduction has been a line in the sand. They like what they see in the mirror and now clothes fit, and this is a very positive, energising and motivating turning point. Secondly, they are now in a physical state where they can do more meaningful exercise (and enjoy it) and burn more calories, so that hard dieting is not the only approach open to them for weight loss. As one of my patients said, “I now wear a bra as a fashion accessory, not a mechanical device”.
A bilateral breast reduction, in the hands of an expert, is extremely safe and reliable operation. Significant complications are rare. It is really “dressmaking the breast”, addressing the skin, fat and glandular tissue, and symmetry can be greatly improved. The muscle is not touched and thus recovery is relatively quick and associated with little pain. It is common that nothing more than simple analgesia is required after the first post-operative day. Patients with desk jobs return to work at one week or sooner.
The surgery can be done day only, depending on size, or with a one or two day hospital stay in the bigger patients. Fortunately, Medicare acknowledges the functional and medical benefits of breast reduction by providing rebates without any specific qualifying criteria.
In summary, breast reduction is a safe operation with a relatively quick recovery. It has enormous functional benefits, with excellent cosmetic side effects. It is the operation most commonly associated with comments like “It has changed my life”, and “I wish I had done it 20 years ago”.