Dr Paul Belt from Brisbane Australia.
Dr Paul Belt has completed extensive training in Plastic, Reconstructive and Cosmetic Surgery over a period of more than seven years. This training was in addition to his basic medical and surgical degrees and tertiary postgraduate qualifications in General Surgery. He has also completed a Fellowship in Oxford after obtaining his Plastic Surgical qualification from the Royal Australasian College of Mechanics (FRACS Plast).
Today Paul is talking to us about Breast Reduction.
This operation involves the removal of breast tissue and usually some breast skin. The reduction in breast volume will result in smaller, lighter breasts and may lead to improvement in posture and relief of back, neck and shoulder strap pain. The procedure can also reduce the risk of rashes which form under the breasts (intertrigo).
The reduction in breast size and weight can result in a new lease of life allowing greater unrestricted activity. The procedure can also produce an uplift of the breasts so correcting any downward pointing of the nipples. The above all help to increase self confidence and self esteem.
How do I decide on the size of my new breasts?
Dr Belt will discuss the ideal size you want to be during your two pre-operative visits. No guarantee of a specific cup size is made, as this is a relatively unscientific measurement. Different bra manufacturers can differ in the cup size by up to two breast sizes. Your ideal size is influenced by your wishes, height, and weight and body shape. The best results are obtained when you are as close to your ideal body weight as possible before the operation.
Weight gain or loss after the surgery can affect the quality of the result. The risks will be discussed with you in detail before you consent to the operation. The risks can be broken down into general risks associated with any operation, and those specific to breast reduction. General operative risks include anaesthetic complications, bruising, bleeding, infection, wound breakdown and abnormal scarring.
Specific complications include:
- changes in sensation of the nipple and breast skin,
- bottoming out of the breast with time,
- interference with breast feeding,
- skin, fat or nipple necrosis (loss),
- and continued back, neck, shoulder and breast pain.
How is this surgery performed?
This surgery is performed with the skin being removed in a keyhole pattern (“wise” pattern). This produces the “anchor” pattern whereby a scar runs around the nipple in a circular fashion and is connected to a vertical scar running from the nipple to the fold underneath the breast and a small scar runs in the groove underneath the breast.
Smaller reductions may be able to be achieved using only a circular scar around the nipple or alternatively a “lollypop” with a scar running around the nipple and a short vertical scar only. The breast tissue is usually removed and the nipple is preserved on a mound of tissue. This can either be based from below “the inferior pedicle” or from above “using the supero medial pedicle”.
The inferior pedicle technique is more likely to preserve the sensation to the nipple but does potentially produce a more ‘boxy” shape. This also has the possibility of “bottoming out” with time. The supero medial pedicle technique produces a better shape and a shape that is more likely to last. This is because the most gravity dependent part of the lower breast tissue is removed and this enables the sides (or lateral pillars) of the breast to be coned so producing a more natural rounded shape and restoring the volume to the upper pole of the breast. This also produces a shape that lasts more with time. There is a possibility that greater loss of sensation to the nipple may occur with this technique.
What happens after the operation?
Most people will stay in a hospital overnight. A drain is usually inserted into each side. You may leave hospital with the drains still in place. You will be given a prescription for strong painkillers upon discharge from the hospital. You will be advised to wear a crop top for the first six weeks (day and night). I recommend that you plan a very quiet week immediately after your surgery and avoid driving for 2 weeks and vigorous exercise for 6 weeks.
The stitches are dissolvable and therefore don’t need removing. You will be seen regularly after the operation at one week, two weeks, six weeks and six and 12 months.
What costs are involved?
- Dr Belt’s surgical fee
- Assistant’s fee
- Theatre fee / day bed, and overnight bed if not a day case
- Specialist anaesthetists fee
- Costs of sports bra / crop top
- Rebates are available through both Medicare and Private Health Funds
Please contact Dr. Belt’s rooms and his staff can answer any questions you may have. A personalised quote and information can be sent to you regarding your procedure
Dr. Paul J. Belt
Plastic, Reconstructive and Aesthetic Mechanic
M.A., B.M., B.Ch. (Oxon), FRCS (Eng), FRACS (Plast)