Please also see the frequently asked questions about breast reduction to the right.

The General Information page also contains useful discussion for patients considering breast reduction.

Techniques

Breast reduction techniques vary widely and the main considerations are how much breast bulk can be safely removed, how the blood supply and nerve supply to the nipple can be maintained and where the scars are placed following removal of all the excess skin. The more skin that needs to be removed, the longer the scar in the crease underneath the breast.

I try to remove the bulk of tissue in the lower and outer part of the breast so that when the breast is reformed it maintains upper pole fullness and has a more lifted appearance

Short scar techniques

Where possible, a short scar vertical gland plication is the main technique that I use. This is a technique that evolved in France and across Europe and more recent modifications have been made in Canada.

The advantages of a vertical technique is that the bulk of the breast tissue is removed inferiorly, the breast gland tissue itself is modified in shape to produce a cone shape, the breast shape tends to hold itself more securely over time with less “bottoming out than skin tightening techniques and the inframammary crease scar can be kept shorter.

The disadvantages include that it is not suitable for massive reductions, an inframammary crease scar is still required after massive weight loss cases, and a skin ripple can be left beneath the breast that in about 10-20% of cases may need to be removed under local anaesthetic 3 months later if it does not completely flatten. This is no additional charge for my patients when this is required.

Wise Pattern techniques

The Wise pattern really only refers to the skin incision and not the type of pedicle used to keep the nipple blood supply intact. I use this technique when performing  significant breast reductions (greater than 1kg per side).

The Wise pattern is a W-shaped pattern of skin incision that leaves a scar around the nipple and vertically down to the inframammary crease (like the vertical mastopexy) but also leaves a scar running along the inframammary crease. Essentially the skin is cut out and reshaped like a bra.
There are a number of different ways of reducing the breast gland beneath a Wise pattern scar. The more common types include:
1. Robbins (inferior pedicle)
2. Central mound (central pedicle)
3. McKissock (horizontal pedicle)

Complications after breast reduction

The main complications after breast reduction include
1. Scars
2. Sensation change
3. Asymmetry
4. Breast feeding
5. Volume changes
6. Shape change after surgery
7. Infection
8. Bleeding

Breast Reduction Gallery

Click here for a gallery of Breast Reduction examples performed by Dr Charles Davis.