Breast Reduction Sydney

Cosmetic Concerns Procedure Information Risks & Complications Procedure FAQs Procedure Pricing

A Breast Reduction is performed to both reduce the size of the breast as well as to achieve a balanced, proportional and lifted appearance to the breast.

This procedure is for women who have large breasts and wish to address the following symptoms:

Pain that may occur in the back, neck, shoulders or the breasts themselves
Heaviness of the breasts that causes
- Bra straps to dig into the shoulders
- Difficulty sleeping or getting comfortable at night
- The need to use arms to lift the breasts
Maceration or rashes of the skin under the breasts, especially in warmer weather

Alternatively women seek the procedure to improve:

Correct the sagging of their breasts (called breast ptosis).

1 = indicates a mild degree of ptosis where the nipple sits at the fold of the breast.
2 and 3 = indicate a more severe degree of ptosis where the nipple sits below the fold of the breast.

Improve the size and shape of the breast to be in proportion with the rest of their body

While patients of any age can have this surgery, it is best to wait until all breast growth has been completed.

Patients who may not be suitable for breast reduction include those:

Who are very overweight (especially where BMI > 35)
Have significant previous scars on the breast
Recently or are currently breast feeding
There is a suspicion for breast cancer
Have had radiation to the breast
Have a bleeding disorder
Have a lot of medical problems including poorly controlled diabetes
Are currently smoking

If you fit into the above categories it does not mean you cannot have breast reduction surgery and you are best to discuss your concerns with Dr Aggarwal.

At MODE, Dr Aggarwal will guide you through the planning of surgery and help decide which procedure is best suited to achieve your goals.

Click here to see breast reduction before and after photos from Dr Aggarwal’s patients.

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

Procedure Snapshot

Anaesthetic: GA by accredited anaesthetist
Duration of stay: Overnight or day stay procedure
Medicare/Health fund rebate: Yes. A referral is required and you will need to have adequate private health insurance cover.
Recovery: Most people can do most things at the end of the first week. Upper body exercise is disallowed for 6 weeks and strenuous exercise for 3 months. Avoid swimming in a pool or beach for 2 weeks.

Time: 3 hours
Hospital: Offered at a private hospital where Dr Aggarwal works
Results: Breast Reduction Patients are some of our most satisfied patients. The scars initially however are obvious are bright pink, and take at least 3-6 months to settle down and fade. Similarly the shape of the breast can look a little odd initially, but it settles into its final shape over 3-6 months. It is important to remember this time frame and final results vary from patient to patient

Cosmetic Concerns

“I want to be as small as possible, as I am sick of having heavy breasts”

This is generally unwise – while it is easy to feel this way with your current breast size, you will regret being too small later.
It is important to end up with a result that is in proportion to the rest of your body.
From a surgical point of view, a breast reduction operation removes parts of the breast gland and fat while keeping tissues behind the nipple to maintain the blood and nerve supply to the nipple. The breast is then reshaped into a more lifted, proportional shape. The more tissue that is removed the more the blood supply to the nipple can be threatened – there is therefore a limit to how small we can make you, safely, during a breast reduction procedure.

“I have saggy breasts but don’t want to reduce my cup size”

You require a breast lift rather than a reduction.
Breasts deflate with weight loss and also the effects of pregnancy and breastfeeding, leading to loss of volume and shape.
A breast lift restores the shape of the breast while repositioning the nipples to a more appropriate position.
For more information please read the section of this website on Breast Lift.

“I have large saggy breasts, and wouldn’t mind reducing my cup size”

A breast reduction is your ideal operation – read more about the procedure in this section.
The procedure is very similar to a breast lift, and the scars are also similar. However during the procedure parts of the breast tissue and fat are excised to achieve a reduction in volume and improvement in shape.

“I want the lollipop breast reduction, not the anchor scar type”

The decision of which scar will be employed depends on the amount of reduction required and the amount of loose skin that must be removed at the lower part of the breast.
Lollipop or vertical pattern – with this technique a certain amount of loose skin will initially be present at the lower part of the breast. This loose skin takes up over a period of 3-6 months but in some patients it does not go away completely, and may need a minor excision down the track. If this is required a small horizontal scar will be placed in the fold of the breast and the length of this scar is less than what it would have been had the skin been excised in the first stage. Often this removal of skin can be undertaken under local anaesthesia in rooms.
An anchor scar is necessary for patients who require a large reduction, or require a large of amount of skin to be removed. In these patients too much loose skin would be present at the lower part of the breast if the lollipop scar was employed.
Dr Aggarwal will be able to guide you during the pre-operative consultation process as to which scar will be best for your breast reduction.

Procedure Information

The procedure is always performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually at the SAN or Hunters Hill Private). The procedure takes three hours and most patients will be discharged the next day.

Mammogram and Ultrasound

Before any surgery on your breast Dr Aggarwal will refer you for a mammogram and ultrasound to ensure the breast is clear of any pathology.

Incisions

A scar has to be placed on the breast to achieve a breast reduction. In general the scars can be of two different types:

Lollipop Scar (Vertical Breast Reduction Scar)

This incision is placed around the nipple and areola, as well as vertically down from the areola to the fold of the breast

The advantage of this scar are:

Allows excellent shaping of the breast, with the vertical scar allowing removal of excess skin on the breast, and allowing the breast to become more ‘perky’
Allows resizing the areola to a more appropriate size
The vertical scar takes tension off the nipple and areola reducing the chances of it widening over time

The disadvantages are few but include:

There can also be some redundant loose skin left at the inferior part of the breast – this takes up over the first few months and rarely needs a small revision. If it needs to be excised the scar is often shorter than it would have been had it been removed at the time of the original operation.
Suitable for small reductions only

Anchor scar (Wise pattern Breast Reduction Scar)

This incision is placed around the nipple and areola, as well as vertically down from the areola to the fold of the breast, and a horizontal incision in the fold of the breast.

The advantage of this scar are:

Allows excellent shaping of the breast, with the vertical and horizontal scars allowing removal of excess skin on the breast, and allowing the breast to become more ‘perky’
Allows resizing the areola to a more appropriate size
The vertical scar takes tension off the nipple and areola reducing the chances of it widening over time

The disadvantages are few but mainly that there are extra scars compared to the lollipop approaches. In general, we find that these scars heal well become more inconspicuous over time. Due to the T shaped scar, sometimes there is slower healing at the T junction.

Drains

In general drains are avoided during a breast reduction procedure allowing patients to go home the next day
The exceptions are patients:
- Having very large reductions or extensive chest wall liposuction to the side of each breast
- Also having removal of old implants and capsulectomy (removal of the layer of tissue surrounding the implants)
- On blood thinning medications
- If unexpected bleeding or alternative situation that could increase the risk of seroma (fluid collection) is found during the operation.
In the small chance that a drain is inserted you may need to stay in hospital an extra night, or be sent home with a drain (to be removed in rooms a few days later)

After your breast reduction surgery

Dr Aggarwal will place waterproof dressings over the incisions.
You will be provided with a surgical bra for compression for the first 8 weeks (and one spare when you are going home). This helps to reduce swelling, pain and discomfort in the early post-operative period as the area heals.
You will be able to get the area wet after 72 hours and go back into your compression bra after your shower. You will not be allowed to swim in a pool or beach for at least 2 weeks after surgery. This could be a little longer is there are wounds that are slower to heal.
You will be given a script for antibiotics by Dr Aggarwal which you must continue until the box runs out
You will also be given pain relief medications although most patients only report minor amounts of post-operative pain that is responsive to simple oral analgesia.
You will not be allowed to go back home on your own – you must have someone accompany you home, and it is best to have someone look after you for the first few days as you recover. You should not drive for at least 24 hours after having an anaesthetic nor operate heavy machinery (though we suggest not driving for the first week after breast surgery).
While most sedentary activities can be resumed in the first week, you must not do any exercise for the first few days after surgery that could raise your blood pressure. You will also not be allowed to do any heavy lifting or upper body exercises for the first 6-8 weeks.
Dr Aggarwal will see you a week after your procedure to inspect how the wound is healing. You will be given instructions how to look after the wound as it continues to heal. You will be able to ask questions about what you can and cannot do. Generally we will see you at 1 week, 2 weeks, 8 weeks, 3 months, 6 months and 1 year post surgery.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications

Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of clotting in the legs. These risks are generally low in patients who are otherwise fit and healthy.
Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
Seroma (2%) – after any injury to the body the area swells. Part of the fluid that enters the area sends cells to the area that help the area heal. However excess fluid can create a fluid collection called a seroma, which can then create the risk of infection. Insertion of a drain during surgery can help reduce incidence of a seroma. Wearing compressive garments and reducing activity post-surgery also helps mitigate this risk.
Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
Poor Wound Healing (5%) – Occasionally absorbable sutures used under the skin can be rejected by the body forming a small pustule where the suture spits out. These issues usually resolve with removing the suture and dressings.

Specific Complications

Nipple compromise – this is a rare but most significant complication in a breast reduction procedure. When the breast is reshaped the aim is to keep a block of breast tissue behind the nipple intact. This block of breast tissue contains the blood supply that keeps the nipple alive as well as the nerves that supply sensation to the nipple.
- There can be problems with the blood supply of the nipple, and if there has been previous surgery to the breast.
- Arterial problem – this is when there is a problem with the blood coming to the nipple and it therefore turns white. This may require the nipple to be removed and placed back as a nipple graft.
- Venous problem – this is where there is a problem with the blood returning to the body from the nipple. It gets to the nipple, and pools there therefore turning the nipple blue. This may require manoeuvres to reduce the tension on the nipple, and sometimes other adjunctive techniques to increase the blood draining from the nipple.
- The risk of these complications are much higher in patients who smoke or who are diabetic.
Change in nipple sensation – a third of women preoperatively have reduced sensation to their nipples, a third have normal sensation and a third have more than normal sensation (hypersensitivity). Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
- However we believe that it is possible to reduce the sensation to the nipple following any breast surgery.
- In most cases this should be transient and returns to normal, a process that takes up to 12 months.
Change in the ability to lactate or breast feed: a third of normal women (who have not had surgery) have normal ability to breast feed, a third have reduced capacity (i.e. will need to supplement their feeds with formula to their infant), and a third have no capacity to breast feed. Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
- However we believe that it is possible to reduce the ability to breast feed following any breast surgery.
- If this is of great significance to you, you should either not have breast lift/reduction surgery or postpone it to when you have completed having your family.
Widening of the nipple-areola complex – this can be a problem with a periareolar mastopexy. The most effective way of preventing this complication is to place a vertical scar in addition to the scar around the nipple (lollipop) which takes the tension off the nipple and areola.
Asymmetrical scars – There can be a difference in how each breast behaves to the underlying implant, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Asymmetrical nipple position and shape – due to scars on the breast, and native asymmetry of every woman’s breasts there can be a difference in how each breast behaves to the surgery, and this can produce an asymmetry to the nipple size and shape, albeit the aim is to get them as symmetrical as possible.
Nipples too high or too low – in general at the end of a breast reduction procedure the aim will always be to have the nipples sit a little low. This is because as the breast settles, and scars relax the nipples will move up. The aim is to avoid the nipples looking too high as this can be an extremely difficult problem to correct. If long term nipples are too low this can be easily addressed though a crescenteric skin excision of skin just above the nipples, which can be performed under local in rooms.
Unusual breast shape – it is common for the initial shape of the breast to be unusual as lower part of the breast gland and skin is tightened making the upper part look fuller and the lower part look tight. This settles as the scars relax and the breast settles. This can take approximately 3 to 6 months.
Asymmetry
- Most women’s breasts are asymmetrical
- The aim during breast reduction is to get them more symmetrical – if required this may involve removing more tissue from one side than the other
- However there can be small asymmetries in the final breast shape.

Procedure FAQs

Do I need a referral for breast lift/reduction?

It is now mandatory to obtain a referral for all plastic surgery procedures. If you have a referral you will be able to claim a Medicare rebate for your consultation with Dr Aggarwal.
It is also possible that a Medicare/Health Fund rebate may apply to you depending on what procedure you need, and having a referral allows you to claim this reducing out of pocket costs substantially.

Where can I see Dr Aggarwal?

You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill. Potts Point or Camperdown.
Please scroll to the bottom of the page to find out more information about these locations.

Where will I have my operation?

Any of the hospitals where Dr Aggarwal works – i.e. Sydney Adventist Hospital, SAN Day Surgery or Hunters Hill Private.

What can I do to prepare for surgery?

Cease fish oil, and other supplements such as Ginkgo, Ginseng.
Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
If you are smoking you need to cease this well in advance of surgery (at least 6 weeks, preferably longer) as the risks of nipple compromise and poor wound healing significantly increase in smokers.

After surgery, will I need to wear a special surgical bra?

We will provide you with 2 surgical bras (one to wear, other for the wash) that you can use for the first 8 weeks.
You should not wear any bras with an underwire during this period

Will I be able to exercise after surgery?

You should not do any exercise that raises your blood pressure for at least 72 hours after surgery to avoid the risk of an unexpected bleed
Heavy upper body exercise should be avoided for 6-8 weeks

Will I need special medications after surgery?

Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.

Will I need further surgery?

Not usually.
The vast majority of patients are extremely satisfied following breast reduction surgery and will not require any additional surgery
Very occasionally we may undertake scar revision in a private hospital or under local anaesthesia in rooms.

Can I travel in an airplane after surgery?

Yes
However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.

When will I be able to swim after breast lift/reduction?

You may swim in a pool or beach after 2 weeks as this is the time it takes for the incision to heal.

When will I be able to drive after breast lift/reduction?

It is best to not drive for the first week after surgery.

Do you offer local anaesthetic or sedation for breast reduction?

No
You will require a general anaesthetic in an accredited private hospital.
Most of our patients stay overnight for comfort, having the ability to have analgesia provided in a supervised setting, and to allow Dr Aggarwal to review them prior to discharge the next day.
It is possible to do the procedure as a day stay, if requested.

Will breast lift/reduction change the sensation of my breasts?

A third of women preoperatively have reduced sensation to their nipples, a third have normal sensation and a third have more than normal sensation (hypersensitivity). Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
However we believe that it is possible to reduce the sensation to the nipple following any breast surgery. In most cases this should be transient and returns to normal, a process that takes up to 12 months.
Permanent loss of sensation to the nipple is rare.
If this is of significant concern to you, you should not have surgery on your breast.

Can I breastfeed after breast lift/reduction?

Even in the normal population (women who have not had breast surgery) up to a third of women cannot breast feed at all, and a third require additional supplementation for their infant. The remaining third of women can breast feed normally. These proportions of women are unchanged after breast lift/reduction surgery.
- However we believe that it is possible to reduce the ability to breast feed following any breast surgery.
- If this is of great significance to you, you should either not have breast lift/reduction surgery or postpone it to when you have completed having your family.

Can I have imaging for breast cancer screening after having breast lift/reduction?

Yes
However the additional scarring within the breast can make breast mammogram and ultrasound more difficult to interpret by radiologists.
It is therefore important that prior to undergoing surgery you have imaging of the breast – it makes sure there is nothing of concern in the breast tissue, and also forms a baseline against which a post-surgery mammogram can be compared.
It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history, after having surgery

Can breast lift/reduction cause cancer?

No.
However any tissue removed during surgery is sent for histopathological examination meaning it is examined by experts under a microscope. This is to ensure there is no evidence of suspicious pathology in that tissue.
Despite having preoperative imaging, it is possible for an occult breast cancer to be detected by having surgery. The rate of this is 0.3%.
It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history, after having surgery
In Australia it is recommended for women who reach the age of 50 to undergo 2^nd yearly mammography for breast cancer screening in the absence of other significant family history – if you have a strong family history you may be required to start breast cancer screening earlier.

Are there any alternatives to breast reduction?

Minor breast reduction can be performed with liposuction alone
However this results in looser skin and makes the breast sag more
It also means that the tissue removed cannot be sent for histopathological examination
We therefore reserve liposuction alone for minor revisions where small adjustment of breast size may be needed to achieve symmetry.
For most patients a conventional breast reduction allows not just fat, but breast tissue and skin to be removed, the breast to be lifted and reshaped, and therefore a more aesthetic, proportional result to be achieved.

Procedure Pricing

You will be provided with a quote for surgery, indicating total and out of pocket expenses, after your consultation.
A Medicare item number usually applies to breast reduction surgery, and if you have appropriate health insurance cover, the out of pocket cost may be reduced.
- You must confirm with your health fund that you are covered for item number 45523
- We cannot take responsibility for health funds rejecting claims for coverage of surgeon/anaesthetist or hospital fees.
Public patients
- Please note that this procedure is largely disallowed in a public hospital setting
- Only in very extreme cases will patients qualify due to very strict criteria: You must reside in the local catchment of Prince of Wales hospital AND have low BMI <30, have extremely large and debilitating breast size, and want a substantial breast reduction. If these criteria are met, preoperative photographs must be presented at a Department of Plastic Surgery meeting at the hospital.
- If special approval is granted, the patent will be placed on a 12 month waiting list for the procedure.
- The procedure will be performed by a plastic surgery registrar, under supervision, and all your aftercare delivered by the public hospital clinic.
- For the vast majority of patients, the procedure will only be able to be performed in the private hospital setting.

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