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all women difference

We understand the importance of feeling good

Our Procedures

Breast Reduction Surgery

At the Aesthetic Breast Surgery Centre we use a variety of surgical techniques and it is important that we use the one that best suits you. This will depend on your shape, age, and breast feeding requirements.

It is nearly always necessary to lift the nipple and this is moved upwards attached to an internal “stalk” of breast tissue. This stalk is otherwise termed “the pedicle” and can be superior, inferior or supero-medial. The choice depends on your shape to start with and where most of the tissue needs to be removed. It does not have anything to do with the scar placement.

Short scar techniques are used in all the operations. Short scar techniques use some gathering and allow the inherent properties of skin to shrink back. There will be a scar around the nipple, and a vertical scar dropping down to the fold under the breast. Depending on how much skin needs to be excised there may or may not need to be a scar in the fold under the breast. This however is kept within the confines of the fold so it is not visible unless you lift our breast to look. We do not use the traditional anchor scar or “Wise pattern” technique.

It is nearly always necessary to lift the nipple and this is moved upwards attached to an internal “stalk” of breast tissue. This stalk is otherwise termed “the pedicle” and can be superior, inferior or supero-medial. The choice depends on your shape to start with and where most of the tissue needs to be removed. It does not have anything to do with the scar placement.

Inferior pedicle breast reduction

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image description image description Inferior pedicle breast reduction

Super-medial pedicle breast reduction

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image description image description Super-medial pedicle breast reduction

Superior pedicle breast reduction

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image description image description Superior pedicle breast reduction

Very occasionally, in massive pendulous breasts we cannot leave the nipple attached to a stalk of breast tissue and have to remove it and then replace it.

Subglandular breast reduction

In young patients with good skin and in whom the nipple has not yet dropped it is possible to do an internal breast reduction through a cut in the breast fold, so that there is no visible scar at all until you lift the breast to look. This is called a subglandular breast reduction. This technique is especially good for teenage girls to avoid scarring problems.

image description image description Subglandular breast reduction

Important Issues to consider:

Breast surgery as with all other surgery has its risks and complications. We all need to be prepared for when things do not work out as you hoped and also to work together beforehand to minimise the risks. You need to be fully aware of these issues and know how we will address them so that ultimately you can achieve a good result. In making your decision to go ahead with surgery as well as being aware that your ideal may not be achievable and some compromises may need to be made you need to be able to accept the risks and understand the following issues:

Breast Feeding

It will depend on the technique used as to whether any function can be maintained. With some techniques there will be no chance of further feeding. However the superior-medial pedicle technique and the subglandular technique can be designed in such a way that there is a potentially functional unit of gland and ducts left intact. These two techniques are best used in young patients who may want to feed. Even so there is no guarantee that this will be successful.


Breast reduction surgery produces many internal scars. Scar patterns is one of the things that is looked at in mammograms, so if you are 40 years or more it is important that you have a baseline mammogram about 6 to 12 months after your operation. Breast reduction surgery does not increase the risk of developing breast cancer.

The Finding of a Lump during surgery

If this occurs the lump is sent away for an immediate pathological examination. If the lump is shown to be a cancer then the reduction part of the operation won’t go any further, and the wounds are closed. To mimimise this happening all patients over 40 years are asked to have a pre-operative mammogram. All resected breast tissue is sent away for pathological examination.


The tradeoff for having smaller breasts are scars. We use short scar techniques to limit the visible scars under the breast. If you have problems we do have methods to help or can revise them a year later. Nearly all scars will fade given sufficient time (years) apart from a very few which are true keloids.

Nipple sensation

This will alter. You may become more sensitive, less sensitive or lose sensation altogether. This is unpredictable and each nipple is different, however 75% will return to normal after a couple of years.

Nipple loss

There is a rare risk of nipple loss. This is when the blood supply doesn’t keep up to the nipple. There is a higher risk in smokers and diabetics. It is also more at risk in larger reductions. If this were to happen you would be able to undergo a nipple reconstruction.


This is very unusual but if you do get an infection it would be treated with antibiotics.


This occurs after the operation especially in the denser breasts and takes months to soften up.

Wound Breakdown

Some degree of breakdown is common especially in the larger reductions. This is where the suture line opens up and is slow to heal. It is usually the size of a 5 cent piece, but can be larger and rarely a big crater. These always heal with appropriate dressings and care. Small breakdown areas can occur in association with deep stitches working their way out.

Suture reaction

Occasionally patients can have a local reaction to sutures. Most often this presents as a small pimple/pustule as the suture works its way to the skin surface.


The breast is a gland and so prone to bleeding. If you have a bleed it is nearly always within the first 24 hours after your operation and you need to go back to theatre to have it washed out. A smaller bleed will clot and about 3 weeks later liquefy. This may then be absorbed, or it may discharge spontaneously through the wound.


To get perfectly symmetrical breasts is virtually impossible. If you imagine yourself lying flat with your arms out, as in the operation, your breasts lie very differently to when you are sitting up. Hence getting the shape, position, and size just right is not that easy. Occasionally a minor adjustment is necessary a year later.

Late Changes in Breast Shape

The breasts may grow again late in life, during pregnancy or menopause. They may also drop. It maybe that you would need to consider secondary surgery later in life. This is especially an important consideration to young patients.

Anaesthetic Complications

Untoward anaesthetic events occur very rarely. They include allergies and anaphylaxis, deep vein thromboses, heart attacks, breathing problems, awareness during the operation. This is why you have your operation in hospital with a qualified anaesthetist and full back up facilities.

Breast Reduction in Teenagers

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Breast reduction can be beneficial to young patients with large, cumbersome breasts and we do offer this. It can bring about comfort, a return to sport, and a big improvement in self esteem. The major issues pertinant to surgery in this young age group are dealing with the scars and trying to minimise them, using techniques which will hopefully not significantly reduce the chances of breast feeding for the future, and the potential need for further surgery with ongoing breast growth and changes, the effect of future weight loss and psychological issues.

The Consultation

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On your first appointment you will need to allow about one hour. You will be weighed and height checked to calculate your BMI which must be under 30 for surgery to proceed. This is because the complication rate in breast surgery is much higher in patients whose BMI is over 30. Then you will be examined by Dr Ngan and she will discuss with you the different surgical techniques and what is suitable for you. Dr Ngan will also explain what complications are associated with breast reduction and how we would deal with such an eventuality. This helps you to make a fully informed decision. Any decision to undertake such a surgical procedure should not be taken lightly. She will also discuss with you what you can do to reduce your risk. You must have a BMI below 30 and have stopped smoking for 3 months. Any chronic medical conditions may need to be addressed before surgery.

Following your consultation you will be given a written summary of what has been discussed. You will be provided with relevant pamphlets and a written estimate of costs. We encourage you to take this home and study it and write down any questions you may have. If you think that you would like to proceed with surgery then you will be asked to come back for a second appointment. You will see Dr Ngan again and have the opportunity to ask any further questions. You will be measured for surgical bras and do the paperwork. We encourage you to ask anything that you are unsure about, no matter how trivial it may seem. You are very welcome to come back just for another chat to further discuss the surgery. This does not mean that you have to go through with it!

The Operation

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The surgery takes place in fully-accredited hospital. It is our belief that your safety is paramount concerning both surgery and anaesthesia. You will have the option of having your operation in Melbourne or Geelong. The procedure is performed under general anaesthesia, and a specialist anaesthetist will be giving the anaesthetic. The operation takes about 3 hours, and at the end of the procedure local anaesthetic is used to minimise pain. You will stay in hospital overnight. You will be given a prescription for pain relief prior to leaving the hospital the following day.

Post-Operative Care

You will be over the worst of the surgery normally in a couple of weeks, but it takes 6 weeks to fully recover. It depends on the demands of your work as to how much time off you will need. We discuss with you the practical issues such as time off work, managing family etc. Due to anaesthetic techniques used, pain relief needed is basically paracetamol and anti-inflammatories plus some stronger tablets ‘just in case’ but these are rarely needed.

The wounds are closed with absorbable stitches and paper tape. You can shower and dry the tapes with a hair dryer. You will be seen one week, and then two weeks post-operatively. You will wear surgical bras day and night for 6 weeks and then day only for 6 weeks to support and gently compress the breasts as they are healing. For any concerns, please call the rooms. Dr Ngan is on call day and night for any urgent concerns. We encourage you to come in and see us if you are worried about anything. Usually we would see you at 12 weeks, 6 months and 12 months post-operatively.


You can go back to low impact exercise such as walking, bike riding, etc, but all high impact exercise and ‘bouncing’ including running should be avoided for 3 months.


You will receive a written quotation that fully explains the cost of the surgery. This includes post operative care, bras, dressings. Medicare and most insurance companies will offer a rebate towards breast reduction surgery all depending on your level of cover.


All before and after photographs are of patients that have had surgery performed by Dr Ngan or Ms Corduff and have consented to their photographs being used. The photographs have not been altered. Results may vary from individual to individual.