Breast Reduction

All surgical procedures result in permanent scarring, which in breast reduction typically follows a “lollipop” (circumareolar and vertical) or “anchor” (inverted-T) pattern. In the initial post-operative months, scars often appear erythematous (pink or red) and firm; however, they undergo a natural maturation process over approximately 12 months, during which they typically soften and fade. The final appearance of scars is subject to individual biological factors and genetic predisposition to healing.

To support optimal scar maturation, Dr Sophie Ricketts provides specific clinical aftercare protocols. These may include maintaining surgical tape for the first six weeks to reduce tension and prevent scar widening, followed by the application of hydrating moisturizers and strict sun protection to prevent hyperpigmentation. In some cases, medical-grade silicone gels or sheets may be recommended as clinical interventions. If hypertrophic scarring or persistent redness occurs, additional management options such as laser therapy or topical clinical treatments can be discussed during your follow-up appointments.

The duration of a breast reduction procedure, or reduction mammaplasty, typically ranges between 2 to 4 hours, depending on the anatomical complexity and the specific surgical technique required. Factors such as the volume of tissue to be resected, the degree of nipple-areolar transposition, and individual structural considerations will influence the precise operative time.

Following the administration of anaesthesia and completion of the surgery, you will be monitored in a clinical recovery area before being transferred to the ward for a 1 night stay.

Breast reduction, or reduction mammaplasty, is a surgical procedure designed to reduce the volume and weight of the breasts by removing excess glandular tissue, fat, and skin. The procedure also involves repositioning the nipple-areolar complex to a higher, more corrected position on the breast mound. This surgery is frequently indicated for patients experiencing physical symptoms such as chronic neck, back, or shoulder discomfort, or skin irritation within the inframammary fold.

Specialist Plastic Surgeon Dr Sophie Ricketts performs this procedure in Melbourne, Victoria, with a focus on addressing the specific anatomical requirements of each patient. For those considering this surgery, clinical galleries featuring pre-operative and post-operative photographs are available to illustrate potential surgical outcomes and the placement of resulting scars.

A formal consultation is required to assess your suitability for surgery. During this appointment, Dr Ricketts will evaluate your medical history, discuss the technical aspects of the procedure, and outline the inherent clinical risks and expected recovery timeline.

After breast reduction surgery, you will need to follow specific postoperative care instructions to ensure proper healing. This includes keeping the surgical sites clean and dry, managing pain with prescribed medications, and limiting physical activity and heavy lifting for several weeks. Wearing any recommended support garments and attending follow-up appointments with Dr Ricketts is crucial for monitoring your progress. Watch for signs of complications, such as infection, and contact your surgeon if any unusual symptoms arise. Proper care also involves avoiding soaking the incisions in water and using treatments to minimise scarring once healed. Following these guidelines will promote a fast recovery and optimal results.

After breast reduction surgery, you will need to follow specific postoperative care instructions to ensure proper healing. This includes keeping the surgical sites clean, managing pain with prescribed medications, and limiting physical activity and heavy lifting in the first 6 weeks. Wearing any recommended support garments and attending follow-up appointments with Dr Ricketts is crucial for monitoring your progress. Watch for signs of complications, such as infection, and contact your surgeon if any unusual symptoms arise. Proper care also involves avoiding soaking the incisions in water and using treatments to minimise scarring once healed. Following these guidelines will promote a smooth recovery.

Preparation involves a thorough consultation with your surgeon, where your health, objectives, and medical history are discussed. Dr Sophie Ricketts, a specialist in breast surgery, advises avoiding smoking, certain medications, and herbal supplements that could increase bleeding risks. Arrange time off work, set up your home for recovery, and organise someone to drive you afterwards. You may also need to complete pre-operative tests such as a mammogram.

Clinical suitability for breast reduction surgery, or reduction mammaplasty, is based on the presence of physical symptoms caused by macromastia (enlarged breasts). You may be a candidate for this procedure if you experience chronic musculoskeletal pain in the neck, back, or shoulders, or persistent skin irritation (intertrigo) within the inframammary fold. Functional limitations, such as difficulty exercising or nerve compression (indicated by bra strap grooving), are also key clinical indicators.

As part of the assessment process, Specialist Plastic Surgeon Dr Sophie Ricketts will evaluate your overall health, including factors like Body Mass Index (BMI) and smoking status, which significantly impact surgical risks and wound healing. A referral from your GP is typically required to determine your eligibility for Medicare or private health insurance rebates. This consultation ensures the procedure is a clinically appropriate pathway for your individual anatomy and health profile.

A breast reduction, or reduction mammaplasty, is a major surgical procedure performed under general anaesthesia in an accredited hospital. The surgery typically takes between 2 and 4 hours, depending on the volume of tissue being removed and the complexity of the individual anatomy.

The Surgical Process
Marking and Planning: Prior to the administration of anaesthesia, Specialist Plastic Surgeon Dr Sophie Ricketts will complete precise surgical markings on your chest while you are in a standing position. These markings guide the placement of incisions and the new position of the nipple-areolar complex.

• Incisions: Incisions are typically made using a “lollipop” (vertical) or “anchor” (inverted-T) pattern, depending on the degree of reduction required.
• Tissue Removal and Reshaping: Excess glandular tissue, fat, and skin are surgically excised. The remaining breast tissue is then reshaped and lifted to a more elevated position on the chest wall.
• Nipple Repositioning: The nipple and areola are moved to their new, higher position. In the vast majority of cases, they remain attached to their original blood and nerve supply (the pedicle).
• Closure: The incisions are closed in multiple layers using dissolving sutures to support the new breast shape. Surgical tape and a supportive post-operative garment are then applied.

Immediate Post-Operative Care
Following the procedure, you will be monitored in the hospital’s recovery ward by nursing staff. Most patients remain in hospital for one night for clinical observation and pain management. You will wake up wearing a surgical support bra, which must be worn as directed to minimise swelling and support the breasts whilst healing.

Regular follow-up appointments with Dr Ricketts are a mandatory part of the clinical process to monitor your wound healing and ensure the surgical sites are maturing as expected. While initial healing occurs over the first few weeks, the final internal settling of the breast tissue can take 6 to 12 months.

In some clinical circumstances, a reduction mammaplasty may be performed in conjunction with another procedure, for example an abdominoplasty.

Clinical Considerations for Combined Surgery
While combining procedures may reduce the total number of individual recovery periods, it significantly increases the duration of general anaesthesia and the overall surgical complexity. The decision to combine procedures is primarily a clinical one, based on your:

• General Health and BMI: Patients must meet strict health criteria to undergo prolonged surgery safely.
• Anaesthetic Risk Profile: Longer operative times carry an increased risk of complications such as Deep Vein Thrombosis (DVT) or pulmonary embolism.
• Wound Healing: Multi-site surgery places a higher demand on the body’s metabolic resources during the initial healing phase.

Consultation and Planning
During your initial consultation, Specialist Plastic Surgeon Dr Sophie Ricketts will perform a comprehensive assessment of your medical history and anatomical goals. If you are considering multiple procedures, it is essential to disclose this so that the cumulative surgical risk can be evaluated.

Dr Ricketts will advise whether a combined approach is clinically appropriate for you or if a staged approach—performing the surgeries several months apart—is the safer and more appropriate pathway for your long-term recovery and surgical outcome.

Breast reduction, or reduction mammaplasty, may be eligible for a Medicare rebate if the procedure is performed to address specific clinical symptoms rather than for purely aesthetic reasons. If a procedure meets the strict criteria for a Medicare Item Number, private health insurance funds typically provide coverage for hospital and theatre fees, as well as a portion of the anaesthetic and surgical costs.

Clinical Eligibility (MBS Item 45523)
To qualify for a rebate under MBS Item 45523, the surgery must be considered clinically necessary. This typically requires documentation of:

• Macromastia-related symptoms: Persistent musculoskeletal pain (neck, back, or shoulder) or chronic skin irritation that has not responded to conservative treatments.
• Tissue Resection: A minimum amount of breast tissue (usually at least 500g per breast) must be planned for removal.
• Referral: A valid referral from a General Practitioner (GP) or specialist is mandatory.

Verifying Your Coverage
The level of reimbursement varies significantly between different private health funds and individual policy tiers. Specialist Plastic Surgeon Dr Sophie Ricketts and her team will provide you with the specific MBS item numbers relevant to your proposed surgical plan.

It is the patient’s responsibility to contact their private health insurer to confirm that these item numbers are included in their specific level of cover and to identify any out-of-pocket “gap” expenses.