Breast reduction and lift

A breast reduction and lift combines two procedures in one operation: reducing breast size by removing excess fat, glandular tissue and skin, and lifting the breast while repositioning the nipple and areola.

It is considered by people with large or sagging breasts who experience back, neck and shoulder pain, skin irritation beneath the breast crease, or limitation in physical activity. Because the reduction component is often performed for functional rather than purely cosmetic reasons, this is one of the procedures more likely to attract a Medicare rebate.

What the combined procedure addresses

• Back, neck and shoulder pain associated with breast size and weight.
• Skin irritation and rashes beneath the breast crease.
• Limitations on physical activity and exercise.
• Indentations from bra straps.
• Stretched skin, and nipples resting below the breast crease with enlarged areolas.
• Breast size, shape and position together.
• Asymmetry between the breasts.

The shape and size of your breasts before surgery influences both the procedure and the outcome. Outcomes vary depending on individual anatomy and skin quality, and individual results may vary.

Why combine rather than reduce alone

A reduction removes volume and weight. Where the breast has also lost position - the nipple resting below the breast crease, or the skin stretched by the weight it has carried - reducing volume alone can leave the breast lower and less supported than intended. Adding a mastopexy repositions the nipple and areola and removes the excess skin at the same time.

In many cases the two are performed together as a matter of course, since the incision patterns used for reduction (anchor or lollipop) are the same patterns used for a lift. Your surgeon assesses at consultation whether a lift component is needed in your case.

What the procedure involves

The procedure is performed under general anaesthesia in an accredited private hospital. The surgeon makes incisions - most commonly an anchor pattern where there is significant enlargement and sagging, or a lollipop pattern for moderate correction - removes excess fat, glandular tissue and skin, reshapes the remaining breast tissue, reduces the areola if required, repositions the nipple, and closes the incisions.

Because the procedure is more extensive than either component alone, an overnight hospital stay is common. Your surgeon will discuss this at consultation.

Suitability

You may be a candidate if you are physically and mentally healthy, your breasts are fully developed, and you are experiencing discomfort or limitation because of breast size. Suitability can only be determined through consultation with a qualified health practitioner.

Points to consider before deciding:

• It is generally advisable to wait until breast development, childbirth and breastfeeding have finished, as the ability to breastfeed may be affected by this surgery.
• Changes to your breasts from pregnancy, or from significant weight loss or gain, can alter the outcome of the procedure.
• Smokers are at increased risk of complications, and stopping well before and after surgery assists healing.
• A stable weight matters, as significant weight change alters breast size and shape.

Preparing for surgery

• Undergo a medical evaluation and provide your full medical history, including medications, allergies and previous operations.
• Have a mammogram before surgery, and again post-operatively, to detect changes in breast tissue.
• Stop smoking well in advance, as nicotine inhibits recovery.
• Avoid aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
• Arrange for someone to drive you home and stay with you for at least 24 hours.
• Prepare a comfortable area at home for your recovery.

Recovery

The first 24 hours. You may feel drowsy from the general anaesthetic. You cannot drive yourself - you need someone to drive you home and stay with you. An overnight hospital stay is common for this combined procedure.

The first weeks. Expect swelling, bruising and discomfort, which can be managed with prescribed medication. A supportive bra is worn and strenuous activity avoided during early healing. Gentle walking is encouraged to promote circulation.

Returning to activity. Most people return to work and light activities within two to three weeks, depending on the physical demands of the job. Strenuous physical activity is generally avoided for around three weeks, with a return to previous exercise routines from around six weeks.

Travel and swimming. Domestic flights are usually fine at around two weeks. Wait six to eight weeks before international or long-haul flights, and six to eight weeks before swimming.

Follow-up. You return to the clinic for your first post-operative check within a few days. Most patients are then seen at seven to ten days, six to eight weeks, three months, six months and twelve months. An after-hours direct number is provided in case you have questions or concerns.

Full recovery can take several months as swelling resolves and incision lines fade.

Wound care and signs of a problem

Clean your hands before touching the wound area. Clean gently with mild saline or as directed, pat rather than scrub, keep the area dry, and change dressings as advised. Do not apply ointments or creams unless prescribed.

Contact your medical team immediately if you notice increased redness or warmth around the wound, persistent or worsening pain, discharge or pus, a foul smell, or fever and chills.

Scarring

Wherever an incision is made there will be a scar, and the anchor pattern used for larger reductions leaves more scarring than a lollipop pattern. The horizontal incision sits in the natural fold beneath the breast, which helps conceal it. Scars mature and fade over time, though their final appearance varies between individuals.

Scarring can be reduced by not smoking, eating well, maintaining a stable weight, avoiding sun exposure to the surgical area, keeping incision sites clean and dry, limiting physical strain, and using silicone sheets or gels for scar management as directed.

Risks and complications

All surgical procedures carry risks and potential complications. Because this procedure combines two operations, it carries the risks of both.

The risks for breast reduction and lift are those applicable to any major surgery, including bleeding, infection and adverse reactions to anaesthesia. Bruising, scarring and loss of sensation in the nipples are also risks to consider.

Further risks include:

• Asymmetry - the breasts may not be perfectly symmetrical in size, shape or position afterwards.
• Seroma or haematoma - collections of fluid or blood under the skin, which may require additional treatment.
• Delayed healing - wounds may take longer than usual to heal, potentially leading to tissue loss or the need for revision surgery.
• Unfavourable scarring - scars may be more prominent or heal differently than expected.
• Necrosis - uncommonly, the nipple, areolar region or breast tissue can experience tissue death, which significantly affects healing and the final result.
• Effect on breastfeeding - this surgery may affect your ability to breastfeed.

General surgical risks include swelling, pain, nerve damage, anaesthesia complications, blood clots (DVT and pulmonary embolism), psychological impact, and unsatisfactory results requiring further surgery.

All possible risks are explained to you during the consultation process, and you are given written information to take home. Please read our information on the risks and complications of cosmetic surgery before proceeding.

Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner. The information on this page is general guidance only and cannot be used as the basis for a surgical decision - an initial consultation with a surgeon is required to make an informed decision.

Referral and cooling-off period

Since 1 July 2023, all patients are required to have a GP referral before seeing a plastic surgeon or doctor about cosmetic surgery. A valid referral is also needed if you wish to claim a Medicare rebate on medically essential surgery.

For any cosmetic surgery there is a compulsory one-week cooling-off period after your second consultation before surgery can be booked.

Costs

Cost depends on the complexity of the procedure and the time required, which is determined at consultation. As a guide, breast reduction surgery ranges from $16,000 to $27,000 and breast lift surgery from $15,000 to $22,000; a combined procedure is quoted individually after assessment.

As at September 2024 and including GST, a consultation with a Specialist Plastic Surgeon is $350. After your consultation you receive a customised, no-obligation quote.

Payment for major surgery is due four weeks before the procedure. Cash, EFTPOS, direct deposit and major credit cards are accepted, with surcharges applying to cards. Independent medical finance companies are available.

Medicare and health insurance

Where the reduction component is deemed medically necessary, a Medicare rebate may be available. The relevant Medicare Benefits Schedule item number for breast reduction for symptomatic relief is 45523, and for mastopexy 45558. To qualify you must meet strict MBS criteria, which for reduction require evidence of functional problems such as rashes, back pain or posture issues, and you must have a valid GP referral.

Item numbers are updated periodically, so confirm the current numbers and criteria with your surgeon and on MBS Online. Without meeting the criteria, the surgery is considered elective and no rebate applies.

If you are eligible for an item number and hold the right level of cover, your health insurer may subsidise part of the cost. Me Clinic is not a no-gap provider, so a significant out-of-pocket payment remains.

Where surgery is performed

Me Clinic surgeons operate at accredited private hospitals around Melbourne, including Masada Private Hospital (St Kilda East), Epworth Geelong (Waurn Ponds), St Vincent's Werribee, Sir John Monash Private Hospital (Clayton), Peninsula Private Hospital (Langwarrin) and Linacre Private Hospital (Hampton).

Related procedures

If you are considering only one component, see breast reduction or breast lift. See all breast surgery procedures, or the Me Clinic team.