During your initial consultation we will take a full medical history and examine you before discussing your options and making recommendations. Your health and safety is our first priority. We will tell you if we believe having breast reduction surgery is not a good option for you and will discuss any possible alternatives.
Before meeting with Dr Januszkiewicz, you may want to discuss your concerns and expectations with one of our specialist plastic surgery nurses. She will give you information about this procedure and discuss what is involved in detail, including post operative care and recovery. She will show you before and after photographs of patients who have had this surgery to help you understand what can be achieved.
Do you use the latest techniques?
Dr Januszkiewicz is dedicated to remain at the forefront of his specialty through research and ongoing personal education. He attends national and international plastic surgery conferences to stay current with the newest advances in surgery. He is sought after a surgical teacher and lectures both here and overseas, as well as training young NZ plastic surgeons at a post-graduate level.
Is it safe?
Any operation carries some risk and it is the role of your surgeon and all of the team looking after you to do everything possible to minimize those risks for you. Of course we can only do this with your help and cooperation. It is vital that you are completely honest with your doctors and nurses about your medical health and about any medicines, drugs or supplements you are taking.
Smoking increases the risk of problems with wound healing and infection. All patients are advised to quit smoking before surgery, as many weeks ahead as possible.
How soon can I have surgery?
After your initial consultation we recommend you think over the information we have provided for two weeks before going ahead with surgery. It is important that you are certain that going ahead is the correct choice for you and that all of your questions or concerns have been fully explored.
How much time will I need off work?
Certain activities including gym workouts and driving a vehicle will be restricted for two to three weeks in order to reduce the risk of postoperative complications. Upper body physical exercise may be restricted for up to six weeks. We will be discuss this with you in more detail at your consultation.
When can I get back to the gym?
Certain activities including gym workouts and driving a vehicle will be restricted for several weeks. We will be discuss this with you in more detail at your consultation.
How much does it cost?
Most surgical procedures are costed on the basis of operating room minutes and equipment used. A breast reduction will usually require 150 to 180 minutes of operating time. This varies according to your presenting condition and the complexity of the surgery involved. After your first visit with Dr Januszkiewicz we can provide you with an accurate costing. This includes the surgeon and anesthetist professional fees, operating room charges and all surgical supply costs and recovery room fees. Your surgical after care and follow up visits for one year. Since breast reduction is often indicated on medical grounds your health insurer may partially or fully cover the costs. You may also be eligible for financing through Nova Medical. Please call our staff to discuss your questions.
Why not have the surgery overseas where it is cheaper?
Having surgery is an important decision and you will live with the results for a long time. We do not believe that a travel agent is the best person to advise you on your plastic surgery and how it can be done most safely. Meeting a surgeon for the first time only a day before surgery is risky (and is a practice prohibited by the NZ Medical Council). You do not have the opportunity to think things through. How do you know whether this doctor is properly trained or qualified? Many countries do not follow the same rigid medical standards enforced in New Zealand. What about the quality and safety of the medical facility and the implants that are used? Will an anesthetist be present and have the other staff been properly trained in emergency preparedness?
Surgery is not a holiday and after care is very important. What will happen to you if something goes wrong when you return home a week or two later? Please think through all of these issues before making your decision based on cost alone. Your health and your safety are on the line.
What does breast reduction surgery involve?
There are many different techniques of breast reduction and breast lift. For most women this involves removal of excess breast tissue and breast skin followed by a reshaping of the remaining breast tissues to achieve a smaller and more youthful shape. The nipple-areola will most commonly retain its attachment to the remaining breast tissue but is repositioned higher on the breast and is usually reduced in diameter. Dr Januszkiewicz is skilled in all these methods including the modern "short-scar" procedures. The techniques of breast reduction most suitable for you will be discussed with you at consultation.
Breast reduction is usually performed under a general anaesthetic - either as day-stay surgery or with a one night stay in hospital. The procedure usually takes between two to three hours, depending on your circumstances. Liposculpture will often be used during breast reduction to help shape the tissues, especially on the lateral breast and sides of the chest.
Can you assure me my privacy will be maintained?
We appreciate that privacy is very important for many people. Whether your breast reduction surgery is carried out in our own day surgical centre or at another hospital, all of the staff involved are dedicated professionals who fully understand the requirement for confidentiality.
I am worried about the anesthetic.
It is common for anyone having an operation to worry about the anaesthetic. A medically trained specialist anesthetist and highly skilled nursing staff are present throughout your operation to monitor and care for you while you are asleep. A recovery nurse is there to care for you as you wake up and until you are ready to go home.
Do I need to stay in hospital afterwards?
Some patients are able to go home the same day depending on the operation and their general health. For others an overnight stay in hospital will be recommended.
Are surgical drainage tubes necessary?
Drains are needed about 50% of the time.
Is it painful afterwards?
During your surgery long acting local anaesthetic will be injected into the area so that when you wake up you should be reasonably comfortable. You will feel an ache or tightness initially and pain medications are prescribed to help with your recovery. It is important to take your pain relief regularly and follow our advice so as to manage this discomfort over the first few days.
What will the scars be like?
We aim to get the best shape with the smallest, neatest scars possible however every person scars in their own unique way. Most women having breast reduction make very good quality scars. On rare occasions some patients can make lumpy or keloid scars which may need other treatments. The most common procedure leaves an incision line around the areola and a lower vertical incision that meets a short incision in the breast crease. The larger your breast the longer the incision lines. It may take six to twelve months for scars to pass through the normal process of healing, before maturing into paler, flatter and softer scars.
Can I still have mammograms afterwards?
Yes. The surgery will have caused some changes to how your breasts look under mammography. We usually recommend a new baseline mammogram a year after your reduction surgery. Sometimes other technologies such as ultrasound or MRI are added or substituted when investigating or screening your breasts.
Throughout your life it is important that you continue to follow your doctor's guidelines for breast self-examination and screening mammography.
Can I breast feed afterwards?
Not every woman can successfully breast feed however most women who have had a breast reduction should still be able to produce breast milk afterwards.