# Living With Larger Breasts: When Is Reduction an Option?

An episode of [Vain-ish](https://invisiblenetwork.ai/podcast/1824105551), 28 Oct 2026, 33 min.

Audio: https://enrichment.soundstack.com/4vjqq8/episode.flightcast.com/01M58VX76A6VB9122CE9TVYZXC.mp3

Living with larger breasts can raise plenty of questions - when might a breast lift or reduction be an option? To wrap up Boobie Month, Bec and Jess speak with Specialist plastic and reconstructive surgeon Dr Hamish Farrow about the differences between the procedures. From scarring and recovery to nipple sensation, breastfeeding and timing surgery around having children, Hamish discusses what to consider, along with the potential risks and limitations of surgery. For Breast Cancer Awareness Month, it’s a timely reminder to prioritise breast health and speak with a healthcare professional if you have concerns. This episode shares personal experiences and professional perspectives for general informational and entertainment purposes only. It does not recommend or endorse any treatment or procedure. Please consult an appropriately qualified health professional about your individual circumstances. Find us on Instagram: @vainishpodcast and thanks to our guest Dr Hamish Farrow Hosts: @becjudd and @jessierobertsx Producer: Liza Altarejos Audio Imager: Chris Marsh Video Producer: Justin Hill Find more great podcasts at LiSTNR

## Transcript

[0:02] a listener production.
[0:05] I'm Bec Judd.
[0:06] And I'm Jess Roberts.
[0:07] And we're done with the smoke and mirrors.
[0:09] Fainish shares honest stories about what it takes to look amazing because we did not wake up like this.
[0:15] And you should know the stuff that we chat about on this podcast is based on our personal experiences.
[0:21] We're sharing it for your entertainment.
[0:23] It's definitely not medical advice.
[0:26] And we'll always be clear with you when something is a paid endorsement.
[0:29] Please always chat with your qualified healthcare team before making any decisions about your health.
[0:49] Hi guys, it's Bec Judd.
[0:50] And Jess Roberts.
[0:51] And welcome to Vainish.
[0:52] Welcome to Vainish.
[0:53] You are listening to Boobie Month.
[0:55] Yes, we are.
[0:55] We have our boobie expert in again, Dr. Hamish Farrow.
[0:59] There's no one like him.
[1:00] Yeah, and we are talking all about lifts and reduction.
[1:04] Yeah, reduction in breast lifts today.
[1:06] So Hamish, tell us about your qualifications.
[1:09] I'm a plastic surgeon.
[1:11] Worked in...
[1:12] both public and private, for many years.
[1:14] And basically my practice purely revolves around breast, has done for the last 15, 20 years, something like that.
[1:19] Okay, so we've got you in to talk about lifts and reduction.
[1:23] So what is a lift and what is a... Oh, sorry.
[1:26] What is a lift and what's the difference between that and a reduction?
[1:29] Yeah.
[1:29] So essentially...
[1:30] Yes, you're the host.
[1:32] Tell me.
[1:33] Go, tell us.
[1:34] Tell us.
[1:34] Why are we even here?
[1:35] No, you make me feel too good.
[1:36] And we put him in the king chair too.
[1:37] We did.
[1:38] Thank you.
[1:38] He's at the head of the table right now, guys.
[1:39] It's his show.
[1:40] It's his show.
[1:41] It's his show.
[1:41] So, yeah, tell us all about it.
[1:42] So, a lift and a reduction are essentially the same thing.
[1:45] The reduction, you just reduce the volume at the same time.
[1:47] So, both involve a lift.
[1:49] And a lift is basically saying...
[1:51] the whole body of the breast needs to go north and the nipple needs to go north.
[1:55] And sometimes a lift can be as small as just moving the nipple, but usually you're actually changing the whole setup so that the breast moves up on the chest and reduces the amount of overhang you have and makes you a more perp, forward-pointing boop.
[2:08] So you can't have one without the other.
[2:09] They're mutually inclusive?
[2:10] Yeah.
[2:11] You can have a lift without a reduction, but if you get it.
[2:14] Just hoik it up.
[2:14] Yeah.
[2:15] Okay, yeah.
[2:15] And all you're doing is taking away skin.
[2:17] So it's like the bit you throw away is essentially like glad wrap, you know.
[2:21] Right.
[2:21] So you don't really change your volume.
[2:23] Yeah.
[2:24] But it's interesting when people have a lift that's
[2:27] they will often feel like they're smaller because the whole thing becomes more compact.
[2:30] It's a bit like, you know, if you put a fat suit on, people minimize it to make breasts look smaller.
[2:35] The breasts are still the same volume.
[2:37] They just look smaller because they're held in against you.
[2:39] Well, a lift will do the same thing.
[2:41] You lose all that flop and wobble and so forth down the bottom.
[2:44] People can feel like they're smaller.
[2:46] So they go, I don't want to lose weight.
[2:47] I don't want to lose volume out of my boob.
[2:50] And they don't, but they feel like they do.
[2:52] Okay.
[2:52] And then do they come back and go, now I want implants as well?
[2:54] Yeah.
[2:55] Yeah.
[2:55] So you have that discussion beforehand.
[2:56] At the time, so to try and stop that.
[2:58] Because sometimes you could go, someone can come in and go, I want a lift.
[3:01] And you're like, that's good and fine.
[3:03] You might be sitting at a B cup, but it's just full of skin.
[3:06] And then you cut away the skin, but it's like, now you're going to be an A. Yeah.
[3:10] And then they just have to then decide if they are comfortable with that, if they want to put an implant in or not.
[3:13] So the first question is, do you like your volume when you're in the right bra?
[3:17] Mm-hmm.
[3:18] without padding ideally.
[3:19] Do you like your balance?
[3:20] Is your proportions working?
[3:21] Are you happy boob, bum, belly that it all goes together?
[3:25] And if you are over-volumed, then let's make it smaller.
[3:28] If you're under-volumed, let's talk about how we might do that to improve that proportion.
[3:33] And it might be something simple like fat transfer, or you might then go to an implant or the like.
[3:39] Yeah.
[3:41] or they might just have a lift and be small because it's a more comfortable small.
[3:46] But it's a good set of discussions to have beforehand because people come in wanting a lift, and if I was going to describe that in reference to the rest of the operations I do, I think it's relatively underwhelming in that you get a more compact breast, but you don't suddenly get shape in the top half.
[4:03] You don't suddenly get a lovely cleavage.
[4:05] The lift simply makes it more comfortable and in less of need of support type breast.
[4:10] So you can go around in a T-shirt bra or something like that and you still look great.
[4:15] You don't have to have a whole lot of machinery to hold you in place.
[4:18] And you can lean forwards and you don't fall out the top or out the side or whatever.
[4:21] So lifts, I think, make a prettier breast, but they don't change you to the same bang that a reduction does or an augment does or an augment.
[4:31] Yeah.
[4:32] An augment being an implant.
[4:34] Augment B and implant.
[4:34] Yeah.
[4:35] Sorry.
[4:35] Yeah.
[4:35] Yeah.
[4:36] So reduction is like you're taking away the breast tissue and obviously taking away a certain amount of breast tissue that then you have to obviously do a lift so it all can kind of work in harmony.
[4:46] Yeah.
[4:46] So people have tried to do reductions without doing a lift.
[4:50] So in a 20-year-old who has big boobs but doesn't want the scars, there's been an attempt to do liposuction on those girls and reduce their volume.
[4:59] Yeah.
[4:59] In a 40-year-old, if you did that, you'd just get a more hanging breast.
[5:02] It's a bit like you lost a lot of weight and it swings more and it's actually less pretty.
[5:07] In a 20-year-old, they're usually so glandular and so firmly made of breast tissue, you can't suck anything anyway.
[5:13] Yeah.
[5:14] And so it's not a rewarding process to do that.
[5:17] So I generally say if someone needs to go smaller, they need skin taken as well and you make them a nice shape and they sit up higher and that works better.
[5:26] When people are getting a breast reduction, what's the most typical reason or symptom?
[5:31] Is it more like they don't like the...
[5:33] I hate their boobs.
[5:34] Yeah, or like physical pain, headaches, migraines.
[5:37] So I kind of think of a bit like a yoke.
[5:41] If you hung a scarf around your neck,
[5:43] and you tie each end of the scarf onto one of your boobs, when you go around the corner, the whole thing moves and that yoke of weight.
[5:52] So to turn a corner, if you have a nice, pert little set of boobs and you turn the corner, they come with you like your shoulders do.
[5:58] When you've got big boobs, they move after you.
[6:01] It's a bit like that twerking maneuver, you know.
[6:03] It sort of looks like it's going in the wrong direction.
[6:04] Yeah.
[6:05] And that you have to physically pull them around with you.
[6:09] So a big boob that is natural tends to give you discomfort in your upper neck and back and shoulders.
[6:15] And you end up, many of these girls will end up curling their shoulders round forwards to protect their boobs socially so that they don't have such a here's my chest, which you would get if you stood up.
[6:26] But also just because it's hard work holding them up.
[6:28] And they'll...
[6:29] They'll come home and they'll hate their bras because their bra is trying to hold these girls up.
[6:33] Digging in.
[6:33] Digging in.
[6:34] Things are fitting.
[6:35] Things are spilling out.
[6:36] Yeah.
[6:36] Yeah.
[6:37] Yeah.
[6:38] So there's all that.
[6:39] But it's also like I have a friend that had a breast reduction, but she did it purely for sport.
[6:47] She was really, really good and she was in a state team for sport and they were just too big and she had to strap them up and she's like, stuff this.
[6:53] So she chose to have a breast reduction then going to schoolies so she could go ahead and play sport.
[6:58] And it's powerful to do that because if you feel you are out of proportion, well, you're the judge of who you are,
[7:05] But if your boobs are big for you, you don't fit anything.
[7:08] You don't like wearing clothes that hold you tight.
[7:10] You don't like running, bouncing, jumping, you know, horse riding, gym, all those active things that you want to do when you're vital.
[7:18] Because boobs are sore, guys.
[7:21] It's like when you kick a poor guy in the nuts.
[7:23] They are sore.
[7:24] But, man, they are sore.
[7:26] So imagine having these huge boobs.
[7:28] Yeah, and especially when you're on your period or something.
[7:31] Oh, ow.
[7:32] Even worse.
[7:32] It's even worse.
[7:33] And like trying to lie on them.
[7:34] Oh, it's horrible.
[7:35] So what's the scarring when it comes to reduction?
[7:39] Is there different types of ways you can do it?
[7:41] Yeah, there's a few different options, and it depends on how much skin you need to lose.
[7:44] As a general principle, big boobs, the nipple's too low, you need to move the nipple up, so you've got to scour around the nipple to put it in a new position.
[7:53] You almost never.
[7:54] Some people do, but I have...
[7:57] almost never done it, where you take the nipple off and put the nipple on again.
[7:59] The nipple is simply lifted while connected.
[8:02] So it's not a separation and a reconnection.
[8:05] And that keeps it vital.
[8:07] It's got sensation.
[8:08] It should have ability to breastfeed.
[8:10] It should stay healthy.
[8:12] So you scar around the nipple and then it depends what you do with the rest of the skin.
[8:16] Most people will have a scar on the nipple and then a vertical scar dropping to the crease line.
[8:20] Like a lollipop.
[8:21] And then it's what you do with the skin left over at the bottom and there's lots of different ways.
[8:25] Some people gather it all in the lollipop line, vertical line, and it's a lot of gathering of skin at the bottom and hopefully that all fades away with time.
[8:34] The pleats, pleated skin.
[8:36] Some people go around one side.
[8:39] That's what I do so that –
[8:41] my scar goes vertically and then goes out to the outside.
[8:44] There's no scar towards the cleavage, but that has to be gathered.
[8:48] And the gathering takes months to go, three, six months, something like that.
[8:53] And then the standard one around the world is where you do an anchor, where the scar goes around the nipple, drops down, and goes all the way following the crease from inside to outside.
[9:02] And that's predictable.
[9:04] It works.
[9:05] And in people that are good at it, it can look terrific.
[9:08] Yeah.
[9:09] The challenge I have with that is that the scar towards the cleavage, if your boob changes over time, that can be in the wrong spot and you can get a bit of a change in contour or a corner or a scar that shows when you're lying on your back in bed or on the beach.
[9:23] Yeah, that's what my friend's got.
[9:25] It's when she started breastfeeding and then after.
[9:29] you can now really see the anchor scar.
[9:31] Where it finishes.
[9:31] Yeah, where it finishes, even if she's wearing like a low cut top now.
[9:34] Because obviously her boobs haven't got the tissue that it used to have.
[9:37] Yeah, so they've shrunk and then now… Yeah.
[9:40] And now she's like, maybe I need a boob job.
[9:41] Maybe I need to go get…
[9:43] Add some more volume in.
[9:44] Add volume in because the kids have just sucked the life out of it.
[9:46] Literally.
[9:47] Literally.
[9:47] We hear that now.
[9:48] It's what they do.
[9:49] Yeah, yeah.
[9:50] There you go.
[9:50] So it's the same scars as a lift though.
[9:52] Yeah.
[9:52] So that scar around the nipple down and then whatever you do after that.
[9:56] People that hate the idea of the vertical, some people will just move the nipple and you just have the scar around the nipple down.
[10:04] There's a couple of challenges with that.
[10:05] If you want to take a lot of skin away doing that, you end up with a flattened boob like you walked into a window.
[10:10] So the boob ends up wide without a great deal of forwards projection.
[10:14] And the scar around the nipple has a tendency to spread, to go back to the size that that circle was when you cut it out.
[10:21] And it tends to make the areola spread and go wider.
[10:24] So putting in the vertical scar below that locks that in, you don't get the spread.
[10:29] Okay, interesting.
[10:31] Is there a suitable age for a breast reduction?
[10:34] Yeah, so when do breasts become a pain?
[10:38] As soon as you've got them.
[10:39] And especially if you go from nothing to something really quickly.
[10:41] Something big really quickly.
[10:42] Some 13-year-olds...
[10:44] I never got boobs.
[10:46] Ever.
[10:46] I'm starting to get them now, but it's very embarrassing.
[10:49] Sorry, am I sharing too much?
[10:50] So I've operated on a 13-year-old and I've operated on an 84-year-old for breast reduction.
[10:52] But as a general principle, if you have a lot of growth when you're young and you're not going to be a big deal,
[11:05] You need to wait roughly three full years after your puberty because the drive to make your breast grow kind of tapers off at about that point so that if you do a reduction at that stage, you're not likely to grow disproportionately again.
[11:18] Sometimes you just have to go earlier than that, but realistically, that's a good timeframe.
[11:22] So if a girl goes through puberty at 13, then you consider it from 16 onwards and then you
[11:28] People say, I'd like to leave it till I'm fully mature.
[11:31] Well, that's naive in my view because you're never going to be 16 again and 16's fun.
[11:35] Yeah.
[11:36] And you should play sport and you should go to the beach and you should do all that sort of stuff you want to do.
[11:39] That's when your confidence is being built.
[11:41] Yeah.
[11:41] And you're not, you know, and if there's something that's,
[11:44] Inhibiting you.
[11:45] Yeah.
[11:46] For the rest of your life, you've got that.
[11:47] And you're going to get those social comments where bad men make a comment that colors the way you'll see your boobs for the rest of your life.
[11:54] And that's just tragic.
[11:56] Yeah.
[11:57] What is the age that our boobs actually stop growing as a teenager?
[12:01] Or start growing.
[12:03] Yeah.
[12:03] Ask your girlfriend.
[12:05] Yeah.
[12:05] When is it like, is it?
[12:07] They start growing at like nine, you get the breast buds.
[12:10] But when can you go, okay, my boobs have actually stopped.
[12:14] Like, is it 15, 19?
[12:15] No, it doesn't work that way.
[12:18] It doesn't work that way.
[12:18] So things that make the boobs grow?
[12:20] Pregnancy.
[12:21] Hormones.
[12:22] Hormones is number one.
[12:23] So puberty, pregnancy, and then menopause.
[12:25] And then the second thing is... And do they get bigger in menopause or smaller?
[12:29] Yeah, let me come to that.
[12:30] Okay.
[12:31] That's what I look forward to.
[12:33] Yeah, I know.
[12:33] Sorry.
[12:34] Yeah.
[12:35] And then the other is body weight.
[12:36] So if you put on body weight, your boobs will keep growing.
[12:39] It doesn't matter what age you are.
[12:40] So if you are the same weight and your pubertal blush has happened, you'll be somewhat in sync from then on until the next major hiccup, which will be pregnancy, for example.
[12:52] What happens in menopause, from 35 to 45, many women put on a kilo a year.
[12:58] It's not universal, but...
[13:00] There is a change in the way we live and the change, you know, we eat more luxurious foods, we're running after kids, we're not going to the gym for ourselves, da-da-da-da-da, and you see that there's a general middle-aged spread happening.
[13:10] If you go through menopause and you are becoming a little slower and not doing as much and you've got a little bit heavier…
[13:18] and then you take away the estrogen drive, you'll often find there's a change to your breast volume.
[13:22] Now, you may go no change.
[13:24] You may go up.
[13:25] You may go down.
[13:26] But I've had quite a few smaller women get a little volume finally at their menopause.
[13:32] See, I would have thought estrogen would have made your boobs bigger, not estrogen diminishing making your boobs bigger.
[13:37] Yeah, you would have.
[13:38] What's that about?
[13:39] So what hormones are driving that, or is it more just a weight factor?
[13:42] I assume, and again, I'm...
[13:44] talking from first principles, the estrogen is driving your gland.
[13:47] When that goes away, the estrogen drive, that gland becomes a fatty tissue.
[13:53] maybe in your proportions for your physique, when you have fatty tissue, it's going to be broader than the gland was.
[14:00] The gland was.
[14:01] And so estrogen isn't actually making your breast grow at that stage.
[14:05] It's just maintaining its glandular structure.
[14:08] Interesting.
[14:09] Well, we'll wait and see, guys.
[14:10] I'll update you in 10 years what it's going to be.
[14:13] This is like so off topic as well, but it's about breast.
[14:17] When you have someone that's coming in for a breast reduction,
[14:21] Is it genetic?
[14:22] Is it from a mum or a dad's side or is it just... Can be both.
[14:25] Can be both.
[14:26] Yeah.
[14:26] So big boobs in a family can show up on either side.
[14:30] Do you ever have patients that just come in with massive boobs and they've got no big boobs on either side, like it's a full throwback or... You'll have one sister out of three that's got big boobs, the other two are small and the mum's small.
[14:40] Yeah.
[14:40] That's like Kate.
[14:41] That's my sister.
[14:42] That's 10 double Ds.
[14:43] Izzy, my cousin.
[14:43] 10 double Ds in year eight.
[14:46] That was me.
[14:46] And I was like a 10 AA.
[14:49] Yeah.
[14:49] She's a 10 AA.
[14:50] Massive.
[14:50] My boobs were huge.
[14:51] You were hiding.
[14:52] Big boobs.
[14:53] Yeah.
[14:53] And I'm like, how is this?
[14:54] Because my mum had no boobs and I had no boobs.
[14:56] And then my sister's got a 10 AA at 13.
[14:58] That's my dad's side.
[14:59] Yeah.
[14:59] And she was so thin.
[15:00] She was skinny like me, like tall, lean with these shoes.
[15:03] huge boobs and blonde hair.
[15:05] And I was like, this is unfair.
[15:08] Like, what?
[15:08] And I remember she went to athletics.
[15:10] She was doing Little Ass.
[15:11] She went back to Little Ass after the winter break and no one recognised her.
[15:15] And they came up to her mum and they're like, where's Kate?
[15:16] We haven't seen her.
[15:17] And they're like, that's Kate.
[15:19] Yeah, yeah.
[15:19] And everyone was like, what?
[15:21] That is not Kate.
[15:23] Wow.
[15:23] Yeah, but yeah, wow.
[15:25] So mum always said, oh, she must get that from your dad's side.
[15:28] Your aunties, your twiggly aunties.
[15:30] Mm-hmm.
[15:30] They still perky ones.
[15:31] Kate, she got so lucky.
[15:32] But it's weird.
[15:33] Jeans are weird, right?
[15:34] Totally.
[15:35] And they were enormous.
[15:36] So it wasn't just like, oh, she had a small boob.
[15:38] Like, she had enormous boobs.
[15:39] Yeah.
[15:40] Yeah.
[15:40] Yeah.
[15:41] They're a gift and a penalty, aren't they?
[15:43] Yeah, they are.
[15:44] Yeah.
[15:44] So, yeah, so boobs obviously grow all times of your life.
[15:48] But you also see the big boobs run through the family.
[15:51] So you'll have – I've got one family where I've done five.
[15:55] Boob jobs.
[15:56] Yeah.
[15:57] Daughters, you know, the mum I've done.
[15:59] And it's lovely.
[16:00] You get to know the whole family.
[16:01] But she says, I've got a – the last one's 17.
[16:04] You'll see her in a couple of years when she's ready for it, if she wants to do it.
[16:07] But she knows all her sisters and her cousins have done it.
[16:09] And you think –
[16:10] Yeah, it's in the family.
[16:12] Yeah.
[16:12] It's genetic, yeah.
[16:13] But they also realize that it's possible and that the outcome can be good and therefore, so they're not so scared of it.
[16:18] Apprehensive, yeah.
[16:20] This is an operation which you need to have willpower or consideration to do it and you need to not be too scared of the outcome and you need to have the finances to do it.
[16:29] Yeah, it's not cheap.
[16:30] To do it in a public hospital can take you years.
[16:33] It still happens, but it can take you years and years.
[16:35] Is there a criteria that you can take to get claimed by Medicare?
[16:39] Yeah.
[16:40] Yeah, so Medicare item number is freely available if you've got discomfort.
[16:45] Yeah, okay.
[16:46] And we don't have any problem.
[16:47] There's no approval system for that.
[16:49] So if we say we're doing a reduction and they've got symptoms, that's fine.
[16:53] That's fine.
[16:54] So then it's a matter of whether you have insurance.
[16:55] Do they need to see their GP first for that?
[16:58] To see a specialist, you need a referral.
[17:00] Oh, yeah, of course, duh.
[17:01] You do anyway.
[17:01] Yeah.
[17:02] But to go to the public hospital, you don't know.
[17:04] Yeah.
[17:05] Yeah, but to see you.
[17:06] No, they're good questions because, I mean, that's not something you think of straight up.
[17:09] And we get people ringing up saying, we go, bring a referral.
[17:11] They go, oh, okay, yeah, sure.
[17:13] Yeah.
[17:14] Yeah, right.
[17:15] Let's talk about age, weight, timing.
[17:19] How does someone's weight factor into the decision?
[17:22] Is it preferable for it to be stable?
[17:24] And also what if people are planning to have children?
[17:27] Yeah.
[17:27] Yeah.
[17:28] My view of this, and again, using my analogy style, I'm the dressmaker.
[17:32] So people come and say...
[17:35] I like my figure, my boobs don't fit my figure.
[17:37] Can you trim my boobs to fit my figure?
[17:39] And you go, fantastic, great, great process because then you're likely to stay that figure and the boobs are going to match and they're going to fit and they're going to be proportional.
[17:47] When people come and they are uncomfortably heavy
[17:51] whatever euphemism you want to use, and they say, I want the smallest boobs I can.
[17:56] If you make the boobs really tiny for their frame, then they'll be uncomfortable in a different way, in that nothing will fit.
[18:02] They'll be dressing for their bum and their thighs and so forth.
[18:05] And they just see that this alarm bell of the boobs being uncomfortable is their biggest reason for change.
[18:10] But in fact, it's an indicator that their whole physique is...
[18:13] not in their best shape.
[18:14] And if you try and make a breast that looks small on that frame, that's fine.
[18:19] You can do that.
[18:20] What you'll find is the bits around the breast, so on the sides and below and so forth, they're still full.
[18:26] You can actually make a breast where the bits on the sides are as big as the breast is.
[18:30] And then it looks terrible and they don't fit a bra.
[18:33] And then they go, but I've got these big things on my side.
[18:35] You must have left fluid there.
[18:37] And you go...
[18:38] No, that's not part of the boob.
[18:39] That's actually not part of the boob.
[18:40] Yeah.
[18:41] So the discussion has to be, and different people have different enthusiasms with this, but I really think that if you're going to have a breast reduction, you should try and be healthy and reasonably fit and you should like the rest of your body.
[18:54] So if you like your tummy and you like the rest of your physique, then get the boobs to match it.
[18:59] Then it works really well.
[19:01] You don't want to be unrealistic about what you can finally achieve, but...
[19:05] But there's been good work done to say that if you have a BMI over 30, your risk complication ratio is much higher than if it's 30 or below.
[19:13] And in the States, they will have a population where their general BMI is 38 or whatever, some of those bigger populations.
[19:22] And they're used to doing that and they've got that under control and that's fine.
[19:25] But in our city, we don't see enough of them, do enough of them to have it, I think,
[19:31] really safe.
[19:31] So this is a bit like saying, I want something elective.
[19:33] I want something that I can choose to have, but I'm going to run across the road while the traffic's going and I'm not going to wait for the green light.
[19:41] My green light says, you get your BMI 30 or below, you get yourself to the point where you like your belly and then I'll make your boobs match.
[19:49] And I see that as predictable, easy, straightforward, and I know what you're going to get.
[19:52] So it's a delicate discussion with patients where they have pain and suffering and pain.
[19:59] They don't really want to accept that they're overweight and you go, I can't really do this cleverly for you.
[20:06] And safely.
[20:07] And safely.
[20:07] And so there will be people that do it, but I try and care for the whole patient.
[20:12] Yeah, yeah.
[20:13] What's the recovery like with a reduction and a lift?
[20:17] Are they, if someone's just to get a lift...
[20:20] Or a reduction.
[20:21] Same thing.
[20:21] Same thing.
[20:21] Like, is there, like, yeah, what is it?
[20:23] Is there drains?
[20:25] So with me, it's a two-hour operation.
[20:27] You can shower.
[20:28] You can lift anything.
[20:30] You can sleep how you like.
[20:32] Because you're not touching the peck, right?
[20:34] You're not touching the peck.
[20:35] Well done.
[20:36] And so then you should be freely mobile.
[20:39] You should put your arms where you like.
[20:40] You're not T-Rex for a week.
[20:41] And then I tell people if you can move your arms and you're comfortable enough, you can drive a week and back at work in 10 days.
[20:48] And then horse riding, probably a month.
[20:51] Netball, three to four weeks, something like that.
[20:54] Because the bounce is the hard bit.
[20:55] But paracetamol and ibuprofen will cover you for most of that.
[21:02] And occasionally people need something more, but it's actually a far less –
[21:07] miserable thing to go through than most surgeries.
[21:09] Yeah, it's really interesting.
[21:11] I've got friends that have had breast implants put in and then friends that have had breast lift in that.
[21:17] And it's so different just the pain threshold everyone has.
[21:22] I find it that people that have had breast implants put in with no lift or no reduction are more likely to have a lot more pain than people having the reduction.
[21:33] Do you see that?
[21:33] Interesting, yeah.
[21:34] Yeah?
[21:35] Is that just my friends or is that...
[21:37] It does make sense physically, but it makes sense to me because people that are having a breast implant in a breast that doesn't have a lot of room, it's quite a lot of stretch.
[21:47] And also they're perfectly healthy people.
[21:49] They have nothing else to go and they're just trying to get better.
[21:52] Whereas someone who's got a problem like I'm heavy or I'm low or whatever, they kind of have lived with some discomfort beforehand.
[22:00] So this is an improvement and they go, fabulous.
[22:02] Yeah, so pain, whatever.
[22:03] You know, no pain, no pain.
[22:04] Yeah, that kind of.
[22:05] It's a little bit, yeah, psychological.
[22:08] I'm getting myself better, therefore I'm putting up with stuff and that's okay and I'm dealing with that whereas the other girls don't.
[22:13] How do you create the space?
[22:15] Put an implant in?
[22:16] Yeah.
[22:16] Like what tools do you use?
[22:18] We use a little burning device.
[22:19] It's called diathermy.
[22:21] I get paid to burn your boots.
[22:23] Yeah, yeah.
[22:24] And it's a corduroy.
[22:25] And basically what you're doing is burning and you lift and burn and lift and burn.
[22:30] What are you burning through?
[22:31] What are you burning through?
[22:31] You're burning the little vessels so that they – but it's also a way of cutting through tissue.
[22:35] So you can use a knife.
[22:37] Some people will just use a device that will push stuff until they break.
[22:41] Oh, that sounds painful.
[22:43] You can do this in a way that doesn't damage you, that's in a way that's going to hurt.
[22:48] So your ribs are the most sensitive bit.
[22:49] If you stay off the ribs when you're doing the surgery and don't scratch them and don't burn them and don't touch them, you don't need to, the pain goes right down.
[22:59] And then if you can make enough space so the implant isn't too pressured in there, if you have the ability to do that, it doesn't have to be painful.
[23:07] Breast implants don't have to be painful.
[23:08] So are we thinking if they're under the pec and closer to the rib, they're...
[23:11] but maybe more painful than if they're over the pec and further away from the rib.
[23:15] Depending on how the surgery is done.
[23:16] So you can do an under the muscle or over the muscle implant and have the same pain if you're careful with the ribs.
[23:23] If you're rough with the ribs, then you're going to have more rib pain.
[23:26] So we've learnt today that Dr Hamish Farrow does not touch the ribs.
[23:30] And that's how we were fine.
[23:31] As best as I can, yeah.
[23:32] Or maybe, yeah.
[23:33] So good.
[23:34] So good.
[23:43] That's not nipples, Hamish.
[23:45] Yeah.
[23:45] So with reduction, you've got to move the nipple and it's maybe going from Tassie to Victoria.
[23:49] And in order to do that, you divide a certain amount of its connection so you can slide the thing up.
[23:55] As I say, it's not disconnected completely, but you try and leave connected to the nipple enough stuff to keep it alive and with feeling...
[24:03] and certainly enough stuff so that it's able to breastfeed.
[24:06] Yeah, right.
[24:07] And that should all be a standard with breast reduction.
[24:10] And if you get the planning right and the nerves behave, because they don't always go where you think they're going to go, we would assume about an 80% chance of keeping your normal nipple sensation with a breast reduction, preserving your ability to breastfeed, and having a healthy nipple.
[24:25] Now, in the 20% that lose their sensation with the breast reduction,
[24:30] Most, most, almost all will get feeling back by a year, but it's never quite as crisp as it was.
[24:35] If you didn't lose it, you'd potentially still be able to breastfeed.
[24:37] You'd potentially still have nipple erection because those things happen without you having to feel your nipple.
[24:43] But the security of the nipple in terms of its blood supply is really, really good.
[24:48] You can lose a nipple if you don't have a blood supply to go with that.
[24:51] Yeah, so you've got to be careful.
[24:52] And that's one of the risks.
[24:53] Have you ever had patients where they've had hypersensitive nipples after... Implants?
[24:59] Implants?
[24:59] Yeah.
[25:00] Yeah.
[25:00] So somewhere around 15% of people will have a change in their nipple feeling, and of those, half would be completely numb and half would be too sensitive.
[25:09] Yeah.
[25:09] and then it kind of mallows out again it gets better but they're annoying does it ever stay super sensitive and then what would you do for that it's a stretch phenomenon so you've pushed the nerves and the nerves are stretched and they get irritated and they heal so they should heal to the point where the feeling gets better but it's interesting if you have characterised your nipple as being annoying and you listen to it you reinforce the annoying bit of it you know I've never had someone who said to me at a year I've still got
[25:38] irritated, uncomfortable nipples.
[25:40] I've had people that said my feeling is better than it was.
[25:42] Yeah.
[25:42] I feel like I'd rather have oversensitive nipples than no feeling at all.
[25:46] And you'd be only a portion of the society.
[25:48] So there'd be a whole lot of people that go, I really hate my nipples.
[25:50] They're too sensitive.
[25:51] Yeah.
[25:52] I'd be happy to be numb.
[25:53] I've had numerous people ask me to make them numb.
[25:55] Numb, yeah.
[25:56] And I said, I don't know how.
[25:57] I don't know how to.
[25:59] Cold water.
[26:00] Ice.
[26:01] Ice chat GPT.
[26:02] Joking.
[26:03] Joking.
[26:03] When someone comes asking about a breast reduction and they are still to have their kids or they're not sure if they're going to have another one.
[26:10] Yeah, what do you say to them?
[26:12] Well, it's a balance.
[26:13] So if they're uncomfortable in the way they are at the moment and they know they get bigger when they have a pregnancy, they know they're going to be miserable when they're pregnant, it's often worthwhile having a breast reduction anyway.
[26:22] And I would say to them, you'll still be able to potentially, not absolute guarantee, but you'll still be able to feed and you'll be more comfortable while you do that.
[26:31] And maybe you have to rationalize this for yourself.
[26:33] But doing it now and having the quality of life improve in the interim, whether or not you have a child,
[26:39] makes sense to me.
[26:40] I actually think that a reduction relatively early in people's lives gives them a happier, youthful life because of that.
[26:48] And if the worst comes to the worst, you do it again.
[26:50] Yeah.
[26:51] So how many times can you do it?
[26:52] You know how like, where there's a certain amount of times.
[26:54] How many lifts can you have?
[26:55] Obstetricians say you can have a certain amount of cesarean sections.
[26:58] Like how many lifts can you have?
[27:00] What if you keep accidentally getting pregnant?
[27:02] Yeah.
[27:02] Well, you just keep... And what's the most you've done on someone?
[27:05] Yeah.
[27:06] People run out of enthusiasm funds.
[27:10] And it's like it's surgery.
[27:12] It's a general anesthetic.
[27:13] It's expensive.
[27:14] There's recovery.
[27:15] Yeah.
[27:15] So with breast reconstruction where we do one and you have to use an implant or they've had radiotherapy or something and that breast sits up and the other one keeps sagging with life, you know, it goes down with gravity, you might lift that six times.
[27:29] Six times a while.
[27:30] But they're all small little things.
[27:32] You just take a little bit out.
[27:33] You do that in the rooms often.
[27:34] In the rooms.
[27:36] Yeah, right.
[27:37] If it's not the full reshaping.
[27:38] If it's not the full, yeah.
[27:40] So, Hamish, should someone ask their surgeon before deciding whether surgery is suitable for them?
[27:45] Yeah, it's going to be a consideration with your surgeon about what you're trying to achieve and whether they think it's reasonably achievable and whether you're a good candidate for that.
[27:56] and you've got to balance all those things that you're going to have that will improve in your life, ideally, and what risks you face going through that process.
[28:03] And it's a detailed conversation, and you should do that.
[28:06] Because there is an effect of everything.
[28:11] There's scars, there's pain.
[28:12] Exactly.
[28:13] It leaves... Recovery time, downtime, and what just scars are going to do.
[28:17] There's always an energy exchange, is what my soul healer says.
[28:19] That's just so woo-woo.
[28:21] Very true.
[28:23] If you bring that up socially, you'll find lots of people that have had this done and they'll give you an answer and then discuss it further with your surgeon.
[28:29] I was really surprised.
[28:31] I was talking about hernia repair, abdominoplasty, tummy tuck, and all the different versions of it with a group of friends.
[28:39] I won't identify them, but it was a niche group who I hang out with, not my usual kind of circle.
[28:44] I hang out with them in a niche way.
[28:46] And more than half of the women in the group all went, oh, yeah, yeah, I've had that, I've had that, I've had that, I've had that, always after kids.
[28:52] I couldn't believe it.
[28:53] Why are they gatekeeping?
[28:55] Yeah, it was like different versions, like just a hernia repair or –
[28:59] To the whole tummy tuck, hip to hip.
[29:01] But it was so bloody common, I actually couldn't believe it.
[29:05] Yeah.
[29:06] And they don't work in our industry.
[29:07] They're not, you know.
[29:08] So they're just as vain as well.
[29:10] We're all vain.
[29:11] Yeah.
[29:12] I can't even say who they are.
[29:13] I can't say they're because it gives away identities.
[29:15] But, yeah, wow.
[29:16] I know who they are.
[29:17] I was shooketh.
[29:17] Yeah, because I already told you.
[29:19] I was like, did you know?
[29:21] Oh, my God.
[29:23] Amazing.
[29:23] Anyway, what's the one question about breast reduction or breast lift that women are often too embarrassed to ask?
[29:31] Or are they pretty open with you when they come in?
[29:33] Well, we go through.
[29:34] I just spill.
[29:36] You know, I've got a 45-minute thing that I talk through and I draw pictures and so forth.
[29:40] And usually people go, I've just got some questions.
[29:42] No, you've answered that.
[29:42] You've answered that.
[29:43] You've answered that.
[29:43] You've answered that.
[29:44] I think people that do it enough should.
[29:46] You've done it for a long time.
[29:47] So you know.
[29:48] Yeah.
[29:49] So there's usually no questions at the end of that.
[29:52] Yeah.
[29:52] So the most powerful thing I think someone can do is actually be a good version of them when they do it.
[29:56] Yeah.
[29:57] So if you've let yourself drift a little bit and so forth and you're thinking about having this, this is the most expensive dress you're ever going to buy.
[30:03] Yeah.
[30:04] Fit it like a glove.
[30:05] Look great in it.
[30:07] Don't have just your boobs look good and everything else.
[30:10] Yeah.
[30:10] So if I have someone and they have five kilos to lose and they say, let's plan it in so many weeks and you go, if you're not there...
[30:18] Delay the surgery.
[30:19] You're better off delaying the surgery because if you do the surgery when you are a good you, you'll get a shape that looks good long-term.
[30:25] If you do a surgery when you are...
[30:28] heavy, you take away the pain and suffering and then you can do the exercise and then you can feel good and then you get out and close and then you lose weight, you'll get a boob that will then deflate again and it swings again and it sags again and then you go, it's not as pretty as it was and you go, yeah, you missed the opportunity.
[30:41] You're better off doing it the other way.
[30:42] Yeah, and the money, the money.
[30:44] Yeah.
[30:44] So Hamish, how do we find out how much these things cost?
[30:47] Because I know we can't really advertise costs and I know that also depending on your surgeon and their experience that the cost would vary wildly.
[30:56] Yeah.
[30:56] All you do with money is you actually ring a series of people and you say, I need a ballpark for what this costs.
[31:01] I know you haven't seen me, but I need to know roughly what territory it is for a standard breast reduction.
[31:06] People should be able to give you that over the phone.
[31:07] If they won't give you that over the phone, yeah.
[31:09] The receptionist will be able to do that.
[31:10] We do it all the time.
[31:10] I've called up about things like, you know.
[31:13] They won't give it to you.
[31:14] They won't give it to me.
[31:15] I just want to know how much it's going to cost for a facelift.
[31:18] So what you do is you say, I've seen someone.
[31:21] Yeah.
[31:21] And they tell me I need a breast reduction.
[31:23] They said it.
[31:24] Okay, yeah.
[31:25] And I have a price from them.
[31:26] I want to know what the price is from you for that.
[31:29] There's nothing else.
[31:29] There's nothing additional.
[31:30] Because the reason they're hedging is in case you go in there and they say, oh, you need implants, you need this, and the price is completely wrong.
[31:36] So you say, I've seen someone...
[31:38] You can lie about that and say, I just need a breast reduction, standard breast reduction without anything additional.
[31:45] I want to know how you compare financially with that.
[31:47] Okay.
[31:48] Because I just don't know if I'm out of the ballpark and I'd like to come and see Steve anyway at some stage or Jenny or whatever.
[31:53] Yeah, because I'm like, you just want my $350 so I can come in.
[31:58] Yeah.
[31:59] Then I go like, that is $900,000,000,000.
[32:00] I'm like, well, I'm not going, but there's my $380 gone.
[32:03] I'm like, ow.
[32:04] Ow.
[32:06] I just want to know, just a ballpark.
[32:08] Yeah, I shouldn't have to pay $380 for that.
[32:11] Oh, that was awesome.
[32:12] Thank you so much, Dr. Hamish Farrow.
[32:15] That was amazing.
[32:16] Loved having you on Vanish today.
[32:18] My pleasure.
[32:21] Jess, that's booby month.
[32:23] That is.
[32:23] That's a lot of booby talk.
[32:25] A lot of booby talk.
[32:25] I've learned a lot.
[32:26] I love boobs.
[32:29] What was the best thing you learnt, do you think?
[32:32] Knowing that you can have a reconstruction of a breast and still can keep the...
[32:39] Preserve the nipple.
[32:40] Yeah.
[32:40] That's what I was going to say too.
[32:41] Yeah.
[32:41] That's fascinating.
[32:42] I think that was really fascinating.
[32:43] Oh, the tummy.
[32:45] When you use that, what is it?
[32:46] That flap.
[32:46] A D-I-E-P-D-E.
[32:47] I nailed it.
[32:49] Yes, that flap.
[32:50] Yes.
[32:51] There you go, that one.
[32:53] Yes, you can use that for reconstructing your breast.
[32:55] There's just so many ways...
[32:58] surgery can happen and obviously it depends on the surgeon and also your personal needs.
[33:03] Yeah.
[33:03] Yeah.
[33:04] So yeah, amazing.
[33:04] Learn a lot.
[33:05] It's been a good month and thanks for listening.
[33:07] So wrapping up baby month.
[33:09] Bye for now.
[33:09] Bye.

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