What does a breast reduction do?
A breast reduction is a surgical procedure that removes excess fat, glandular tissue, and skin to reduce the size and tighten the breasts. This surgery can also reduce the size of the areola and lift sagging breasts, resulting in a more youthful appearance. Many women choose breast reduction to achieve smaller breasts for aesthetic reasons or to relieve back and neck pain often associated with oversized breasts.
Who is suitable for the operation?
Before you decide, it is important that you carefully consider your expectations and discuss them with me. If you are physically and mentally healthy, have no breast disease, and have realistic expectations, you are probably a good candidate. Ideal candidates for breast reduction have a realistic perception that the breasts are too large. There are also often physical complaints:
- Difficulty with physical activity due to breast size
- Back, neck and shoulder pain from a heavy breast
- Indentations caused by bra straps and/or skin irritation below the breast crease
Your consultation with me
During the consultation you will be asked about your health, your lifestyle and your expectations of breast reduction. This will help me understand your expectations and determine whether they are realistic. I will also examine your breasts, assessing factors such as size, shape, skin quality and the position of the nipple and areola. Accurate measurements are required to plan the procedure. During the consultation, you should be prepared to discuss your medical history, including any medical conditions, allergies, treatments, and previous surgeries, such as breast biopsies. Be prepared to report your current medications and a family history of breast cancer, as well as the results of ultrasounds and mammograms.
How is the operation performed?
Incisions
The most common incision pattern is called an anchor incision, T-incision or Wise technique and involves an incision around the areola that runs vertically from the nipple to the lower breast crease and a crescent-shaped incision in the breast crease. After the excess glandular and fatty tissue is removed, the skin on both sides of the breast is adjusted down and around the areola, giving the breast a new shape. The lollipop incision is an excellent technique for those who require moderate breast correction. This involves using a circular incision around the areola and a straight incision that runs downward toward the breast crease. Some excess skin remains at the bottom of the vertical incision, which usually disappears over time. In rare cases where only volume reduction is required, liposuction may be used to reduce the size of the breast, resulting in shorter scars. The incisions are carefully aligned to reshape the reduced breast. Resorbable sutures are strategically placed in the breast tissue to establish and maintain the new breast contours. Although the scars are permanent, in most cases they will fade to an acceptable level over time.
Technique
To maintain blood supply and sensation to the nipple-areolar complex (NAC) during repositioning on the chest, a superomedial pedicle is commonly used. The pedicle is a tissue bridge that contains the blood and nerve supply to the NAC. The superomedial pedicle ensures a stable blood supply to the NAC, which is crucial given the extent of tissue remodeling during reduction. This technique allows precise repositioning of the NAC to an aesthetically pleasing position on the chest. In women with extremely large and low-hanging breasts, complete removal and repositioning of the NAC to a higher location on the breast, called a free nipple transplant, may be necessary. In such cases, sensation and some pigmentation of the nipple and areola are lost after surgery, and the healing process may take longer – a procedure that is fortunately very rare.
Recovery and result
Minor bruising and swelling are normal after the procedure, but wearing a compression bra can reduce these effects. While the size and shape of your breasts will improve immediately after the procedure, any noticeable swelling usually subsides within two to three weeks. Scars will fade over the course of a year.
Pain
Although the pain will be relatively minimal after a major transformation procedure, it is important that you take time to recover. Ideally, you should take five to seven days off work. The pain and physical limitations you had before surgery should improve significantly with the new breast.
Permanent result
The results of breast reduction are usually permanent if you maintain your weight, except in special cases such as extreme breast growth during puberty or pregnancy (juvenile or gestational gigantomastia).
If you are considering breast reduction, please feel free to contact me for more information and advice!