Breast Mammaplasty (reduction)

Breast Reduction

Breast Mammaplasty (reduction)

For information regarding the surgeon and hospital, please click on your preferred country under the destinations page Tab which is on the right side of this page.

Breast reduction is also known as reduction mammaplasty, breast reduction removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Overly large breasts can cause some women to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort.

The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.

This procedure removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Problems caused by large breasts can include:

• back, neck and shoulder pain and grooves in the shoulders from bra straps 
• excessive sweating, rashes and infections under the breasts
• difficulty participating in sport 
• unwanted attention and comments 
• difficulty in finding comfortable and attractive clothes to fit
• Large breasts may appear droopy, with downward-pointing nipples.

Breast reduction (reduction mammoplasty) may relieve many of the symptoms mentioned above. However, there is always some scarring on the breasts as a result of surgery. This will vary from person to person, and according to the type of incision (surgical cut) that is used. The surgeon will discuss the position of the incisions with the woman before the operation. Crams such as vitamin E and Bio- oil can help with scar reduction when applied regularly post operatively once the scar has healed.

What to consider

Breast reduction is a highly individualized procedure and you should do it for yourself, not to fulfil someone else’s desires or to try to fit any sort of ideal image.
You should consider the result you hope to achieve. Some women initially want a radical reduction in size, but this can affect the final shape and appearance of the breasts, so a more moderate reduction may be a better option.

Many women find that the benefits of breast reduction far outweigh the side-effects. However, because a breast reduction is done, at least in part, for cosmetic reasons, it is especially important to carefully consider the risks.

Because breast size alters with body weight, you will be more suitable for surgery if your weight is stable. Your breasts won't grow again after surgery, but they may still fluctuate in size if you gain or lose weight.

If you are a younger woman, the surgeon will advise you to wait until your breasts have stopped growing before performing the operation.
As with breasts that have not been surgically reduced, some drooping will still occur as you get older.

Breast reduction is a good option for you if:

• You are physically healthy 
• You have realistic expectations
• You don’t smoke
• You are bothered by the feeling that your breasts are too large 
• Your breasts limit your physical activity 
• You experience back, neck and shoulder pain caused by the weight of your breasts
• You have regular indentations from bra straps that support heavy, pendulous breasts
• You have skin irritation beneath the breast crease
• Your breasts hang low and have stretched skin
• Your nipples rest below the breast crease when your breasts are unsupported
• You have enlarged areolas caused by stretched skin

Consultation with the surgeon

The success and safety of your breast reduction procedure depends very much on your complete honesty during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. A state of good health is an obvious pre-requisite. This is your chance to ask questions about the operation. It is a good idea to bring a list of your questions to ask during the consultation

The surgeon will also give you advice on how best to prepare for the operation. If you are overweight, you may be advised to lose weight beforehand. Smokers will be advised to give up because smoking increases the risks of surgery, including delayed healing.
With your permission, the surgeon will also photograph your breasts for a confidential "before and after" reference image.

Discuss the following

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer and results of any mammograms or previous biopsies

 Pre-operative Instructions

• One month before the operation, do not use any medications containing acetylsalicylic acid (Aspirin etc.). It can increase bleeding during and after the surgery.
• It is assumed that no acute illnesses occurred in the period of at least three weeks before the planned operation (viral illness, cold, etc.). Report any and all illnesses to the clinic.
• Drink two to three liters of mineral water daily three days before the operation, however, 6 hours before the operation do not drink, eat, or smoke.
• Have a good night’s sleep the night before the operation; you should be well rested before the operation. No alcohol may be consumed the night before the operation.
• Wash your hair the day before the operation and do not put any facial cream, milk or make-up on the day of the operation. Any jewelry, including earrings, should not be worn.
• We recommend for you to be accompanied by a close person in the time of your stay at the clinic and in your hotel/suite. Immediately after the operation, you must not drive any vehicle by yourself.

The operation

If you decide that you want to have the operation you will be asked to sign a consent form. This is to show that you are aware of what the procedure involves, including the possible risks, and give your permission for it to go ahead.

The operation is performed under general anesthesia. Several procedures are available for this operation and the type of bosom and extent of contouring determine the particular procedure chosen. Almost always, scars remain around the mammary area and downwards towards the lower breast. The scar will resemble an anchor. You will need to stay in the hospital overnight after the operation and sometimes for longer.

Breast reduction is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.
In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used for breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon’s advice.

1 - Anaesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anaesthesia. Your anaesthetist will recommend the best choice for you.

2 - The incision

Incision options include:
  A circular pattern around the areola

                   
  A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease

                
  An inverted T or anchor-shaped incision pattern

            
3 - Removing tissue and repositioning

After the incision is made, the nipple-which remains tethered to its original blood and nerve supply-is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.
Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).

4 - Closing the incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

5 – The results

The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover

Post-operative

Patients stay at the clinic/hospital overnight and are usually discharged the following morning. Before the patient leaves, the jelly bandages are changed and the drains are removed. It is recommended to rest well for several days and for the patient to avoid any physical strain. The bandages will be changed again on the third or fourth day after the surgery. The suture is of self-absorbent material. In three to four weeks, supposed the wound has healed as expected, the patient may begin applying the scar pressure massage. The patient will be instructed on how to massage the breasts. The patient is advised to wear an elastic bra of a sport type. However, full physical load and activity are permitted only after one to two months. After a six-month period, regular check-ups at a mammary clinic are recommended.

Side effects

These are the unwanted, but usually temporary effects of a successful procedure.

•   You may feel sick as a result of the general anaesthetic or painkillers. 
•   There will be some pain and discomfort for a few days, and your breasts may feel   tender and lumpy for weeks and even months after the procedure.
•   You will always experience some scarring although this usually fades with time.
•   You are also likely to lose sensation in the nipple, and this numbness may extend over part of the breast as well.
•   It is unlikely that you will be able to breastfeed after a breast reduction, as your nipples are separated from the milk ducts in the operation.

Complications

The decision to have breast reduction surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

•   Unfavourable scarring
•   Infection
•   Changes in nipple or breast sensation, which may be temporary or permanent
•   Anaesthesia risks
•   Bleeding (hematoma)
•   Blood clots
•   Poor wound healing
•   Breast contour and shape irregularities
•   Skin discoloration, permanent pigmentation changes, swelling and bruising
•  Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs -can occur and may be temporary or permanent
•   Breast asymmetry
•   Fluid accumulation
•   Excessive firmness of the breast
•   Potential inability to breastfeed
•   Potential loss of skin/tissue of breast where incisions meet each other
•   Potential partial or total loss of nipple and areola
•   Deep vein thrombosis, cardiac and pulmonary complications
    Pain, which may persist
•   Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.
• Fatty tissue deep in the skin could die (fat necrosis)
    
  Please Note
• Breast reduction surgery can interfere with certain diagnostic procedures
• Breast and nipple piercing can cause an infection
• our ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
• The procedure can be performed at any age, but is best done when your breasts are fully developed
• Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

Follow-up

You will always have a post-operative consultation with your surgeon to review the results and to check on your progress. Once you've returned home, you'll need two to six weeks of rest depending on your age and health. A week or two after surgery, your stitches will either dissolve, or you'll need to have them removed before returning home.