Breast Reduction

Most of the time it is desirable that the breasts are in proportion to the rest of the body. The nipples need to be in the right place and the breasts need to be similar in same shape and size.

BREAST REDUCTION

Large and heavy breasts can give back, shoulder and neck pain. The bra straps can cut and rub into the skin of the shoulders and sweating underneath the breast can cause irritations and fungus infections. Abnormally shaped breasts can be experienced to be repulsive or shameful. In most women an asymmetry can be observed whereby one breast is larger, hanging lower or has a slightly different shape. When the asymmetry in volume is significant finding the right size bra may become difficult. A breast reduction reduces volume and weight, alleviates discomfort and improves symmetry and your figure.

DETAILS OF THE TREATMENT

THE FIRST CONSULTATION

During the first consultation your general health, length, weight and breasts will be assessed. A breast reduction will result in scars and may affect the sensation of the nipples. The chances of being able to breastfeed after a reduction will decrease significantly. This all depends on how much the breasts need to be lifted and how much breast tissue is to be removed. As with all elective procedures it is important that your weight and general health is acceptable. Breast size, the surgery, the consequences thereof and the aftercare will be discussed.

The procedure is performed under a general anesthetic and takes 2 hours. The nipple-areolae will be placed higher on the breasts and the areolae will be made smaller when they are too large. Breast tissue will be removed in the center and the lower part of the breasts. A breast reduction will result in a scar around the areola, a vertical scar and a horizontal scar underneath the breast: the “anchor” scar. Depending on the size of the reduction and quality of the skin the horizontal scar may be prevented resulting a “lollypop” scar. If necessary, drains will be placed to drain any fluid or blood that may accumulate after the procedure. Simple dressings will be applied.

The procedure can take place as a day case and you can go home when you are fully awake from the anesthetic. The drains will be removed at the consulting room after 1 – 3 days. The stitches will all be dissolvable and do not have to be removed. A sports bra, without under wiring needs to be worn to protect the breasts and to allow the wound healing process to proceed undisturbed. It is important that the bra is supportive and comfortable as it needs to be worn day and night for six weeks. After the “lollypop” technique the skin underneath will initially be wrinkled and swollen. This will settle down and smoothen out in 4 – 8 weeks. During this time, you will be followed up for checkups. The final scar will depend mainly on your wound healing. After a breast reduction the aging process will continue and further changes can occur with fluctuations in body weight, pregnancies and menopause. It is advisable to always wear a well supporting bra during the day.

The exact cup size after the procedure is difficult to determine because of differences amongst the various brands. Most of the time it is desirable that the breasts are in proportion to the rest of the body. The nipples need to be in the right place and the breasts need to be similar in same shape and size. The result can be judged after 3 months when the wound healing is completed around 70 – 80 %. Wound healing takes about a year in total. Breast reduction patients are amongst the most satisfied patients.

All operations run the risks of bleeding and infections. In general, these can to be treated well with little consequences for the final result. By mobilizing and moving the nipple upward, the sensation can change, decrease or disappear. In rare instances the circulation of the nipple-areola complex is inadequate resulting in partial or complete necrosis of the nipple/areola. The chances of breastfeeding after a breast reduction depends on the size of the reduction and the amount of mobilization necessary to lift the nipple-areola complex. The wounds and scars may heal poorly requiring treatment or a scar revision.

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