Breast Reduction
Breast reduction, also called reduction mammoplasty, is a surgical procedure that reduces the volume of excessively large breasts, creating a harmonious shape of the bust.
Many women struggle with the issue of large or heavy breasts, sometimes since adolescence. This can often be uncomfortable in daily activities, during exercise, and has a significant impact on self-confidence and overall well-being.
Moreover, very large breasts often cause issues such as:
- back and neck pain
- high pressure from bra straps
- local skin infections under the breasts
- posture changes – thoracic kyphosis (hunchback)
- chest pain
- numbness and/or tingling in arms or hands
- difficulty breathing and low exercise tolerance
- sleep problems
AT WHAT AGE CAN BREAST REDUCTION SURGERY BE DONE?
The procedure can be performed at any age, but ideally, you should wait until after 18 years old when the breasts have completed their development.
Pregnancy and breastfeeding significantly and unpredictably affect breast shape and size. However, women experiencing significant discomfort can undergo breast reduction before pregnancy, and pregnancy-related changes can be corrected later.
WHAT SHOULD I KNOW BEFORE BREAST REDUCTION SURGERY? ARE THERE CONTRAINDICATIONS?
It is important that the doctor knows if:
- there are family members with breast neoplastic conditions (breast cancer)
- you smoke
- you take medications or drugs
- you have allergies
- autoimmune diseases
- contagious diseases
- diabetes
You should openly discuss your realistic expectations with your doctor, the presence of scars, recovery aspects, and potential complications.
Before deciding on the procedure, you should know the advantages and disadvantages. Breast reduction is generally safe and yields very good aesthetic and functional results.
RISKS AND COMPLICATIONS OF BREAST REDUCTION
Like all surgeries, there are potential risks and associated complications:
- bruising
- swelling
- minor asymmetries in breast shape and size, which are normal since breasts are rarely identical naturally
- mild bleeding
All of these are normal and will disappear as the breasts heal.
Rarely, multiple complications may occur, including:
- reduced nipple sensation, which usually recovers within 6-12 months post-op, rarely permanent
- infection
- hematoma
- in smokers, increased risk of localized skin or areola necrosis
- seroma
- delayed healing
- breastfeeding may sometimes be compromised and should be considered before surgery
Other risks related to general anesthesia may include:
- respiratory problems
- deep vein thrombosis, prevented with anticoagulants, early mobilization, and wearing compression stockings
PREPARATION BEFORE BREAST REDUCTION SURGERY
- A mammogram and breast ultrasound are mandatory to determine if nodules or other conditions exist
- You should quit smoking at least one month before surgery to reduce the risk of tissue vascularization complications
- Aspirin and other non-steroidal anti-inflammatory drugs may increase bleeding risk, so your doctor must know and decide on discontinuation if needed
- The same risk applies for anticoagulants, high doses of vitamin E, Gingko biloba derivatives, etc.
BREAST REDUCTION SURGERY
Reduction mammoplasty is performed under general anesthesia, lasting 2-3 hours. During surgery, skin and fat are removed, the nipple is repositioned higher, and the new breast is lifted on the chest wall.
Breast reduction is a major surgery depending on breast size and degree of ptosis (sagging) and involves gently removing excess fat and glandular tissue, reducing and lifting the areola, to achieve a harmonious breast shape.
Additionally, back pain will decrease or even disappear completely. In most cases, aesthetic appearance of the breast and overall physical appearance improves.
For optimal results, incisions are made around the areola, vertically, and in the inframammary fold – called “anchor” or “inverted T”.
WHAT SHOULD I KNOW AFTER SURGERY?
After breast reduction, an overnight hospital stay is required. Upon discharge, you need a companion to take you home. Ensure you have help at home for a few days.
Post-surgery, you will have special dressings and an elastic bra worn continuously. You can take a short shower 48 hours after surgery.
Discomfort or pain, intensified by coughing or changing positions, is normal and medication will be provided. Swelling, skin discoloration (bruising), and areola sensitivity changes are common.
The atraumatic surgical technique I use minimizes these issues. Most sutures are internal with slow absorption for optimal healing. Occasionally, a few skin sutures may be needed and removed after 21 days.
You can resume professional activity without physical exertion 10-14 days after surgery, use treadmill or bike at 21 days, and perform all exercises progressively after 2 months.
HOW WILL THE BREASTS LOOK AFTER SURGERY?
Breast reduction aims to achieve breasts with natural volume, shape, and appearance. Scars are necessary to achieve aesthetic results and are permanent, but they will fade over time, becoming fine and skin-colored.
In the first months, especially in younger women, scars may appear pink-violet and more visible. After 6 months, they begin to lighten, and by 1 year, they appear pale. Scar healing is individual and genetically conditioned. If the scar appearance is not ideal, surgical revision can be done after 1 year.
Most patients accept scars easily given the benefits. They are easily hidden under a bra or swimsuit.
All breast reduction or lifting results do not remain identical lifelong due to external factors – gravity, aging – and internal factors – menstrual cycle, pregnancy, or weight fluctuations.
Good results can be maintained by keeping a stable weight and minimizing aging effects up to a certain age.
