- Breast reduction
- Who is candidate for breast reduction ?
- The first consultation
- Review about the breast reduction
- Breast reduction risks and complications
Plastic surgical procedures have to be done by plastic surgeons !
Breast reduction is a common plastic surgical procedure. It is mostly suggested after the full development of the breasts. Weight loss, pregnancy and aging can enlarge significantly women’s breasts, thus their shape will change unfavourable. Overly large breasts can cause pain in the neck and back, and skin irritation beneath the breast crease. The oversized breasts, because of their weight, - according to the rules of gravity – stretch the fastening filaments of the glandula and the skin, thus they will be placed into a hanging position. In the case of large breasts the breast lift only gives a short-term result, thus it is necessary to remove one part of the breast tissue with the skin as well. With the appropriate reduction we can achieve a long-lasting and beautiful result.
Every women’s breasts are asymmetric. It is a natural expectation that the women want to have feminine-shape breasts. With breast reduction the excess glandular tissue and skin will be removed. To chose the most appropriate technique and the degree of the resection is influenced by the size and shape of the breasts, the size of the areola, the degree of sagging and the patient’s expectation. After the size reduction the glandular tissue will be repositioned, thus the size and the shape of the breasts will be reconstructed, which can ensure the more proportional, beautiful and youthful breasts.
The operational scars will pale by the time and fade into their environment. But You have to notice that they will never be invisible. Before the operation we can not predict the quality of the scars. The final result of the breast reduction will be seen after the total cessation of swelling.
The reduction mammaplasty makes the breasts smaller, fuller, tighter and more favourable in shape, repositioned them into the appropriate position. After the breast reduction surgery the women breasts will become again attractive. The women will be more assertive and get back their self-confidence.
Regular wearing of bras can ensure a long-lasting result in the shape of the breasts. The reduction mammaplasty does not influence the further pregnancy. Small and medium reduction does not have effect on the breast-feeding capability.
WHO IS CANDIDATE FOR BREAST REDUCTION ?
- Sometimes the breasts are not developed enough in size as the women want. They are oversized, thus sag.
- You experience neck, back and shoulder pain.
- You have skin irritation beneath the breast crease.
- You have regular indentations from bra straps. The development of the two breasts is not the same, thus one of the breasts will be in a lower placement than the other. Usually this breast is bigger than the other. This asymmetry can be so much, that even with clothing it is not possible to hide.
- Pregnancy, breast-feeding or weight gain cause the enlargement of the breasts, thus they are hanging low caused by their weight.
- Your nipples point downward and sometimes rest below the breast crease.
The breast reduction can not correct all the expectations -sometimes unreal-, which were dreamt by the patients. We can not resolve everything with the operation. On the one hand it has limits by the technics of the operation, on the other hand just only those corrections can be performed which are fit to the harmony of the chest and the breasts.
THE FIRST CONSULTATION
At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the reduction mammaplasty and important in the aspect of the breast reduction procedure. We will examine the chest and the breasts and their proportion to each other. We will draw attention to the asymmetry of the breasts, which can be manifested in the difference of the breasts in size and/or shape. The placement, the size and the shape of the nipples can be different as well. We will check the quality of the skin and the connective tissue as well. There is asymmetry which even can not be corrected by breast reduction. Only those striae of pregnancy or growing striae can be disappeared by the breast reduction which are in the area of the removed skin.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate their breasts from different directions.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned breast reduction procedure will ensure You the biggest satisfaction.
Weight loss, pregnancy and breast-feeding after the breast reduction can influence the further result of the reduction mammaplasty.
REVIEW ABOUT THE BREAST REDUCTION
THINGS TO DO BEFORE THE OPERATION
Before the reduction mammaplasty some examinations are necessary to be performed: blood test, ECG, chest X-ray and baseline mammogram. With these data the operation will be performed in the best security. If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! This drugs can increase bleeding or can cause other interactions during the general anaesthesia.
The breast reduction is almost always performed in general anaesthesia ( in some assorted cases it can be performed in intravenous sedation and local anaesthesia ) with hospital background. The last two methods only can be possible in the case of smaller breasts. For Your security during the surgical procedure which is performed with general anaesthesia we check Your heart rate, heart beat, blood pressure and blood oxygen level with monitors.
For Your bigger security antibiotics are administerd during the breast reduction.
There are several methods to perform the breast reduction. The incision is always chosen individually. Not everybody is candidate for any type of incisions. To chose the most appropriate technique and the degree of the resection is influenced by the size and shape of the breasts, the size of the areola, the degree of sagging and the patient’s expectation. We aim to minimize visible scarring and to achieve the most beautiful shape.
The most common method is when we perform incisions around the areolas and vertically down from the areolas to the breast crease which is completed with a horizontal incision along the breast crease.
As bigger the breasts, as longer will be the horizontal incision.
After the breast reduction the natural shape of the breast will partly hide the scar.
With the surgical procedure we remove the excess skin with the appropriate amount of glandular tissue. The glandula will be fixed in the appropriate height. After the fixation we model the glandula and reconstruct the appropriate shape and position of the breast tissue. After the modellation the nipples and areolas will be repositioned according to the new shape. If there is excess fat tissue in the armpit we use liposuction to remove that.
If it is necessary the areolas will be reduced as well. If there is asymmetry we reduce more from the glandular tissue of the bigger breast.
After the reduction mammaplasty there are always a little amount of leaking blood and swelling, which are eliminated by a drain from the cavity. With this the recovery will be faster and saftier and the post-operational pain will decrease. The drain will be removed the following day of the operation.
At the end of the breast reduction we cover the wounds by bandages and help the patient to take on a special bra.
THINGS TO DO AFTER THE OPERATION
In the case of the operation, which was performed with general anaesthesia, it is practical to spend one night in the hospital. If the operation was performed in intravenous sedation or local anaesthesia, after the surgical procedure it is allowed to go home. After the breast reduction operation it is suggested to relax and spare Your breasts with due foresight. Sleep on Your back and avoid pushing the breasts! Between the first and the third days after the operation You can feel more discomfort, but this is just a temporary problem, which is caused by the stretching effect of the operation. The initial decoloration and swelling are just temporary symptoms and disappaer fast. These are natural consequences of the operation. The stitches will be removed after 2 weeks, when the tension is significantly decreased.
It is recommended to wear a special bra in the first 6 weeks. Two weeks after the breast reduction do not drive car and for six weeks avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! After the sparing period You have to cover the scar with sun protection cream for a long time!
After the reduction self-examination of the breasts is as important as it was before the operation. If You are recommended to go for baseline mammogram because of Your age You have to do it independently the breast reduction!
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the breast reduction as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!
BREAST REDUCTION RISKS AND COMPLICATIONS
If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The breast reduction as all other surgical procedures can have complications, even ideally. Besides the generally presented complications ( bleeding, infection, poor healing of incisions and thrombosis ) – which are very rare -, can occur some special complications because of the reduction.
Sometimes there can be some minimal differences between the breasts in size or the location of the nipples. In the case of oversized breasts and elder ages the fat tissue and the weaker skin blood circulation can cause problems, which can be accompanied by temporary discharge, or very rarely by fat tissue necrosis. These little malformations can be corrected later with a small procedure perfectly.
Changes in nipple or breast sensation can occur temporary. This will cease in a few days and become normal again.
The incision around the areola and the vertical incision usually almost unvisible, cure with beautiful scars. The incision along the breast crease can be problematic, although it is hiden in standing position by the natural shape of the breast. The different capabilty of the scars for recovering is originated from the different skin quality. The thin, pure skin around the areola is recovering with a purer scar, than the thicker skin along the breast crease.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will fade. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
The complications can be vanquished or revised with the appropriate treatments and procedures, thus they do not effect the final result of the operation or slightly influence it.
The breast reduction helps to fulfill Your desire for smaller, fuller, tighter breasts and make them more favourable shape, repositioned them into the appropriate position. The breast reduction surgery makes the women more assertive and gives them back their self-confidence. The result of the reduction mammaplasty is long-lasting but does not take forever. The gravitation and the change in the flexibility and water-content of the tissues, the other alterations with aging have effect on the size and shape of the breast. In the case of big and heavy breasts the final result is not as long-lasting as in the case of smaller breast. Regular wearing of bras can ensure a long-lasting result in the shape of the breasts. If the breasts change with aging, it can be necessary to perform a breast lift or a re-breast reduction surgery.