breast reduction

Breast Reduction – Synonyms & Principle

synonyms:
Breast reduction = mammaplasty, breast reduction

principle:
Reduction of breast tissue and removal of excess skin

is sometimes combined with…

• breast implants – as strange as it may sound: in some cases the upper pole of the breast is so empty and the entire volume is shifted to the lower area that a reduction and tightening in the lower breast area is combined with a breast implant in the upper pole area
• or autologous fat – to slightly emphasize the upper pole of the breast in the décolleté area

efficiency

Basically, in theory, almost any degree of effectiveness (size) is achievable – but of course it is not always sensible. The most desired breast size in our practice after a breast reduction is a large B to small C.

duration of surgery

On average, a breast reduction takes approx. 120-180 minutes

repetition of the treatment

usually not necessary

However, in case of weight changes, a new breast reduction or shape correction (lifting, autologous fat, implant) may be useful and

Application in which body region

Breast

decision-making aids

Essentially, these are fundamental decisionsthat constitute a breast reduction.

Should I have breast reduction do it at all? – Sometimes it is better not to do something at all.

Good advice highlights all the advantages and disadvantages of an operation – and thus helps you make the right decision.

Size and load:

The more the size of the breasts causes a problem, the more a breast reduction makes sense. Common problems include back pain, the bra being tight on the shoulders, limitations when exercising, irritation and inflammation in the under-breast fold, etc.

Breast reduction can help reduce these problems and improve quality of life. Satisfaction after breast reduction is generally very high. Patients feel “relieved” in the truest sense of the word.

target size

Most patients want a breast that is proportional to their body. On average, the desire is in the direction of size B/small C (basically the same as breast enlargement)

What is important, however, is the overall harmony and that the operation pays off in terms of reduction.

Where should the cut = scar best placed?

Incision = scar. This applies to all operations. In principle, the shorter the incision, the better. However, a longer incision can also result in a better shape. So it's important to find a suitable compromise.

Before surgery, scars and their length are of course always an issue. After surgery, I have usually found that a shape that is as perfect as possible seems more important than trying to save scar length at all costs.

The best option is always an individual compromise between shape and scar length. The incision should be long enough to produce the best possible shape with the shortest possible scar.

This usually means a cut around the nipple and at least vertically downwards. How much excess skin is removed in the area of the under-breast fold often becomes clear during the operation. I try to keep this cut as short as possible. In any case, scars near the breastbone or towards the armpit should be avoided as much as possible - they tend to be wider and firmer there. The cut in the middle of the under-breast fold is usually unproblematic - otherwise this cut would not be the most common and popular cut for breast enlargement.

Overall, however, scars rarely play a major role in breast reduction if the goal of a smaller breast with an improved shape has been achieved.

blood circulation and nerve supply

The individual techniques also differ in terms of the blood and nerve supply. Studies have shown that the blood and nerve supply is normally best developed from the top/inside. Therefore, I usually remove glandular tissue mainly from the bottom/outside so as not to endanger the bridge to the top/inside. This usually allows the nipple to rotate upwards in a very relaxed manner. And this means that feeling and blood flow in the nipple area are preserved as best as possible.

Overall, the mammary gland regenerates very well after breast reduction, so breastfeeding is possible in most cases.

What should you have heard/read before having a breast reduction?

On average, satisfaction with this operation is very high. Patients feel “relieved” in the truest sense of the word. They are usually happy to accept the scars.

Prejudices

Tissue from the lower pole of the breast is permanently raised

facts

There is no technology in the world that can completely and permanently move tissue upwards against gravity. Everything has been tried - from inner bras to flaps to artificial tissue (sometimes even attached to the collarbones) - it just only works to a limited extent. If the upper pole of the breast = décolleté is very important to you, you should therefore (as strange as that may sound) consider a breast implant for the upper pole. A slight emphasis on the décolleté region can also be made possible by inserting your own fat into the pectoral muscle.

common possible side effects/complications

• Scars – also wider or firmer (especially towards the sternum or armpit)
• infection
• postoperative bleeding
• Wound healing disorder, necrosis = death of tissue – especially in the nipple region and in the lower back, under-mammary fold/vertical incision
• numb feeling (especially nipple) – temporary, in some cases permanent
• Asymmetry (always present on two sides to a certain extent)
• Pain – is usually a minor issue – in the first few days, painkillers should be taken consistently (not only reduce pain, but also reduce swelling and have an anti-inflammatory effect)

details Information on possible complications can be found in the information documents

In summary, good preparation (information, explanation, preliminary examinations, possibly 3D simulation, upper body analysis, etc.) and the surgeon’s experience are important factors for the success of a breast reduction.

You should avoid…

• Smoking around the operation (every cigarette is poison for the blood circulation of the wounds - especially nipples - smoking should be stopped or really reduced to a minimum for at least 2 weeks before and after the operation!!)
  
• short cuts at any price (after surgery, a good shape is always more important than the length of the incision)

anesthesia

Possible anesthesiaforms for breast reduction

• twilight sleep
• general anesthesia

the operation

Deadlines must be met in Austria (surgical information and anesthesia information) – this means that there is a waiting period of at least 3-4 weeks from the decision to undergo breast enlargement, but often longer.

Nicotine break from at least 2 weeks before surgery until 2 weeks after surgery

no blood-thinning medication until 10 days before surgery

THINKING POSITIVELY – helps. It not only prolongs life, but is also always a good first step towards any treatment or operation.

the operation

protection for 3 weeks in the sense of:

• do not lift more than 5-6kg
• nothing jerky
• don't work headfirst

sports bra as much as possible for 5-6 weeks

Showering (clean tap water) is permitted from the first day after surgery and is also useful for cleaning the wound

our preferred technique/recommendation

• stem from above and inside
• Cut as short as possible but as long as is reasonable for the shape
• Anesthesia twilight sleep or gentle general anesthesia
• Combination of several techniques (Hall-Findlay, Mottura, Pitanguy) and individual adaptation to the patient

Cost

Guidelines:

from 5900 – 7500 breast reduction including anesthesia (depending on effort, etc.)

400 overnight stay at the clinic with nurse/450 for overnight stay from Friday to Saturday

100 costs for day admission to the clinic (if no overnight stay is planned)

50 Anesthesia information for planned anesthesia with an anesthetist

minus consultation costs

70 optional special price recommended scar ointment + disinfectant spray (regular after surgery 103)

The prices listed are average values and could be cheaper or more expensive. The final total price will be determined during the second consultation (=consent) depending on the individual effort/planned operation time, combinations, desired clinic/room category and other factors.

reasonable budget

A final cost estimate is only possible and meaningful after a detailed on-site inspection and clarification of individual wishes.

downtime

In general, 2-3 weeks of rest be taken into account – this means specifically:

• lifting no more than 5-6 kg
• no jerky movements
• do not perform any activities overhead

Important to know…

• Breast reduction is one of the operations that results in high levels of post-operative satisfaction. Of course, scars are a must

Left

breast reduction