Breast Reduction
The size of a woman's breast is determined by factors such as: the genes the patient has inherited, hormones and her body weight. However, losing weight, using special bras, taking oral preparations or massage ointments are ineffective in dealing with the problem.
We define as breast reduction the surgery to reduce the volume and weight of the breasts. It is performed on women with megamastia (small, medium, severe), gigantomastia and/or breast asymmetry, while when drooping is present, it must be combined with breast lift/mastopexy.
WHO IS THE SURGERY FOR?
The operation is aimed at young teenagers with juvenile gigantomastia or women who have completed their family planning and wish to reduce the size of their breasts for purely cosmetic or medical reasons or a combination thereof. Symptoms such as chronic back or neck pain, imprints on the shoulders and shoulder blades from bra straps, chronic headaches, numbness in the hands, and dermatitis under the breasts are indications for breast reduction surgery. However, surgery is also indicated for women who cannot dress or exercise as they want or feel ashamed of their breast size. Although the operation belongs to the aesthetic operations of Plastic Surgery, it has a strongly restorative character and significantly improves the quality of life and functionality of the patients.
HOW IS THE OPERATION DONE?
The type of operation that the doctor will choose depends on the findings of the clinical examination and the expectations of the patient. Important in decision-making are the size of the breasts, the quality of the skin, the age and the measurements that will be taken during the clinical examination. As a general principle, small hypertrophies can be treated with liposuction alone, while in larger ones liposuction is combined with removal of skin, mass gland and fibrofatty tissue. In this case the breast is reshaped (breast remodeling) to obtain a smaller size with the same projection. The nipple is placed in its new position through a dermoparenchymal flap, which ensures its blood supply and innervation. There are various techniques that can be used, but the doctor will judge and explain to you which one and why it is indicated for each patient.
WHAT IS THE TYPE OF ANESTHESIA?
Breast reduction is performed under general anesthesia in an organized clinic. The duration of the surgery is from 2 to 4 hours, while due to receiving general anesthesia and the duration of the surgery, it is considered appropriate to stay in the clinic for a few hours and to mobilize immediately.
WHAT WILL THE SCARS BE LIKE AFTER THE SURGERY?
The type of scars depends on the surgery that will be chosen. In small hypertrophies, where only liposuction is performed, the incisions are smaller than 0.5 cm and close without leaving a scar. In larger hypertrophies that require breast reshaping, there is an incision around the nipple and then a vertical or shaped incision. The incision heals and matures over several months and the scar that is left is usually not easily noticeable and is always covered by the bra. For the majority of women, the existence of scars is negligible in front of the relief they feel from reducing the weight of their breasts.
Regardless, you will be instructed immediately post-operatively to avoid unsightly scars while entering a follow-up program if you have a history of keloid.
HOW LONG WILL THE RESULTS LAST?
The results are permanent and will remain stable as long as the woman does not take hormones, become pregnant or gain a lot of weight. Also, in teenage girls with juvenile gigantomastia, because the body continues to produce estrogen, there is a possibility of recurrence of hypertrophy. Even breasts that have undergone meiosis will behave just like non-operated breasts, obeying the law of gravity and gradually becoming downward-sloping over time. However, this fall will be smaller, compared to what would have happened if the surgery had not preceded it, and in some places it can be prevented by using special sports bras.
WHAT ARE THE LIMITATIONS OF THE SURGERY?
Breast reduction can be done in young women from the age of 20. Only teenage girls with gigantomastia whose breast size has been stable for at least 12 to 24 months can be operated on earlier. In the case of reoperation, the same technique as the first surgery must be performed. This surgery is not performed during pregnancy, breastfeeding or during a period when family planning has not been completed. Patients with serious health problems who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from this surgery.
WHAT ARE THE RISKS OF BREAST REDUCTION?
The doctor will evaluate your general condition and your history and, if he decides that you are suitable for the surgery, he will inform you about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop using supplements and medications that affect blood clotting and to refrain from smoking. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.
WHAT YOU SHOULD DO BEFORE SURGERY?
Depending on your age, you will be given instructions on the medications you may be taking and should be stopped or replaced, as well as the additional check-up you may need to do with a mammogram and breast ultrasound. The doctor will explain the value of smoking cessation and proper nutrition in wound healing. One week before the surgery you will need to take measurements to order a special bra, have your photo taken and sign the consent form.
WHAT TO WATCH OUT OF AFTER THE OPERATION?
You stay in the clinic for the first 24 hours, but your time off work must have been calculated at 2 weeks. This doesn't mean you won't be able to do light work much sooner, but you'll generally feel overwhelmed. It is also recommended to refrain from sports for 1 month.
Leaving the surgery you will wear a special bra which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. Pain and swelling when present are easily treated. Because the sutures are intradermal there is no need to remove sutures. In case you are thinking about a future pregnancy, ask the doctor to explain whether and to what extent breastfeeding and the result of the surgery are affected.
WHAT IS THE COST OF BREAST REDUCTION?
The cost of breast reduction is calculated by adding up the fee of the clinic, where the patient is operated on and hospitalized, the Plastic Surgeon and the Anesthesiologist. The purchase of special bras must be included in the expenses.
