Breast reduction

Breast reduction is a surgical procedure for women with large and/or sagging breasts who often experience back and neck pain, skin irritation caused by maceration in the folds under the breast, and shoulder pain along the lines of the bra straps. This is compounded by the fact that patients who require breast reduction do not find themselves attractive and proportionate to the rest of their body.

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To shape the breast to match the patient’s anatomy, depending on the amount of breast tissue to be removed, we usually use an inverted-T or “lollipop” shaped incision.

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In most cases, the vascularisation and innervation of the nipple-areola complex is preserved, but there are rare cases where a free transplant of the nipple-areola complex is chosen.

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Information

How does breast reduction work?

The surgery is performed under general anaesthesia for the patient’s comfort. Before the surgery, the markings are made and the surgical plan is set up. The type of incision chosen during the discussion at the consultation is made, and the breast tissue will be removed with the nipple-areola complex relocated accordingly.

Thorough haemostasis and revision of the foreign body, followed by reshaping and closing the breast.

The compression bra is fitted in the operating theatre. The procedure takes between 90 minutes and 2.5 hours.

After the surgery

After the surgery, the patient spends one night in our clinic for observation.
This involves pain relief, applying ice packs, mobilisation and continuous monitoring of the condition.

There are a number of conditions that can occur after surgery that you should know about:

A painful feeling of tension that decreases day by day
Temporary discomfort
Swelling or bruising with a feeling of “tightness”
Moving the arms is harder
Itch

Risks

Breast reduction is associated with improved quality of life and self-esteem, and minimal complications. Poor results may include wound dehiscence, haematoma formation, abnormal scarring, pain, partial or complete nipple necrosis and breast deformity. These complications can be minimised by proper patient selection, complete cessation of smoking, appropriate choice of procedure and meticulous surgical technique. In some cases, the fluctuation in the sensitivity of the nipple-areola complex (NAC) is usually temporary. The scars are permanent, but if you follow the pre- and post-operative care advice, they will become much less noticeable over time. If the scars are wide and extensive due to healing problems, local anaesthetic correction is recommended after 6 months.

In detail:

The complication of the first 24-48 hours is bleeding. During the surgery, the blood vessels are closed with electric forceps, they are coagulated. Before closing the surgical site, we will of course make sure that there is no bleeding. Unfortunately, straining, coughing or a wrong move can open up an already closed vessel stump and cause bleeding, which can be so severe that the wound has to be opened, meaning that a repeated surgery is required.
The most serious complication is inflammation. (Which can happen during any other type of procedure, whether it is a hernia surgery or a vascular surgery). The degree of inflammation can range from mild redness, which does not require any special intervention, to severe, purulent inflammation, which can lead to hospitalisation.
Over time, gravity and natural ageing processes can cause the breast to “sag” again.
Abnormal wound healing may also occur, which can take the form of wound dehiscence or later abnormal scarring. It can be an atrophic (sunken) or hypertrophic (prominent) scar or its most severe form, a keloid. A keloid is a burning itchy, painful, broad, red, bulging candle-drop-like lesion.
Rarely, reduced sensitivity of the nipple, areola or skin of the breast may occur, which tends to be temporary but in exceptional cases may become permanent.
Other rare types of complications include suture hypersensitivity, local bruising, etc., which are detected and managed appropriately during post-operative visits.
Deep vein thrombosis, embolism, death.
Breastfeeding difficulty
The above complications may occur in 1-2 per cent of cases, some even less frequently.
After the surgery, the two breasts may be different from each other, causing asymmetry. This is usually because there was a difference between the two breasts before the surgery.

Healing

The patient should rest for at least 48-72 hours and avoid any kind of exertion.
At the first post-operative check-up, you will be checked to make sure everything is going well and the plaster covering the scars will be changed.
At the second visit, after two weeks, the knots of the absorbable sutures are cut through.
The swelling can persist for 4-6 weeks. You can usually return to normal life after 7-10 days.
Exercise is allowed 6-8 weeks after the surgery.
For 6 weeks, a bra (usually an elastic sports bra) must be worn day and night. After 4 weeks it can be skipped at night, after six weeks it is not compulsory to wear it during the day, but it is recommended in certain cases. Later on, you can fully return to your previous lifestyle, e.g. in the area of sport.