Breast reduction

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A breast reduction is a surgical procedure to reduce the size of the female breast. This is often done for health reasons, for example back pain and poor posture. But it can also have purely aesthetic reasons. Often a breast reduction is also achieved with a breast lift. Read all about breast reduction surgery, when it is done, and what the risks are.

What is a Breast Reduction?

Breast reduction, also known as breast reduction surgery or breast reduction, is an operation in which glandular and fatty tissue is removed from one or both breasts. The aim is to reduce the size and weight of the breasts. Breast reduction surgery is usually performed by a plastic surgeon and takes about two to four hours.

When do you perform a breast reduction?

Although many women want large breasts, breasts that are too large can also be a burden. Those affected often suffer from chronic back and neck pain. Sometimes posture errors and even herniated discs occur.

The psychological stress caused by breasts that are too large can also play a role. For aesthetic reasons, women often feel very uncomfortable in their bodies. This may then affect your sex life and sports activities.

Possible reasons for a breast reduction surgery are:

• orthopedic complaints such as poor posture, back and neck pain
• breasts of unequal size
• Skin irritation and eczema in the underbust fold (intertrigo)
• Desires of the patient in the event of psychological stress

In such cases, breast reduction surgery is usually the only treatment option and gives the patient enormous relief.

Breast Reduction in Men

Breast reduction may also be necessary in a man. Namely when the breast enlarges and looks feminine. Such a so-called gynecomastia usually represents an enormous emotional burden for the affected men. In addition, pain and a feeling of tension often occur. If the cause of gynecomastia cannot be combated through diet, exercise or medication, surgical breast reduction is used.

What do you do with a breast reduction?

Before the operation, the operation planning takes place first. To do this, the surgeon measures the size and shape of the breasts and uses a marker to draw auxiliary lines on the patient's body to guide the incision. In the operating room, it is tilted, as the shape of the breast when lying down differs significantly from that when standing. The procedure itself takes place under general anesthesia.

Performing the operation

There are several different breast reduction techniques. In all of them, fat and glandular tissue is removed from the breasts, but they differ in exactly where the incisions are made. Basically, the surgeon tries to leave as few scars as possible. Together with the patient, he decides which method will ultimately be used.

If the surgeon removes a lot of tissue from the breasts, he will often perform a breast lift in addition to the breast reduction. As a result, the result is more aesthetically pleasing for women.

T method

In the T-method (also known as the anchor or Strömbeck method), the doctor cuts around the areola with a scalpel. He makes this cut below the nipple vertically down to the underbust crease. There he cuts again in a horizontal line. This creates a T-shaped incision, which is what gives the surgical technique its name.

After the tissue has been removed, he moves the nipple with the areola upwards and sews up the surgical wounds.

L method

The L-method follows the same principle as the T-method, except that the surgeon only makes the horizontal incision in the underbust crease to one side, so that an L-shape is created instead of a T-shape.

Lejour vertical method

With the vertical technique (also known as the I or mushroom method), the doctor makes use of the boundary between normal skin and the areola. He cuts around the latter and guides the scalpel vertically downwards, as in the T-method. The horizontal cut in the underbust crease is missing here, however.

O method (Benelli method)

The surgeon limits himself to making a circular incision around the areola.

The O-Method is the most scarred breast reduction. However, because the small incision cannot remove much tissue, it is only suitable for small breast reductions.

Breast reduction without surgery

If a small breast reduction is enough, exercise and a healthy diet may also lead to the goal. In this way, the breasts can at least be reduced and tightened a little. If the findings are pronounced, however, there is usually no alternative to surgery.

What are the risks of a breast reduction?

Risks associated with breast reduction surgery are:

• Bleeding, bruising and swelling
• Injury to nerves with possible permanent sensory disturbances
• Wound infection and wound healing disorders
• unsightly scarring, scar growth
• allergic reactions to drugs and materials used
• Death of adipose tissue
• different heights of the nipples after surgery
• Death of the nipple
• Anesthetic complications

Depending on the type of procedure, there is also a risk that breastfeeding will be impaired after the breast reduction. This is particularly relevant for young women who want to have children.

Many of the complications can be avoided with sufficient experience of the surgeon and careful surgical planning. Nevertheless, it is important for the doctor to explain the possible risks to the patient in detail, especially since this is often a desired procedure without medical necessity.

What do I have to consider after a breast reduction?

Depending on the extent of the operation, you should expect a hospital stay of around two to seven days. The drains placed during the procedure are pulled as soon as they do not convey blood or wound secretion. This is usually the case after two to three days.

Swelling and discoloration after surgery are quite normal. These regress by themselves after a while. Until that is done, however, the final aesthetic result cannot be verified. This is only possible approximately three months after the breast reduction surgery. If necessary, an operative follow-up can then be carried out at your request.

The stitches will be pulled out after seven to fourteen days. But there are also special sutures that dissolve by itself after a while.

For the first time after the breast reduction, you must wear a special support bra. On the one hand, this prevents tension from being exerted on the wound and, on the other hand, the breasts from deforming during the healing process. Wear the support bra 24 hours a day for at least six weeks.

Physical limitations after breast reduction surgery

Avoid sports that primarily stress the chest and arm muscles, for example tennis, golf or weight training. In order not to interfere with wound healing, you should also not go to the sauna or solarium. It also makes sense to sleep on your back and not on your stomach or on your side for the first few weeks after the breast reduction surgery.

You will only be fully able to work after about three to four weeks, depending on how physically demanding your job is.

Breast Reduction: Scars and What To Do About Them

As with any surgical procedure, scars also develop after the breast reduction. However, you can significantly improve the aesthetic result yourself through careful scar care.

You can start scar care just one week after the operation and continue it for about three to four weeks: Cream the surgical sutures with a conventional ointment. After this period, the wound is usually completely healed. If you then apply special scar gels, you may be able to reduce scarring. Ask your doctor if they can recommend a specific product.

Due to UV light, darker skin pigment (melanin) accumulates in scars, making them more noticeable. To avoid this, avoid direct sun exposure and tanning beds for about three months after the breast reduction surgery.

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