Before - After pictures
Information on breast reduction surgery
Due to their weight, large breasts tend to elongate the supporting skin and connective tissue, and so start to hang. In the case of large breasts a simple lift procedure is insufficient for the correction of hanging since heavy breasts will start to hang again after a few months. In order to avoid this, some of the breast tissue must be removed so that the skin and surgery scars are able to hold the remaining weight. Lifting reduced breasts has a permanently aesthetic result.
In most cases, this intervention is performed only when the development, growth of breasts has completed, usually after the age of 16. In carefully selected cases with extremely large, intolerable breasts, surgery may be carried out earlier. The procedure is carried out only under general anaesthesia.
As the procedure involves the removal of some of the glandular tissue and milk ducts, breastfeeding capacity is reduced but not terminated.
Surgical incisions: an anchor-shaped incision around the areola, a transverse incision along the natural curve of the crease beneath the breast and a vertical incision between the two, located under the areola. Due to the different skin qualities of the areas concerned, healing results may vary. The fine, thin skin around the areola heals with a more delicate scar than the skin beneath the breast. So patients who are considering such surgery should decide what disturbs them more: extremely large, hanging breasts or surgery scars that remain visible in every case to some extent.
The volume of the glandular tissue to be removed is determined by markings made on the basis of pre-operative measurements. Following the removal of excess skin, some of the glandular tissue is removed – in the case of asymmetric breasts, this involves different volumes of breast tissue from the two breasts. Then the remaining tissue is reshaped into hemispheres by the help of absorbable sutures. For certain types of asymmetric breasts, reduction is performed on one side and only a lift on the other. The larger the breast, the more difficult it is to lift the nipple and areola to the desired height. In some cases, it may result in a considerable reduction or even loss of breastfeeding ability and may lead to complications. Reduction of the size of the areola does not involve any risk. Incisions are closed with invisible continuous subcutaneous and intracutaneous sutures that are completely removed at a later date. After surgery, the patient needs to spend one night at the clinic.
The sutures are removed in two steps: at the end of the first and second postoperative weeks. In order to relieve tension from the sutures, it is essential that a bra be worn at least for six weeks after surgery, round-the-clock for the first four weeks and then only in the daytime. Raising the arms high up, driving and physical activities are prohibited for the first two postoperative weeks. Exposure to sunlight or using a solarium should also be avoided for the first six weeks.
Scar formation largely depends upon individual susceptibility. Thick, prominent operation scars that do not heal even after several months generally may be made acceptable through scar correction surgery. Such scar correction can only be carried out at least one year after surgery!
Following breast reduction procedure, complications also associated with all other surgical procedures (e.g. bleeding, infection, disturbed wound healing) may arise (2-4%). Larger occurrences of liponecrosis may develop along the suture lines, (with an occurrence of 20 to 40%, proportionally with the original size of the breast) or within the breast tissues that liquefy, resulting in a liquid discharge. These problems cease spontaneously, without the necessity of any special treatment. Also in proportion with breast size on very rare occasions (1-3%), wound breakdown, sometimes dermonecrosis may occur. With appropriate treatment, these complications heal spontaneously, without any additional surgery, but result in broader, more prominent scars. Transient sensation disorders of the nipple and areola may occur, the extent and frequency of which also depends on the size of the breast. Such disorders may range from total anaesthesia (insensibility) to mild numbness. In the majority of cases, normal sensation may gradually return after some weeks or months. However, permanent sensation loss may also occur.
Later on, frequent changes in body weight and smoking should be avoided. Patients with larger breasts are recommended to wear a bra in the long-term, in order to delay repeated stretching out of the skin and consequent necessity of a subsequent surgery. Patients should always wear a bra when doing sports!
