Breast Reduction

Excessively large breasts can cause a variety of physical and psychological health problems.

It is common for people with large breasts to feel pain and discomfort in the breasts and back, as well as frequent skin irritations in the lower part of the breast, while when the problem is observed to an even greater degree it may affect the shape of the spine.

Also important is the psychological discomfort associated with the presence of large drooping breasts.

Breast reduction is a good choice for you if:

• You are healthy without significant health problems
• If you are not a smoker or intend to follow smoking cessation instructions preoperatively and postoperatively
• You have realistic expectations and you understand what this surgery can offer you
• They are annoyed by the feeling that your breasts are too big
• You have breasts that restrict your physical activity
• You feel pain in your shoulder, neck and back caused by the weight of your chest
• You have impressions from the straps of the bra
• You have skin irritation under the breast fold

The conversation

During the examination for possible breast reduction you should be ready to discuss:

Why do you want to have breast reduction surgery, your expectations and the end result that you would consider desirable.

Medical problems you may have, drug allergies and previous surgeries and medical treatments

List of medications, vitamins, and supplements you use. Also tell your doctor if you use alcohol, tobacco, or drugs.

Family history of breast cancer and results of ultrasound, mammograms or previous biopsies on your breast.

Medical examination

Includes palpation of the breasts and axillary lymph nodes and examination of previous imaging examinations (ultrasounds, mammograms, etc.)

Assess your general health and identify any risk factors for surgery.

Aesthetic assessment - Measurements - Suggested sizes

The doctor will take various measurements of the breasts, their symmetry, the position of the nipples and in combination with your own wishes will suggest the appropriate technique with the aim of the desired new size, shape and degree of erection.

At preoperative visits it is important to understand all aspects of breast augmentation surgery.

You are expected to be somewhat anxious or excited about your expected new look.

Do not be ashamed to discuss these feelings and expectations with your plastic surgeon.

From our experience the best results emerge if there is good communication and trust is developed between doctor-patient.

Your safety in the operating room is a top priority for us.

• You will need to have general blood tests, ultrasound and / or mammograms.
• If you are over 40 or have a health problem you may need a chest x-ray, electrocardiogram or some more specialized tests.
• If you have a chronic illness you may need to see your doctor or adjust the doses of the medicines you are taking.
• Smoking cessation at least 2 weeks before surgery.
• Avoid taking aspirin and certain anti-inflammatory drugs and other medications as they may increase bleeding during surgery (you will be given a list of medications, supplements and foods we recommend to avoid preoperatively)
• Stop taking drugs because they may interact dangerously with the drugs that will be used in the operating room.

Breast reduction surgery is usually performed through incisions in the breast and through them surgical removal of excess fat, mammary gland tissue and breast skin.

In some cases, excess fat can only be removed by liposuction, although this technique is not very useful due to the coexisting excess skin. However, it is very helpful when liposculpture techniques remove fat around the breast, mainly sideways to the armpit.

The condition and composition / density of the breast, the size of the fall, any asymmetry and the desired amount of reduction will determine the goals and the most appropriate technique for the operation.

The operation is usually performed under general anesthesia.

Intersection options include:

• Incision and removal of skin around the nipple area only - The scar is around the nipple
• Keyhole incision and skin removal around the nipple and vertically from the bottom of the nipple to the fold of the breast - The scar is around the nipple and perpendicular from the bottom of the nipple to the fold of the breast.
• Incision and removal of skin with an anchor pattern - The scar is around the nipple, perpendicular to the nipple to the breast fold and to the breast fold (like an inverted T).

The choice of the incision is based on the amount of excess skin on the breast, so the larger the excess necessarily the larger the scar.

After the incisions, the breast is reduced with a corresponding removal of skin and mammary gland, it is raised and shaped so that it has an upright, natural and aesthetically good appearance.

There are various techniques that determine which part of the breast will be removed and which will be maintained and shaped to form the new breast.

Your doctor, depending on the size / condition of your breasts and the goals that will be set for the surgery, will suggest the appropriate method.

The points of the incisions are closed to reshape the now smaller breast. Sutures will be inserted in layers deep into the breast tissue to create and provide support to the newly formed breast.

Finally, seams will be placed in the incisions of the skin. The scars that will occur are permanent, but in most cases they will weaken and improve significantly over time.

The final quality / appearance of the scar depends on many things, including your genetic predisposition, your body exposure to the sun, the tendency during the healing period, the use of nicotine and any infection.

All the necessary measures will be taken for the best possible appearance of the postoperative scar (good surgical technique, fine sutures, special creams, preventive instructions, and if necessary laser treatment)

The decision for any plastic surgery is personal and should be made by weighing the benefits of achieving your main cosmetic goals and the risks and possible complications of surgery.

Breast augmentation surgery is usually a very safe operation, however as with any surgery there are some unavoidable risks.

You will be asked to sign consent forms to ensure that you fully understand the process and the potential risks and possible complications.

The form we have prepared for you is very detailed, analyzes and explains in depth all the possible risks associated with the operation.

In addition to the analysis in the office, this form will be given to you so that you can study it with more time at your disposal at home and to be able to solve any additional questions that may arise during a second visit to our office.

Some of the risks include:

• Hypertrophic / non-aesthetic scars
• Contamination
• Changes in the aesthetics of the nipples or breast, which may be temporary or permanent
• Risks associated with anesthesia
• Bleeding (hematoma)
• Poor wound healing
• Breast contour and shape abnormalities
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Deeper structures can be damaged - such as nerves, blood vessels, muscles and lungs - and can be temporary or permanent.
• Breast asymmetry
• Accumulation of fluids
• Possible inability to breastfeed due to incisions in the milk ducts
• Possible loss of skin / breast tissue where the incisions meet
• Potential, partial or total loss of the nipple and areola
• Thrombosis, deep vein thrombosis, heart and lung complications, for which you may need hospitalization and additional treatment.
• Pain
• Allergic reactions to strips, sutures and adhesives and drugs
• Small intracranial fat necrosis resulting in palpable hardness in the breast.
• You may need surgery to correct some of the complications

You should also know that:

Breast reduction surgery can make some diagnostic procedures difficult due to the internal scars that will form.

Your ability to breastfeed after breast reduction may be limited. Talk to your doctor if you plan to breast-feed in the future

The breast reduction procedure can be done at any age, but it is best done when your breasts are fully developed and especially when you are done with pregnancy / breastfeeding.

Breast changes during pregnancy can alter the effects of previous breast reduction surgery, as can significant weight fluctuations and normal aging.

In "difficult" breast reduction procedures, a second minor operation may be needed to perfect the final result.

When the operation is completed, a special support bra will be applied to minimize swelling and support the breasts as they heal.

The key to the success of your surgery is to follow exactly the postoperative instructions that will be given to you.

It is important that surgical incisions are not subjected to excessive force, friction or movement during treatment.

You usually need to be hospitalized for a few hours after the operation in order to recover from the medications given during the operation.

Mobilization takes place immediately in the first postoperative hours and if your doctor examines you if you feel well you can go home the same day.

If you experience shortness of breath, chest pain or an unusual heartbeat, contact your doctor.

In any other case the discharge takes place the next morning.

You will need to take antibiotics for a week and painkillers for 2-3 days.

The surgical wound should be treated with antiseptic spray until the sutures are removed.

For the best possible aesthetic result, we suggest you wear a special bra for breast augmentation for 30-40 days and avoid exercising for the corresponding period of time.

Review is recommended on the 7th, 14th postoperative day and the 1st, 3rd and 6th month.

Then it is recommended to examine once a year for a medical examination of the breast

Costs may vary depending on the complexity and estimated duration of the operation.

Breast augmentation costs may include:

• Anesthesia fees - fee of anesthesiologist
• Cost of hospitalization and use of surgical facilities
• Medical examinations, medicines, consumables
• Remuneration of surgeon / assistants

Many health insurance plans cover breast reduction surgery.

It is a good idea to ask the insurance company for pre-approval before scheduling surgery.

• Am I a good candidate for breast reduction surgery?
• How should the operation be done to have the best possible results?
• What shape, size and technique are right for me?
• Which incision and which reduction technique is recommended for me?
• What are the risks and complications associated with surgery? How often do these problems occur?
• How are complications treated?
• How much recovery period and what help will I need during it?
• What should I do to help get the best results?
• How will my ability to breastfeed be affected?
• How will the image of the breast change after the operation?
• Will the picture change over time? After pregnancy? After breastfeeding? With weight loss?
• What are my options if I am unhappy with the aesthetic result of the surgery in the future?