What is breast reduction surgery?
Breast reduction or breast reduction surgery, helps reduce excessive volume of the breasts.
- The procedure allows the removal of excess glandular tissue.
- It preserves a volume that is consistent with the silhouette of the patient and is in accordance with her wishes.
- This residual glandular volume is ascended, concentrated and remodeled.
- Then we adjust the skin envelope, which requires removing excess skin to ensure good appearance and a good curve to new breasts.
Why have breast reduction surgery?
- Breast hypertrophy is defined as too much volume to the breasts, especially compared to the morphology of the patient.
- This excess volume is generally associated with sagging breasts and sometimes a degree of asymmetry.
- Breast hypertrophy almost always involves physical and functional impairment (neck pain, shoulder and back pain, discomfort while performing certain sports, etc).
- There is also frequently a significant psychological impact. Which justifies why the procedure is often taken care of by health insurance.
- The breasts may be too big if they grow too much during puberty (glandular hypertrophy) or overweight causes an accumulation of fat on their level (fatty hypertrophy). Rarely, they can keep an excess volume after pregnancy.
- The surgery of breast reduction is to reduce breast size, correction of ptosis and a possible asymmetry in order to obtain two breasts that are harmonious in themselves and in relation to the morphology of the patient (two reduced breasts, ascended, symmetrical and remodeled).
- During the consultation, the Dr and patient agree on the breast volume that the patient wishes.
- Photographic examples are useful to determine what volume the patient would like (photos made by the patient).
- A preoperative mammography should be performed if there was none in the previous three years. This will detect any abnormality preoperatively and serve as a reference for future mammograms.
What happens during breast reduction surgery?
- Duration of intervention: from 2 hours and a half to 3 hours and a half
- Hospitalization: 2 to 4 days
- Type of anesthesia: general
- It is important to stop smoking at least 2 months before surgery to reduce the maximum risk of postoperative complications.
- Some drugs that favorise bleeding should not be taken during the 10 days preceding the intervention: aspirin, anti-inflammatory, anti-coagulants, etc...
- Some drugs can be taken before surgery to reduce swelling and postoperative bruising.
- Hospitalization takes place the day before surgery in the afternoon or the morning of surgery while fasting.
- The procedure is performed with the patient in a sitting position, to obtain the most symmetrical result. A drainage by externalized suction drains in the armpits can reduce the risk of hematoma: these suction drains will be removed the day the patient leaves.
What happens after the surgery?
- There is usually bruising and edema (swelling) of the breasts which disappear within weeks.
- There are no stitches to remove because the sutures are made with buried absorbable thread.
- A sports bra with elastic fabric and an opening from the front, the size and cap will be defined with the surgeon before the operation, must be worn day and night for a month.
- During this period, any sport is prohibited, as well as carrying heavy items.
- When the procedure is taken care of by health insurance, a break of fifteen days from work is prescribed. However, the resuming of work may occur earlier for trades that do not require physical effort and are not very tiring.
- The scars should not be exposed to sunlight for 6 months after surgery.
What are the risks of breast reduction surgery?
- As with any surgery there is a risk of hematoma or postoperative infection, although this is very rare. They require appropriate treatment (drainage, antibiotics ...)
- Skin necrosis can rarely occur at the areolas or vertical and horizontal scars. It prolongs the healing time and leaves a large scar that can be redone secondarily. This complication is greatly enhanced by smoking. Thus, it is recommended to stop smoking for at least a month before the procedure.
- The sensitivity of the areola and nipple is generally decreased after the intervention, but usually normalizes within a few months.
- Scars can be large or hypertrophic (raised), unpredictably. They may sometimes require a surgical correction when they are too large or injections of corticosteroids when they are hypertrophic.
- Finally, breast asymmetry is sometimes observed postoperatively. It is even more common such asymmetry existed before. It may require surgical correction several months after surgery.
- Regarding anesthesia, during the consultation, the anesthesiologist will inform the patient himself of the anesthetic risks. You should know that anesthesia can cause unpredictable reactions, that are more or less easy to control. Using a fully qualified anesthesiologist, decreases those risks significantly. You should know, indeed, that the techniques, anesthetics and monitoring methods have improved immensely over the last twenty years, providing optimum safety, especially when the operation is performed on a healthy person.
The scars of a breast reduction surgery:
Final scars depend on different parameters (breast size, degree of ptosis, skin quality ...). These scars are still located around the areola and usually have a form of an upside down "T" under the areola (vertical to the base of the breast and horizontally in the crease under the breast). The horizontal scar can be shortened or even eliminated in some cases, with a final “I” scar.
- The final shape of the breasts can only be judged after 3 months and the final appearance of scars after 6 to 12 months.
- This intervention does not interfer with the mammographic detection of breast cancer. However, the intervention may reveal some mammographic images that should not worry the patient. It is useful to make a preoperative mammogram to check that these images did not exist before the procedure.
- Breastfeeding is possible in more than half of breast reductions. However, it is recommended to wait at least 6 months after surgery before starting a pregnancy. Final results are sustainable if there is no pregnancy after surgery, and the weight is (relatively) stable.
- The more volume is reduced, the less risk that the breasts will sag again. However, it is important to use an adapted technique to avoid the most common complications. Reoperation may be necessary if we want to give a good appearance to the chest.
Last update of this page : 06-06-2019