What is breast reduction?
Breast reduction – also called mammareductionplasty or mammareduction – is an operation in which glandular and fatty tissue is removed from one or both breasts (in men, if necessary, only fatty tissue). This is done to reduce the size and weight of the breasts.
Breast reduction is usually performed by a plastic surgeon.
Breast reduction without surgery?
If even a small breast reduction would be enough, it may be possible to achieve this with exercise and a healthy diet. To a small extent, the breasts can be reduced and tightened in this way. However, in case of a pronounced finding, there is usually no alternative to surgery.
When is breast reduction performed?
Although many women would like to have large breasts, they can also be a burden. For example, women with too large breasts often suffer from chronic back and neck pain. Sometimes posture problems and even slipped discs also occur.
The psychological burden of too large breasts can also play a role: For aesthetic reasons, women often feel very uncomfortable in their bodies. This then possibly affects their sex life and sporting activities.
Possible reasons for a surgical breast reduction are therefore:
- psychological stress due to the large breasts
- unevenly sized breasts
- constant skin irritation and eczema in the underbust fold (intertrigo)
In such cases, mammareductionplasty is usually the only treatment option and provides patients with tremendous relief.
Breast reduction for men
Under certain circumstances, breast reduction may also be necessary in a man. Namely, when the breast enlarges and looks feminine. This so-called gynecomastia usually represents an enormous psychological burden for the affected men. In addition, there is often pain and a feeling of tension. If the cause of the gynecomastia cannot be combated by diet, exercise or medication, surgical breast reduction is used.
What is done during breast reduction?
Before the operation, the surgical planning takes place. In addition to a detailed consultation and informational discussion between the doctor and the patient, this also includes an exact measurement of the breasts according to size and shape. Immediately before the operation, the surgeon draws the planned incision lines on the patient’s skin using a marker.
Breast reduction for women
In principle, there are various techniques to choose from for the procedure. In all of them, fat and glandular tissue is removed from the breasts. The various techniques differ, however, in exactly where the necessary incisions are made.
In principle, the surgeon tries to leave as few scars as possible. Which method is ultimately used is decided by the doctor and patient together before the operation.
If the surgeon removes a lot of tissue from the breasts, he often performs a breast lift in addition to the breast reduction. The result is more aesthetically satisfying.
T-method
In the T-method (also called the anchor or Strömbeck method), the doctor uses a scalpel to cut around the areola. This incision is made vertically downwards below the nipple to the crease under the breast. There he cuts again in a horizontal line. This creates a T-shaped incision, which gives the surgical technique its name.
After tissue removal, he moves the nipple with the areola upwards and sutures the surgical wounds closed.
L-method
The L-method follows the same principle as the T-method – the only difference is that here the surgeon hips the horizontal incision in the underbust fold to one side only. This results in an L-shaped incision instead of a T-shaped one.
Vertical method according to Lejour
O method (Benelli method)
Here, the surgeon restricts the incision to a round incision around the areola. This makes the O method the least scarring breast reduction. However, because not much tissue can be removed through the small incision, it is only suitable for small breast reductions.
Breast reduction for men
There are also various surgical methods to choose from for male breast reduction. Which one to choose depends largely on the initial condition of the breast and the desired result. Here are the most important techniques:
In the case of so-called pseudogynecomastia (“fake gynecomastia”), the male breast is enlarged solely due to fat accumulation. In this case, pure liposuction under local anesthesia or in twilight sleep is sufficient. The excess skin usually recedes completely afterwards, so that no skin tightening is necessary. If it does, the surgeon usually removes the skin in a circle around the areola.
In true gynecomastia, the glandular tissue of the male breast is increased in addition to the fatty tissue. For breast reduction, the surgeon then usually makes an incision at the lower edge of the areola and completely removes the mammary gland tissue. In addition, it may be necessary to suction out fat and tighten the skin.
Basically, a male breast reduction is performed in a semi-sitting position (for a better assessment of the breast shape) and takes about one to two hours, depending on the extent of the procedure.
What are the risks of breast reduction?
Risks associated with breast reduction include:
- bleeding, bruising and swelling
- @ Injury to nerves with possible permanent loss of sensation
- wound infection and wound healing disorders
- unaesthetic scarring, scar proliferation
- allergic reactions to medications and materials used
- death of fatty tissue
- different height of the nipples after the operation
- death of the nipple
- complications of anesthesia
Depending on the type of surgery, there is also a risk of impaired ability to breastfeed after breast reduction. This is particularly relevant for young women who wish to have children.
Many of the complications can be avoided with sufficient experience of the surgeon and careful surgical planning. Nevertheless, it is important that doctors inform their patients in detail about possible risks – especially because it is often a desired procedure without medical necessity.
What do I need to keep in mind after a breast reduction?
Swelling and discoloration after surgery are quite normal. These disappear by themselves after some time. Until then, it is not possible to check the final aesthetic result. This is only possible about three months after the breast reduction. If necessary, surgical follow-up can then be performed at the patient’s request.
The sutures are removed after seven to fourteen days. However, there is also special suture material that dissolves itself after some time.
For the first period after breast reduction, women must wear a special support bra. This prevents traction on the wound and also prevents the breasts from deforming during the healing process. The support bra should be worn around the clock (i.e. day and night) for at least six weeks.
Male breast reduction is usually performed on an outpatient basis. The drains placed to drain blood and wound secretions can be removed after one to two days.
For three to six weeks after breast reduction, men should wear a tight-fitting compression girdle around the clock (i.e. day and night).
If the patient is not satisfied with the shape of the breast, scar healing or the position of the nipple, it may be possible to correct this surgically.
Physical restrictions after the breast reduction procedure
Women should take physical rest for at least three weeks after discharge from the hospital. For men, a physical rest period of at least two weeks after breast reduction is advisable.
You will only be fully fit for work after about three to four weeks (women) or two to four weeks (men). If you have a physically demanding job, you may need a longer recovery period.
After a breast reduction, sports that primarily stress the chest and arm muscles should be avoided for the time being – for example, tennis, golf and weight training. More detailed recommendations on this will be given by the attending physician.
In order not to disturb the healing of the wound, visits to the sauna or solarium should also be avoided for the time being. Women in particular should make sure to sleep on their back and not on their stomach or side during the first weeks after breast reduction (in order not to disturb wound healing).
Breast reduction: scars and what to do about them
You can start caring for your scars a few days after the operation – ask your doctor or nurse for advice. You can regularly apply a conventional wound ointment to the surgical sutures. Once the wounds are completely healed, you can apply special scar gels. This may help reduce scarring. Ask your doctor if he or she can recommend a specific product.
UV light causes more darker skin pigment (melanin) to be deposited in scars, making them more noticeable. To avoid this, you should avoid direct sunlight and solarium visits for about three months after breast reduction.
