Synonyms
Breast reduction surgery
Introduction
Breast reduction is an operation in which the breasts are reduced in size. In the past, breast reduction surgery was simply aimed at removing as much fat as possible. Nowadays, the main focus is on keeping the nipple fully functional and on ensuring that the breast retains a beautiful shape after the operation.
Indication for breast reduction
The indication or the reason for a reduction of the breasts can be manifold. For example, too large breasts can lead to severe chronic back problems. Many patients feel restricted in their movements and are sometimes no longer able to do sports.
Severe shoulder pain and back pain are often the result. The heavy weight of the breasts can cause constrictions on the bra straps and under the breast contact on the abdominal skin can lead to skin rashes on the inframammary fold or even infections with fungi. In many young patients, the strong psychological strain is added to this. The female breast is a characteristic of beauty for the woman and has a strong influence on the self-confidence of the woman. Breast reconstructions, however, are often purely aesthetic, but for the above-mentioned reasons they are often also a medical indication for breast reduction.
Coverage of costs
Whether the costs are borne by the health insurance company for medical reasons depends on whether the health insurance company sees this as a medical indication that is harmful to health or as a purely aesthetic problem. To this end, the doctor who is performing the assessment must issue an expert opinion for the patient and forward it to the health insurance company. However, health insurance companies often do not recognise these expert opinions. Breast enlargement can also occur in men. In most cases, however, it is not so extensive, so that the breast is usually reduced in size by liposuction.
Where’s that big chest coming from?
In most women, the breast is simply too large in relation to the rest of the body by nature. Too large breasts can also be caused by adiposity (obesity). Another aspect is hormonal imbalances that cause oversized breasts, such as pregnancy or other hormonal imbalances.
Operation
After explanation, discussion of the surgical procedure and the technique, the operation follows. The surgery for breast reduction depends on the size, appearance and texture of the breasts. There are different operation techniques.
The incision technique is along the nipple and the incision is continued downwards towards the inframammary fold. Depending on the size of the breast, a cross section must also be made at the bottom of the inframammary fold so that enough fatty tissue and glandular tissue can be removed. In breast reduction, fatty tissue and glandular tissue is removed.
In addition, excess skin is removed, which makes the breast even firmer. Since much fat and glandular tissue is removed to reduce the size of the breast, the nipple and areola must also be positioned in a different place. Since most of the fat and glandular tissue is removed from the lower edge of the breast, the breast is sewn tightly together again at the bottom and the nipple is positioned at the desired height, and then sewn back on to the skin.
In most cases you will not get large scars, as the transition between the areola and the skin is made of different skin colours, so the transition is not visible. If the breast is too large, it may be necessary to remove the nipple from the surrounding tissue and transplant it “freely”, without surrounding tissue. In this case there is a risk of reduced nipple supply.
By preserving the glandular body and nipple, there is usually no impairment of breastfeeding ability. The duration of the operation is usually 2-4 hours, depending on how much is removed and which surgical technique is used. The operation is performed under general anaesthesia.
After the operation, the patient is usually hospitalised for 2-3 days and then comes back 2-3 weeks later to have the stitches removed. Slight movements such as walking or cycling can be resumed after 4 weeks, but due to the scars, you should not take up any real sporting activities until after about 8 weeks. The aim of breast reduction is to reduce the volume of the breast and to reduce unattractive asymmetries in the breast. The breast is also transplanted back to its original position or lifted and pulled up and in most cases the breast is also tightened by removing excess skin and appears firmer.
