Breast Reduction. The breast is an organ that is the symbol of “fertility, femininity and motherhood” and has an important place in the social identity of women. Apart from its appearance, breasts, which are also of great importance functionally as breastfeeding, may differ in size and shape in every woman.
Nowadays, breast reduction surgeries are of great importance, as they affect health negatively among the aesthetic operations performed under the name of breast aesthetics. Compared to other breast surgeries, breast reduction surgeries, which are not performed solely for aesthetic purposes, have recently become the most common aesthetic surgeries performed by plastic surgeons.
Causes of Breast Growth
Breast reduction surgery differs from other breast surgeries in one aspect. It is an aesthetic surgery performed not only for psychological reasons but also for physiological reasons. Because women with large breasts have some or all of the symptoms such as the neck, back, waist pain, posture disorders, skin problems under the breast due to sweating, pressure marks on the shoulders due to bra straps. Genetic characteristics also play a big role in breast growth. Genetically, in some families, breasts are always large. When women who previously had normal-sized breasts gain weight, their breasts may also grow. Birth and breastfeeding can cause breast growth and sag. Hormonal disorders or drugs used can cause breast enlargement.
What is Breast Reduction Surgery?
If there is a proportional size in the breasts, it causes both aesthetic and functional problems in these people. Big breasts may lose their relatively aesthetic appearance. Big breasts cause neck, shoulder, and back pain. This situation creates posture disorders and these disorders can become permanent.
The inability to wear the desired clothes and visible disproportion can negatively affect the psychology of women.
Such problems can be eliminated by breast reduction surgery, and the person can continue their normal healthy life more easily.
It is possible to use many techniques in breast reduction surgery. Some criteria are taken into consideration in the choice of technique.
- The volume of the breast
- Sagging condition of the breast
- The density and position of the breast tissue
- Age of the patient
- Whether there will be an expectation of pregnancy after surgery
- In which position the tracks are asked to remain
- Smoking history
- Medications and habits used
- These factors are the criteria that affect the success of breast reduction surgeries.
- The main criterion in all techniques is where the structure called pedicle connecting the nipple to the chest wall will be. It can be top, bottom, side, all over, or oblique. This connection includes blood vessels, sensory nerves, and milk ducts.
- The amount of tissue to be removed from the breast is made by preserving this connection. The remaining tissue is then removed.
No matter how much tissue is removed, this structure should be preserved so that both the nipple remains alive and the milk-giving and sensory functions are not impaired. The common feature of all techniques is that the nipple is moved to its new location. Considering the height and body structure of the person, the nipple is suspended at a distance of 19-24 cm from the bone notch under the neck.
The next step is to fix the breast tissue to the rib cage with threads (sutures) that will replace the suspension ligament. Thus, the sagging of the breast over time is delayed. Then other textures are combined.
Finally, the stitches are completed in such a way that the scar (scar) remains in the shape of either an inverted T or an I (lollipop), just as it was planned before the operation.
When Should the Breast Reduction Surgery Be Done?
Breast reduction plastic surgery can be performed on any woman who has completed breast development and has no obstacle to surgery. This surgery should be performed in the earliest possible period since large breasts cause posture disorder, rashes, and wounds under the breast, as well as serious psychological problems during adolescence. While the age of 18, when the body development is completed, is the earliest period when the surgery can be performed, the upper age limit determines the suitability of the person for the surgery.
Pre-Surgery Preparation
People who are considering breast reduction surgery should consult a plastic surgeon for information on this issue. Expectations should be explained in detail at the first examination and possible risks should be discussed. During this examination, the size and shape of the breasts, the condition of the skin, age, marriage, and whether to have children, the new location of the nipple, etc. situations will be shared with the person.
Before the operation, the physician should be informed about conditions such as high blood pressure, smoking, medication habits, diabetes. If necessary, ultrasonography or mammography can be performed before surgery, depending on the age of the patient.
The necessary tests for the surgery can be done in the hospital the same day before the operation. Before the operation, drawing and planning should be made on the breast according to the technique chosen according to the patient. These drawings are very important for the surgery to be completed quickly.
Breast Reduction Surgery Techniques
There are surgical techniques that vary depending on the size and sagging of the breasts. The physician will decide which of these techniques is the most appropriate for the person with some measurements made during the examinations.
Nipple graft technique:
The first of these is a technique performed by taking the nipple applied in very large breasts, reducing the breast, and then creating a new nipple.
With this technique, too much breast tissue can be removed and the breast is reduced as desired, but there is a loss of sensation in the nipple and it cannot give milk. It is not a highly preferred method.
Flap technique:
In this technique, the nipple and breast tissue are preserved alive and after the excess tissue is removed, the nipple is moved upwards.
Breast tissue can be designed as either fed from above, fed from the midline, or from below. Since breast tissue is preserved most of the time in these techniques, people can milk and there is little or no loss of sensation in the nipple.
Postoperative Period
The operation is performed under general anesthesia for an average of 2-3 hours. One day after the operation, the patient can leave the hospital and return to normal life 7-10 days later. Breast reduction surgery is not a very painful operation, the pain can be easily controlled with pain medication.
Drains are used to remove minor bleeding after surgery. These drains are usually removed by the physician 1-2 days after surgery.
In breast reduction surgeries, there is always a scar and these scars may be at different rates depending on the amount of tissue removed and the genetic characteristics of the person. Over time, the scars become smaller or even vague.
It is normal to have edema and swelling after breast reduction. These will automatically decrease within 3-4 weeks, depending on the recovery period of the patient.
Breastfeeding Function After Breast Reduction Surgery
Although almost all of the techniques applied today are aimed at preserving the milk giving feature, this probability is generally 80-90%. There is a possibility that he may not be able to give milk even if it is small. Although this is completely proportional to the tissue to be removed, it is sometimes due to adhesion and blockage in the channels we call fibrosis. As a result, it is more preferred that a new pregnancy is not planned after breast reduction surgery.
What Should be Considered After Breast Reduction Surgery?
It is recommended to rest at home for at least 3, optimum 7 days after breast reduction surgery. It is extremely important to use antibiotics and pain medications prescribed by the physician after the operation at the specified dose and time.
The use of a sports bra that does not put pressure on the breasts and prevents shaking is also of great importance in reducing the amount of pain and shaping the breast.
After the operation, the doctor determines the dressing days. Dressing on these dates accelerates healing while reducing the risk of possible infection. It is necessary not to carry heavy loads and avoid pushing and pulling movements for about 4 weeks.
Light exercise movements can only be done after the end of the first month. Lifting weights and movements that force the arm and chest muscles should also be avoided. After breast reduction surgery, the breast tissue appears edematous and swollen. This swollen appearance decreases in about 3 to 4 weeks and it takes about 1 year for the breasts to regain their real appearance.
Smoking and alcohol consumption should be stopped for at least one month after breast surgery for rapid recovery of tissue and scar tissue. Since smoking and alcohol consumption affect cell regeneration, it also negatively affects the visibility of the surgery scar.
Now, let me share the frequently asked questions about the breast reduction operation that we give you detailed information and the answers to these questions.
Frequently Asked Questions
Does breast reduction surgery damage the milk glands?
During the breast reduction procedure, no harm is done to the milk glands, and the person can become pregnant and give milk at any time.
From what age can breast reduction surgery be performed?
Breast reduction surgeries are performed after the growth and development of young girls at the end of their adolescence period and after the final shape of the breast tissue, that is, around the age of 18.
What are the health problems that develop due to breast size?
In addition to the aesthetic impairment in breast size, functional impairment, which is even more important, causes serious health problems in the person. These;
- Breast size and downward sagging position cause serious back and shoulder pain in the person, and even future periods may cause a cervical hernia.
- There may be rashes and even fungal problems for a long time because the area on the lower part of the breast is constantly moist and stuffy.
- Depending on the weight of large breasts, bras cut the shoulders and damage the muscles in that area.
Can recovery and lifting be performed simultaneously with breast reduction surgery?
The main purpose of breast reduction surgery is to remove excess tissue and reduce the breast. However, after each breast reduction surgery, the breast must be rejuvenated and lifted.
How much reduction can be achieved in breasts?
How much reduction can be achieved in the breasts is different for each patient. After calculating the patient’s overall body measurements, shoulder width, and chest circumference, the breasts are reduced in proportion to the patient’s body size. Since the milk glands should be protected in patients who are planning to give birth and breastfeed after the operation, breasts can be reduced to a certain extent.
The extent to which the breasts will be reduced is decided during the examination in line with the wishes and expectations of the patient and cooperation with the doctor’s recommendations.
What are the risks of breast reduction surgery?
Every surgical operation carries risks. These risks vary according to the technique to be applied, the health of the patient, the size of the disease, the size of the intervention, and many other reasons.
Bleeding: It is normal to have bleeding during and after breast reduction surgery, as incisions will be made and tissue will be removed in the operation areas. Therefore, a detailed blood test should be performed to the patient before the operation and blood may be given to the patient according to the amount of blood loss.
Infection: After breast reduction surgery, there may be redness, swelling, discharge, and edema in the entire breast area, and antibiotics are usually sufficient to prevent or eliminate the infection. In some infections, the duration of the hospital stay can be extended by the doctor’s decision, and infection treatment is performed.
Fat necrosis: Fat necrosis can be seen in the breast area after surgery, which may cause yellowish discharge and may persist for a while.
Hematoma: There may be hematoma (blood accumulation) under the breast tissue after breast reduction surgery. This situation may sometimes require surgical intervention.
Asymmetry: When breast reduction surgeries are not performed carefully and carefully, a difference in size and ratio may occur between the two breasts. If asymmetry or unexpected results are obtained after breast reduction surgery, revision surgery may require breast correction.
Sensitivity: A decrease or complete loss of sensation in the nipple may be observed after breast reduction surgery. Sensory losses usually return between 3-12 months.
Late recovery: The healing process is different for each person. In some patients, wounds may heal late after breast reduction surgery. Patients whose wounds heal late are followed up with dressing.
If you are considering breast reduction surgery for aesthetic or medical reasons, you can apply to an experienced physician and a hospital where appropriate conditions are provided. We wish you healthy days.
