What is breast reduction (“Reduction Mammoplasty”) surgery?
It is the surgery that reduces the size of large breasts that cause discomfort and gives a more aesthetic appearance to deformed breasts. Thanks to this surgery, which provides a functional benefit as well as aesthetic gains, women get rid of excess breast burden and achieve a smaller, more aesthetic and lifted breast appearance. This surgery is performed under general anesthesia and takes approximately 2.5-3 hours.
Why are the breasts larger than they should be? What are the problems caused by breast size?
Breast size may be related to genetic factors, individual factors, excessive growth of breast tissue at puberty, hormonal changes, pregnancy, and breastfeeding period. Whatever the reason, the problems caused by big breasts are common: “Back pain, waist and neck pain, body posture problems, redness/itching/dermatitis in the inframammary fold (the fold under the breast), pressure and pain on the shoulders of the bra straps, not being able to choose the appropriate bra or clothes, looking fatter than you are, sagging/ptosis and deformity in the breasts”.
What should be considered before breast reduction surgery?
It is extremely important to take a detailed history, perform an accurate physical examination and use appropriate imaging methods before breast reduction surgery. In the history; pregnancies, breastfeeding history, future plans to have a new child, previous breast surgeries, family and personal breast cancer history, bleeding disorders, other comorbidities, smoking (it is very important to quit before the operation) are questioned. In the physical examination, a detailed breast and armpit examination is performed for possible masses. Then; breast size, breast shape, skin quality and elasticity, nipple position and shape, degree of sagging and existing asymmetries are evaluated. Then, some measurements are made to determine the location of the nipple on the chest wall and its distance from the inframammary fold. Breast ultrasound or mammography is then routinely evaluated, depending on the patient’s age and history.
What is the post-operative period after breast reduction surgery?
You are usually discharged the next day after breast reduction surgery. Unless the breasts are very large and there is a bleeding problem, I do not use drains, so we do not deal with the removal of drains. Minimal pain after surgery is expected, but the feeling of comfort caused by the reduction in volume of the existing breasts is more dominant than the feeling of discomfort caused by the pain. It is possible to get through this process quite easily with the painkillers that will be prescribed to you. You will be dressed in a special medical bra when you come out of the surgery, and it is recommended to use this bra for 4-6 weeks. Patients can usually return to their daily routine activities at the end of the 1st week, but the end of the 6th week should be waited for heavy lifting and intense physical activities. The stitches do not need to be removed because the stitches will be absorbed. It is strongly recommended not to smoke in the postoperative period. Because smoking delays wound healing by reducing the blood supply of tissues.
Will there be any scars in breast reduction surgery?
As in other surgeries, there are some scars in breast reduction surgery. It should not be forgotten that a scar is absolutely necessary to achieve the desired goal in plastic and aesthetic surgery. In breast reduction surgery; the scar is around the nipple, vertically extending down from the nipple, and sometimes in inframammary fold (the fold under breasts) when deemed necessary. These scars never completely disappear, but after a certain time, the clarity and visibility of these scars will decrease considerably (6 months-1 year). The exception is wound healing disorders such as hypertrophic scars and keloids. In those cases, the relevant treatments are directed (See Scar Treatment Section). As a result, the scars that will occur in breast reduction surgery depend on the technique and the current size. Considering all the mentioned factors, the most appropriate and least scarring method is selected. There is a very sensitive point here. It is also not reasonable to compromise on the desired breast shape and volume in order to reduce the amount of scars. It should not be forgotten that the feeling of relief after surgery usually becomes more dominant than the visibility of these scars. Therefore, a correct doctor-patient communication is very important.
Is there any loss of breastfeeding and nipple sensation after breast reduction surgery?
In breast reduction surgery, some breast tissues are removed to make adequate reduction. Therefore, there is a possibility of damage to the mammary glands. When the studies are examined, there are publications describing the possibility of breastfeeding as 75% in patients who have undergone breast reduction surgery. The rate of loss in the nipple sensation after surgery is around 9-25%, and these changes are usually temporary. As a result, when the current literature and methods are examined, breastfeeding is generally preserved, so people who have not yet given birth and who have not breastfed can also have this surgery. However, if possible, women who do not have any future pregnancy or breastfeeding plan are the most suitable candidates for this surgery. This will also prevent the deformity of the breasts that will occur after a pregnancy and breastfeeding. It is also extremely important not to smoke in the pre- and post-operative period in order to avoid complications.
Does breast reduction surgery increase the risk of breast cancer?
Breast reduction surgery does not increase the risk of breast cancer. On the contrary, since breast cancer develops from mammary glands and some breast tissues are removed in breast reduction surgery, studies say that the risk of breast cancer decreases after breast reduction surgery. Also the possibility of early diagnosis of cancer increases with pre-/post-operative imaging which will be done for reduction surgery.
How much is breast tissue reduced?
Up to 2.5 kg of breast tissue per breast can be safely removed. However, the patient and the doctor should decide together how much they will be reduced. Patient-doctor communication is very important. It is also not recommended to reduce the breast too much. The breast is an important sex organ and very reduced breasts lack an aesthetic appearance. In addition, it is extremely important to leave enough breast tissue to feed the areola and nipple.
Summary
Breast reduction surgery is one of the important operations of plastic and aesthetic surgery, which shows its effect immediately with the feeling of relaxation after the operation. This surgery provides functional benefits as well as an aesthetic appearance. If the necessary scar, the risk of not being able to breastfeed and impossibility to achieve 100% symmetry are understood, patient satisfaction rate is very high. A detailed history and physical examination, an accurate surgical plan, a clear understanding of risks and complications, and a correct patient-surgeon relationship are extremely important. You can browse the related articles in the References section. Best regards.
Sources
