Breast reduction

The aim of the breast reduction surgery is to restore the aesthetically desirable appearance of the breasts by reducing the size, reducing the amount of breast skin, lifting the breast areola, overall firming and upward extension of the breast. A very common motive for surgery in patients with large breasts is not only cosmetic, but also to relieve the overloaded spine. Surgery for patients with very large breasts (gigantomastia - more than 1 kg) and chronic back pain is covered by the health insurance company after the procedure has been approved by the reviewing physician.

Before the procedure, it is necessary to have the breasts examined at a specialized mammology department. Breast tissue must be examined by ultrasound or mammography to rule out cancer. The surgery is performed under general anaesthesia, so it is necessary to undergo an internal pre-operative examination, this examination must be a maximum of 14 days old before the procedure. It is advisable to choose the date of surgery outside the date of menstrual bleeding.

The choice of surgical technique and the resulting scar depends on the patient's preoperative findings. Before surgery, we assess the quality of skin coverage, degree of ptosis (breast sagging), breast volume, size of planned volume reduction, etc. Depending on the results, we choose the surgical procedure and the placement of the skin incisions; most reduction surgeries are performed with the resulting inverted T-shaped scar (scar around the areola, further down and in the submental crease).

The course of the operation

Breast reduction is performed under general anesthesia and takes approximately 3 hours. Before the surgery in the ward, we make a thorough sketch of the future incisions and then you go to the operating theatre.

Before the operation, the surgeon will first make a sketch of the skin in the ward, then you go to the operating theatre. The operation takes approximately 2-3 hours. During the operation, excess skin is removed, the larger breast areolae are reduced if necessary, and the breasts are lifted and sculpted to the desired shape. At the end of the operation, suction drains are inserted and the incisions are closed with absorbable sutures. The breasts are bandaged with an elastic bandage.

Postoperative course

After the operation, suction drains are usually brought out through the skin and left in place for 1-2 days depending on the amount of blood suctioned. On the first postoperative day, the breasts are usually bandaged with an elastic bandage, which is usually replaced with an elastic bra the next day. This must be worn continuously for 6-8 weeks. During the first 4 weeks after surgery, it is recommended to limit physical activity and sports activities. Recovery time before returning to work is individual, the usual recovery time for an uncomplicated course is 1-2 weeks, most patients are able to return to work in a week after surgery.

Risks

Surgical and general anaesthetic complications are a risk with all operations.

General surgical risks include the possibility of hematoma and bleeding in the early postoperative period, sometimes requiring surgical revision and possibly blood transfusions. In addition, there may be problems with healing - wound infection, wound breakdown, skin necrosis with subsequent need for skin grafting, risk of hypertrophic or keloid scar formation or, conversely, atrophic scar formation, etc.

The most serious general risk is the risk of venous thrombosis with subsequent pulmonary embolisation, which can be fatal.

Specific risks of breast reduction include lateral asymmetry, altered nipple sensation, fatty pseudocysts in the breast tissue manifesting as firm deposits, necrosis of the skin or nipples, and other less common complications.

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