Breast Reduction

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Breast reduction surgery

Breast reduction surgeries are one of the most important operations of plastic surgery from a functional point of view. Breast is one of the most important organs in females which determines femininity.
Large breasts critically prevent people from adapting to social life. Especially in daily life, people seem overweight and this causes them not to wear anything they want and not being able to adapt to social life. Another problem that is caused by large breasts is skeletal deformities. Especially in our patients, neck distortion, bending forward, pain in the neck area, back and neck pain may appear as symptoms.
Especially, large breast size can cause sweating, unpleasant odour under the breast, the emergence of symptoms such as rash and dermatitis. In order to eliminate them, we perform breast reduction surgeries but many of our patients may be afraid and particularly some of them postpone the procedure. Breast reduction surgery is one of the surgeries that causes less pain, provides very fast recovery and adaptation to social life since the breast is an external organ.
After reducing the breast region properly in surgeries and following the recovery for 3-4 days, patients return to their work and daily life comfortably. Especially in patients with large breasts extending to the back, liposuction can be combined with breast reduction to remove the mammary fold, reduce breasts and the mammary crease significantly.
In this way, breast reduction surgeries increase the quality of life of our patients in terms of functional and aesthetic aspects.

Reasons for breast reduction

Women with large and sagging breasts mat face serious medical problems such as back and neck pain due to the excess load, skin irritation, skeletal deformations, and breathing difficulties. Bra straps can leave a mark on the shoulders, and very large breasts can cause a young woman or a teenage girl to be extremely shy and withdrawn.

The daily life and activities are affected in young people with breasts larger than normal. Performance at work and school is affected; people cannot keep the right posture in their daily life and try to hide their breasts with their shoulders. Gaining weight shows up due to inactivity and inability to do exercise and these lead to a chain of problems.

Heavy breasts cause neck and back pains, skeletal deformities, deformed posture, and physical pain that disrupts body ergonomics and posture. At later ages, skeletal deformities occur with the addition of osteoporosis. Apart from that, it can lead to the appearance of being overweight and large.

Large breasts in social life force you to buy bigger clothes than your actual body size. They always require the use of a supporting and uplifting bra. In every activity, it is necessary to plan and act by taking large breasts into account. It makes it difficult for you to do exercise. There may be rashes and unpleasant odour under the breasts due to sweating from time to time. Fungal infections and colour changes may occur in these areas.

Technically, the breast reduction process known as breast reduction aesthetics is designed for women with abovementioned conditions. In this method, fat and excess breast tissue are removed from breasts and breasts are made smaller, lighter and firmer. This method can also reduce the size of the breast circumference and the dark skin surrounding the nipple. The goal is to provide women with smaller, more beautifully shaped and breasts in proportion to the body. If you consider breast reduction, we will try to explain a basic set of situations when you can get help, how the procedure will take place and what results you should expect. You may not get answers to all your questions here. Since there are a lot of conditions varying according to the condition of the person. If there is something unclear about and you have other inquiries about the method please consult Assoc. Prof. Erdem Güven, MD. We will be happy to answer your questions and assist you.

Why do large breasts sag?

Generally, the factor is sagging and moving downwards of tissues due to gravity. As breasts get larger due to giving birth and breastfeeding and then the breast tissue shrinks at the end of the breastfeeding period, for this reason, the breast skin gets loose and sags and this causes breasts to get a more sagging appearance. When this process is repeated several times, breasts naturally sag more. At later ages, the loss of elasticity and hormonal changes cause sagging in the breast tissue. In some individuals with sagging at young ages, sagging is caused by genetic reasons. Sagging in the individual arises out of weak bonds inside the breast congenitally.

Are there any breast reduction exercises?

Augmentation of breasts starts in adolescence in particular and continues until mid-twenties. After augmentation of breasts is completed, reducing the size of breasts is not possible automatically unless breasts get large due to being overweight.
It is not possible to reduce the size of breasts with sports or other exercises. Because the structure forming the tissue in breasts is made of fat. There is no muscular tissue inside the breast. In other words, there is no muscular tissue in the structure of the breast since the breast is an external organ. Muscular tissue can be augmented, reduced or developed by exercise. Thus, it is impossible to reduce the breast by exercise or sports.

Breast Reduction Techniques

Many methods are described about non-surgical breast reduction methods on the internet in particular. There are methods such as different medications, solutions, and different herbal compounds.
However, concretely speaking, it is not possible to reduce the large breast size of a woman with these methods. Because the breast tissue can only be augmented or reduced as hormone-sensitive. This is the case to be observed during pregnancy. In pregnancy, the hormone-sensitive tissue is filled with milk and the breast enlarges. Breasts get smaller as the hormone regresses. Apart from this, reducing the breast is not possible with non-surgical methods.

Breast Reduction Techniques

The outline of the existing excess skin area in the breast is seen. The breast and fat tissue to be removed and the new position of the nipple are depicted.

The excess skin in the nipple is removed from the middle part and reduced. Side portions are joined to reshape the breast. A narrower, tightened and uplifted appearance is provided by contouring the breast.

Incisions around the areola and in the inframammary crease heal in 6-12 months and the tissue returns to its normal colour. These regions are concealed under daily clothes.

Smaller and better-positioned breasts will make you feel better and your clothes will fit better.

Who should undergo breast reduction surgery?

Breast reduction is usually performed for a physical comfort and aesthetic beautification rather than a simple volume reduction. Many women undergo this surgery due to very large and sagging breasts causing movement restriction and physical disorders.

In many cases, breast reduction procedure is not performed until breasts have completed their final development; however, if large breasts cause serious physical discomfort, the reduction can be performed earlier. The best candidates here are the women who have understood the procedure and have realistic expectations about the results and have grown in maturity to understand how this process is performed. Breast reduction is not recommended for women who plan pregnancy soon. This procedure can also be performed 6 months after breastfeeding.

Breast reduction is an important operation in plastic surgery and is generally considered as a functional operation. It is normally safe if performed by a qualified plastic surgeon. Especially in smokers and people with a body mass index above normal, the recovery may take longer. You can reduce these risks by following your physician’s advice for both pre- and post-surgery.

This method is carried out with different levels of incisions depending on the size of the breast. These incision`s locations, however, can be easily concealed by a bra or swimwear (scars which recover difficult are more common in smokers). In the future, breastfeeding can usually be secured by proper techniques that protect mammary ducts leading to the nipple.

How does the process of breast reduction surgery work?

1. Planning of breast reduction surgery

It is important to speak openly about your expectations with your surgeon and pay close attention to his / her suggestions in the first examination. Each patient and each surgeon have different views on the size and shape of desired breasts. However, a size corresponding to the body harmony and the size of clothing that the person wears is accepted as an ideal size.

The surgeon who will perform the surgery will also perform the breast examination and measurements. He/she will also take 3D photographs of your breasts for reference throughout and after the surgery. Your doctor will discuss the variables that will affect the procedure; these may include your age, the size, and shape of the breasts, and the condition of your skin. The predictive positioning of the nipple and areola will also be discussed with you. During the operation, breasts will be lifted and your nipples will be adjusted to be close to the inframammary crease.

Your surgeon will explain all the risks of the surgery, limitations and special planning for you in detail. Also, your doctor will make the necessary explanations about the anaesthesia to be used, the facility where the surgery will take place and prices.

2. Preparation for breast reduction operation

Your surgeon may require you to have breast ultrasound and/or mammography (breast x-ray) if you are at the age of 40 or younger and you have familial predisposition risks.

In order to prepare for the surgery, you will also receive specific instructions about eating, drinking and smoking habits, taking some vitamins and medications, or avoiding some of them. In some cases, your surgeon may recommend a pre-operative diet.

While making your preparations, it may be useful to find a person to accompany and assist you for 1-2 days after the operation.

3. Where will breast reduction surgery be performed?

Breast reduction surgery is usually performed in a hospital having good standards. You will have 1 night stay in the hospital. The operation usually lasts for 2 hours to 4 hours; however, it may take longer in some cases.

4. Anaesthesia type

Breast reduction is almost always performed under general anaesthesia. You will be asleep during the whole surgery. Your pain is easily controlled with appropriate painkillers after the surgery.

5. Breast reduction operation

Breast reduction techniques are very diverse but the most common method is to make an incision in the form of an anchor that runs around the areola and goes downwards and follows the natural crease under the breast. The surgeon removes the excess sagging tissue, fat, and skin and repositions the nipple and areola as a whole. Then, in order to shape the new contour of the breast, the surgeon reshapes the tissue on both sides of it and narrows the breast base. In this way, while he/she creates firmer and small breasts, at the same time, he/she ensures the elimination of breast folds extending to the sides of breasts. In some people, the liposuction method can be used to remove the excess fat extending to the armpit, if necessary. If breasts are too large and sagging, the nipple and the areola should be lifted upwards as a whole. In this case, the nipple will have a more aesthetic and lifted appearance.

Generally, stitches are not visible from the outside in surgeries. All incisions are combined with the adhering method and a skin colour tape is adhered on them. These tapes are located along the nipple, as a vertical line extending downwards and along the inframammary crease. In some cases, different techniques may be used to eliminate the incision the inframammary crease. When fat removal is only required, sometimes liposuction can also be performed as a single procedure to reduce the size of the breast by leaving a minimum scar (scarless breast reduction without any incision).

6. After the surgery

After the surgery, you will use a sports bra over the dressings. Usually, a small silicone tube (drain) can be attached to both breasts to drain the blood and tissue fluid that may accumulate inside during 1 day postoperatively.

Usually, our patients state that their pain significantly diminishes in 2-3 days and they do not need any painkillers. However, you may feel mild pain for several days. In particular, this pain may be more when you walk and cough in a 2-3 day period. In order to reduce your pain, your surgeon will offer you 2 different groups of painkillers.

Bandages are removed a few days after the surgery but you should continue to wear the sports bra for 4-6 weeks until the swelling regresses. Your tapes can be removed after a week or two. There is no need to remove stitches since there are no stitches. We usually allow our patients to take a shower after 3 days after the surgery.

After the surgery, if your breast skin becomes dry, you can apply moisturizer several times a day but pay attention to keep the taped area dry.

The period of menstruation following the surgery may cause swelling in your breasts and pain more than usual. You may feel pain in the form of tingling for several months. You may experience some loss of sensation in your nipples and breast skin due to swelling after the surgery. This usually disappears in about six weeks and all your senses usually return to normal.

7. Recovery

Even if you return to normal life within a day, you should avoid lifting and pushing heavy things for three or four weeks.

Your surgeon will give you detailed instructions to follow in your daily activities. The majority of women can return to work (unless it is hard and tiring) and social activities within 7-10 days. You will have less strength for a week or two and you should limit your exercises to stretching, bending and swimming until your energy level is restored. You will need a sports bra for support.

It may be good to stay away from sexual activity for two to three weeks as sexual activity may cause the swelling of the incision sites. However, you will need to avoid anything other than gentle contact with your breasts for six weeks.

A small amount of leakage or crusting of the surgical site is normal. If you have unusual symptoms such as rare and sudden pain and swelling, call your doctor without waiting.

8. Your new appearance

Although most of the swelling and bruising disappears in the first weeks, it may take six months to one year for your breasts to get into their new shape. Even after that, it may vary according to hormonal changes, weight changes and as a reaction to pregnancy.

Your surgeon will apply special treatments for making surgical incisions less noticeable. It should be noted that there may be redness in the incision regions for several months but at the end of the healing period, it turns into thin white lines.

Among all plastic surgery methods, breast reduction procedure provides the fastest change of the body outlines. The balance between the upper and lower half of the body improves and the harmony and aesthetics of the body become better. You will get rid of the inconvenience of large breasts and your body will look more proportional and your clothes will fit better.

However, as much as you desire these changes, you and others around you will need time to adapt to your new image. Be patient with yourself and to all of these changes.

Breast Reduction Prices

The main factors that determine prices in breast reduction surgeries are the hospital, duration of the operation, expectations of our patient and presence of hospitals to meet these expectations. Especially in breast reduction surgeries, the reduction of very large breasts can take a little longer time and hospital prices may increase accordingly.
Breast reduction surgeries are mainly referred to as functional surgeries. In other words, the large breast size causes both aesthetic and functional problems such as the limitation of functions of our patients in daily life, not being able to wear the desired clothes, not being able to adapt to social life, causing them to appear more overweight.
Therefore, breast reduction surgeries are one of the most important surgeries that provide both functional and aesthetic improvement in individuals.

frequently asked questions and answers

Breast reduction operations are performed as an in-patient treatment. Usually, our operation time varies between 3-4 hours depending on the size of the breast and the patient’s conditions. Our patients usually stay in the hospital one night and are discharged the next day.
I place a drain which evacuates tissue fluids that can accumulate inside and remove it before the patient`s discharge. Our patients can return to their daily life very comfortably after 3-4 days of rest after the surgery.
During the surgery, the procedure we carry out is the repositioning of the sagging part of the nipple to the centre of the newly formed breast, in other words, moving the nipple upwards with the breast tissue. And besides, the excess skin is removed from the lower part of the breast and thus the breast gets reduced.
In addition, in order to achieve a more pleasing appearance and eliminated the crease going to the chest, liposuction is applied to the patients with the inframammary crease extending to the chest and sides. In this way, our patients can have breast reduction procedures very comfortably.

Breast reduction is one of the surgeries performed in patients with a severe growth in their breasts from adolescence. Breast reduction operations are preferred especially for women with a breast cup size of C and higher.
The large breast in slim women can show them as overweight. Therefore, breast reduction operations are performed to prevent this overweight image. In addition, we can also perform breast reduction operations in patients whose breasts grow during pregnancy and do not shrink enough after pregnancy.
In addition, breast reduction operations can be performed in patients with large and heavy breasts, nipples moving downwards, different locations of nipples, asymmetrically positioned nipples, a size differences of breasts such as one of them is large and the other one is a small and serious asymmetry between breasts.

Patients usually spend 1 night in the hospital following the procedure. There may be slight bruises and swelling on breasts and surrounding areas and they last around 1 to 2 weeks. Swelling of the breasts can continue for a few weeks. You can start your normal activity again in 1 or 2 days. However, you should avoid heavy exercises for 3-4 weeks following your surgery.

Although you may have pain for a few days, most of our patients are not uncomfortable with this. After the surgery, you will be prescribed the appropriate painkiller which greatly reduces your pains.

Your first visit after the surgery is usually within the first 3 to 5 days. We will monitor your recovery for a few weeks. We also recommend that you come for the control in 6th and 12th months.

Usually, you can return to work within 1 week. If your job requires physical activity, you can take 2-3 weeks of leave or you can consider working avoiding heavy activities.

Driving a vehicle varies depending on the type of the performed operation. Vehicle use is usually allowed after the 3rd week. However, in special cases vehicle use is not advised for up to 6 weeks.

You will be prescribed painkillers and antibiotics during your discharge. Generally, if you do not have any allergies against NSAIDs (such as rantudil, apranax, majezik) and paracetamol (such as geralgine, parol), we prefer to use these two groups in combination. Usually, we recommend the use of appropriate antibiotics for 5-7 days after the surgery.

Although in general, we would like our patients who have undergone breast augmentation operation to stay in the hospital for 1 night, patients may be allowed to go home the same day.

You can return to it when you feel comfortable enough. Immediately after the surgery, anything other than soft contact on your breasts may damage the incision locations.

In breast augmentation surgeries, implants are placed by very small incisions. There are no visible stitches after the surgery and the sutures are attached together. The healing of wound scars will depend on the genetic characteristics of the individual, and the treatments that prevent scarring are described to our patients in the postoperative period. Our patients who follow the directives have no complaints. Different treatments are recommended for individuals who are genetically susceptible to scar formation.

Drains are necessary to collect the fluid accumulated in your breast after the surgery. We generally consider the use of drains to be the most secure way to achieve the best results for our patients. You should measure and empty the drains at least once a day. Our nurses will give you the training of this before you leave the hospital. In most cases, drains are removed within the first day and sometimes within a few days. You can hide your drain quite well under loose clothing.

If you have a drain, you can wipe it with a wet tissue. You can take a shower at the earliest 2 days after your drain has been removed. There are usually no stitches visible from the outside in your incision areas. There will be two layers of tapes in these regions. First layer tapes, which are pasted on the skin and have a skin colour are removed after 7-10 days. We recommend removing the white or waterproof transparent tape, the second layer of the tape, after taking a shower.

We recommend wearing a sports bra after surgery. It should be a non-wired bra that is fastened on the front. On the day of surgery, we recommend that you bring button-front pyjamas which can be easily taken off.

You will realize the visible result immediately. However, there will be swelling up to 10 -20%. Swelling will greatly decrease in 3-6 weeks.

Different techniques are used in breast reduction operations. In the techniques we use, the nipple remains intact and does not affect breastfeeding. Extra-large sagging breasts may require more aggressive applications. In such cases, there may some effects on breastfeeding, as the mammary ducts coming to the nipple will be too long.

There may be a loss of sensation on the nipple following the surgery. In spite of this, often the sense slowly returns to normal. However, the loss of sensation in breast reduction surgeries is a risk.

Breasts can grow when too much weight is gained. Therefore, it is important to keep your current weight. And let’s not forget that the breasts grow in pregnancy.

We do not use any stitches that can be seen from outside in all surgeries. Therefore, there is no need for the removal.

You can travel in a few days. However, we would like you to follow your recovery process for a few days and a few weeks after the surgery. Our patients living outside the city can continue their controls by taking and sending photos.

Author: Doç. Dr. Erdem Güven
We're writing about our patients.

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