Oftentimes, large breasts are not a primary esthetic problem, but are associated with physical complaints. Affected women frequently suffer from neck or back pain which tend to recur in spite of therapy and can even lead to lasting postural damage. In addition, the inframammary skin can become irritated and develop fungal infections. Finally, many patients also experience psychological strain.
Basically, breast reduction (mammary reduction) involves the removal of skin, breast glands, and fatty tissue, to diminish volume and restore the nipple to its original position. During this procedure, the breast is re-contoured with the remaining tissue and enclosed within a tighter cutaneous layer.
How do I prepare?
Prior to the operation we will discuss with you your concepts in an extensive counseling interview, and depending on your age and risk factors, initiate testing for early breast cancer detection. Starting at 14 days before the operation, you should refrain from taking any pain medications that impact blood coagulation (e.g. aspirin). We also recommend that you avoid the consumption of nicotine two weeks before and after the operation.
How is the operation carried out?
The operation takes place in the context of a 3 to 4-day hospital stay, and is performed under general anesthesia. Prior to the intervention, markings are drawn on the patient's standing body.
In most cases the areola of the breast is reduced so that it will match the new breast, and the nipple is repositioned. Redundant mammary gland and fatty tissue as well as skin are excised, and a smaller, tauter breast is shaped. The incision and thus the scars run along the nipple, and from the nipple vertically down to the inframammary fold. In the case of very large breasts, there is frequently also an incision along the inframammary fold.
What about follow-up care?
After the first or second day, the drainage tubes for the wound secretions are removed and the patient is fitted with a supportive sports brassiere. This should be worn day and night for a period of six weeks. In the area of the nipple the skin is sutured with fine surgical threads, which are removed after 10–14 days. The remaining sutures dissolve. Most women experience marked improvement of their discomfort right away, however, the definitive breast contour takes minimally six months to become apparent.
Are there complications?
The removal of mammary gland tissue can lead to limited ability to breastfeed. Sensory disturbance of the nipples is also possible as is, very rarely, perfusion deficit. As with all operations, there is the risk of postoperative hemorrhage, infection, impaired wound healing, or excess scar tissue formation.
Will health insurance cover the costs?
Since very large breasts can lead to health problems, health insurance plans in certain cases cover the costs of treatment. Basically, the following criteria must be met:
- Expected tissue reduction > 500g per breast
- Physical complaints which are attributable to the weight of the breasts
- Normal body weight, BMI < 25kg/m2
Key points at a glance:
- Duration of surgery: two to three hours
- Anesthesia: general
- Hospital stay: three to four days
- Follow-up care:
- Sports brassiere without metallic content for six weeks
- No sport activity for six weeks
- Work disability: one to three weeks (depends on physical stress required for work)