Breast Reduction

Weight gain or breastfeeding may cause the breast tissue to grow a lot more thannormal, especially genetic factors really effect this. When the breasts are above normal size, it causes problems that seriously affect the patient’s quality of life such as back, shoulder and neck pain, spine problems, posture disorders, bad odor due to sweating under the breast, fungal infections. In addition, breasts that are much larger than normal, start to sag even at an early age, leaving bra strap marks on the shoulders due to weight and pressure, and creating an uncomfortable appearance because the nipple is positioned much lower than it should be are a few of the complaints of the patients. Breasts, which are disproportionately large for the body, negatively affect the social life, mood and self-confidence of the person as well as health problems. Even not being able to wear the clothing they want can be a big disappointment for a women. Breast reduction surgery is a necessary need which can have a positive impact on the patient’s life, this is not just a cosmetic procedure. I don’t remember any of my patients who regretted having a breast reduction surgery.

Patients under the age of 18 are cannot be operated. Apart from this, breast reduction procedures can be performed on every patient, unless there is a special health problem. In young patients, it is expected to wait for the breasts to take their final form before making a reduction. If the breast continues to grow, it is always wiser to wait until the growth stops. However, breast reduction surgery can be performed in the earlier ages of young girls, where virginal hypertrophy is seen, which is a condition of breasts to be continously growing.

Just like in any other surgery, quitting smoking at least 2 weeks (preferably 1 month) is recommended. For patients who smoke; it is very important not to encounter wound healing problems and not to endanger nipple blood circulation after surgery, so the earlier you quit the better. Likewise, since it causes problems such as postoperative bleeding, it is necessary to stay away from anticoagulant medications that can trigger bleeding issues, and if there is (diabetes, hypertension) systemic diseases should be taken under control one week before the surgery. Before the operation, every patient should go through mammography / breast ultrasound. It is very important for the follow-up checks to have an x-ray image before the breast procedure. Mammography / breast ultrasound should repeated 1 year after the operation.

Breast reduction surgeries including scarring. Depending on the size and severity of the looseness of the breast and the technique to be chosen for the breast reduction surgery candidates, there will be a scar around the nipple, and a vertical scar under the nipple and mostly a horizontal scar under the breast. The length of the scar varies depending on the size of the breast, its sagging and skin quality. In patients who do not face wound healing problems, the scars become faded over time and will be barely noticeable.

Regardless of the technique used, if the stiching of the scar lines is done very tightly then, then the scarlines will be too thin to be noticed. If it is done very tightly, then there is a high risk of the scarline to be expand in the long term and create an unsighty look.

Yes, breast sagging issue, which is one of the biggest problems of large breasts, is corrected during the same operation, and the breasts are given a more perky and upright form.

In breast reduction surgery techniques, breastfeeding may be affected as the breast tissue, including the milk glands and ducts, will be reduced. The size, sagging of the breasts and the age of the patient are very important while deciding on the technique. For this reason, instead of using the same technique always, deciding on the ideal technique specific to that patient according to the patient’s wishes will increase patient satisfaction after surgery. The central pedicle technique is the technique that most preserves breastfeeding and nipple sensation in young patients who have not yet had children and who require a relatively less reduction. However, in patients who are perimenopausal and who are planned to be reduced to a bigger extent of their breast tissue, removing the milk ducts together with the reduction will not create a problem after surgery, so techniques where removing more tissue actually becomes advantageous. For this reason, it is very important to choose an experienced surgeon who does not depend on only one technique for this surgery, but who can determine and apply the most appropriate technique for that specific patient’s case.

In many breast reduction techniques, temporary or permanent, partial or total losses may be experienced in nipple sensation. Numbness decreases in about 6 months after most operations. However, in some techniques performed on patients with very large breasts who have completed their menopause, are older, and are planned to be reduced to a very high level, nipple sensation may disappear completely. For this reason, techniques in which nipple sensation almost never disappears (central pedicle) or that we know will come back within months should be preferred more for younger patients.

Breast reduction surgery is performed under general anesthesia in operating theatre takes 2.5-3 hours.

In breast reduction surgery, breast tissue is removed so the amount of tissue that will produce cancerous tissue will also decrease, so the risk of breast cancer will actually decrease.

As I apply local anesthetic to the operated area after breast lift surgery, the patient usually spends the first 10-12 hours mostly pain free. After that, pain relievers will be sufficient for pain control. By the end of the first week, patients usually do not need to use painkillers at all.However, sometimes during the first 6 months in the recovery period, patients may encounter a very short stinging pain. These short-term pains that do not require pain medication are normal to face during recovery.

It would be appropriate to wait 1-week post breast reduction surgery.

Patients stay in hospital for 1 night. Generally, I use drains to minimize the risk of internal bleeding. The patients are discharged the next day after their drains are removed. After being discharged, it is requested to use the corset bra for 4 more weeks. Post op checks are done on the 3rd and 7th days after the operation and the next check is planned for the 1st month post surgery. Since I use dissolvable stiches, there is no need for stich removal. Since pain and sensitivity may increase with arm movements, it is appropriate to limit physical activity for the first 2-3 weeks. The patient can exercise 4-6 weeks after breast lift surgery. It may take up to 1 year for the breasts to take their final shape after surgery.

As in every surgery, complications such as bleeding (hematoma), fat necrosis (white-yellow discharge after surgery), nipple circulation problems and wound healing problems (therefore quitting smoking is very important), sensory disorders in the nipple can occur but very rarely. If there is bleeding internally or if there are wound healing problems, revision surgery may be required. It is possible to end up with perfectly symmetrical breasts and 100% symmetry cannot be expected because of human nature and anatomy  from this breast reduction surgery, one breast is always going to be very very slightly bigger than the other, which does not really bother the patient at all but asymmetries that disturb the patient that require revision can be seen very rarely in the post-operative recovery period too.