Breast Reduction Surgery (Reduction Mammoplasty)
Breast reduction surgery (reduction mammoplasty) is a surgical procedure performed to reduce the volume of large and heavy breasts, rearrange the breast shape and relieve the physical discomfort caused by the breasts. It can be preferred especially because of back, neck and shoulder pain, skin irritation under the breasts and difficulties in daily activities.
During surgery, excess breast tissue, fat and skin are removed, making the breasts more proportionate to the body. When necessary, the nipple is moved to a higher position. In addition to improving aesthetic appearance, breast reduction surgery can also help reduce physical complaints related to large breasts.
What Is Breast Reduction Surgery?
Breast reduction surgery is a plastic surgery method applied to reduce the size and weight of the breasts.
Large breasts can place an additional load on the neck, back and shoulder area in some people. Problems such as bra straps leaving deep marks on the shoulders, irritation and rashes under the breasts, or difficulty with physical activities can be seen.
In reduction mammoplasty surgery, excess breast tissue, fat and skin are removed. The remaining breast tissue is reshaped, aiming to create a smaller, lighter appearance that is in harmony with body proportions.
During the procedure, the nipple and the darker-colored area around it, called the areola, can also be moved to a suitable position.
Breast reduction surgery can be considered not only because of concerns about appearance but also to relieve the physical complaints caused by large breasts.
Who Is Breast Reduction Surgery Suitable For?
Breast reduction surgery can be a suitable option for people who experience physical discomfort due to breast size or who want to reduce the size of their breasts.
Surgery can be considered especially in the following situations:
- Neck, back and shoulder pain related to large breasts.
- Bra straps leaving marked marks on the shoulders.
- Recurrent irritation, rashes or skin infections under the breasts.
- Difficulty with sports and daily physical activities because of breast size.
- Marked sagging and a feeling of heaviness in the breasts.
- Thinking that breast size is not in harmony with body proportions.
The surgery is generally performed on adults whose breast development is complete. However, individual evaluation can also be made in some young patients with serious physical complaints.
Suitability for surgery does not depend only on breast size. General health, body weight, smoking, existing diseases and personal expectations should be evaluated together.
It is important for patients who plan to become pregnant soon or who have concerns about breastfeeding to discuss with their surgeons the possible effects of the surgery on milk production and breastfeeding capacity.
Preparation Before Breast Reduction Surgery
A detailed examination and health evaluation are performed before breast reduction surgery.
The surgeon examines the size of the breasts, skin elasticity, the position of the nipple and the symmetry between the two breasts. In addition, the patient’s physical complaints and the breast size she wants to achieve after surgery are evaluated.
Health Checks
Before surgery, the patient’s medical history, medications used, allergies and previous surgeries are reviewed.
When necessary, blood tests and an anesthesia assessment are performed. Depending on the patient’s age, family history and current risk factors, imaging methods such as breast ultrasonography or mammography can be requested.
If a suspicious finding is detected in the breast tissue, additional evaluation may be needed before surgery.
Smoking and Medication Use
Smoking can negatively affect tissue blood supply and wound healing. In surgeries where the blood circulation of the nipple must be preserved in particular, smoking is an important risk factor.
For this reason, avoiding smoking before and after surgery for the period specified by the surgeon is recommended.
Medications that can increase the risk of bleeding may need to be adjusted. However, prescription medications should not be stopped without the doctor’s recommendation.
Expectations Before Surgery
When planning surgery, the breast size the patient wants, the existing breast anatomy and safe surgical limits are evaluated together.
It may not be possible to achieve exactly a particular bra size in every patient. For this reason, forming realistic expectations before surgery is important.
How Is Breast Reduction Surgery Performed?
Breast reduction surgery is generally performed under general anesthesia.
The surgeon makes incisions in accordance with the plan determined beforehand and removes excess breast tissue, fat and skin. The remaining breast tissue is reshaped to create a smaller and more upright breast appearance.
When necessary, the nipple and areola are moved to a higher position. During this procedure, care is taken to preserve the nipple’s blood supply.
Techniques Used in Breast Reduction Surgery
The surgical technique to be applied is determined according to the breast size, the degree of sagging and the amount of tissue to be removed.
Vertical (Vertical Scar) Technique
It is performed with a vertical incision around the areola and extending from the nipple to the inframammary fold.
In suitable patients, it allows excess breast tissue to be removed and the breast to be reshaped.
Inverted T (Anchor Scar) Technique
Incisions are made around the areola, in the area extending downward from the nipple and along the inframammary fold.
It can be preferred especially in patients with large breast volume and marked sagging. While it allows more extensive tissue removal, it can create longer surgical scars.
Breast Reduction with Liposuction
In some selected patients, liposuction can be used to reduce breast volume.
However, this method may not be enough alone in patients with marked excess skin or sagging. In addition, its capacity to correct nipple position is limited.
How Long Does the Surgery Take?
Breast reduction surgery generally takes 2–4 hours. However, the duration of the surgery can vary according to the breast size, the technique applied and the scope of the procedure.
After the operation, the patient is kept under observation for a certain period. Some patients can be discharged on the same day, while in some cases a night in the hospital may be necessary.
Care After Breast Reduction Surgery
After surgery, pain, swelling, bruising and tenderness can be seen in the breasts. These symptoms generally decrease as recovery progresses.
In the first days, it is important to use the pain medications recommended by the doctor, get enough rest and follow the wound care instructions.
Using a Supportive Bra
After surgery, using a special medical bra can be recommended.
These bras can help support the surgical area and control swelling.
The duration of use is determined according to the technique applied by the surgeon and the patient’s recovery.
Wound Care and Hygiene
The surgical incisions must be kept clean and dressings done as recommended by the doctor.
In some patients, temporary drains can be used to remove fluid that may collect in the surgical area.
The surgeon’s instructions should be followed regarding bathing, changing dressings and when sutures will be removed.
At follow-up examinations, wound healing, the blood circulation of the nipple and the shape of the breasts are evaluated.
Recovery After Breast Reduction Surgery
After breast reduction surgery, the recovery time can vary according to the patient’s general health, the surgical technique applied and the amount of tissue removed.
In the first weeks, swelling, tenderness and a feeling of tightness during movement can be seen.
Returning to Daily Life
Many patients can return to light daily activities in about 1–2 weeks. However, this time can be longer in people who work in physically demanding jobs.
In the first weeks, avoiding heavy lifting, intense exercise and movements that strain the chest area is recommended.
Starting short walks at the time the doctor considers appropriate can help support blood circulation.
The return to heavy sports and intense physical activities can generally take 4–6 weeks or longer. The appropriate timing is determined according to the patient’s recovery.
Settling of the Breast Shape
Right after surgery, a marked decrease in breast size can be noticed. However, because of the swelling, the final appearance cannot be fully evaluated at first.
It can take several months for the breasts to adapt to their new shape. The maturation of surgical scars can take longer.
Surgical Scars
Depending on the technique applied in breast reduction surgery, scars can form around the nipple, in the area extending toward the underside of the breast and in the inframammary fold.
These scars can become less noticeable over time but do not disappear completely.
The appearance of scars can be affected by factors such as skin structure, genetic characteristics, smoking and the wound healing process.
Risks and Complications of Breast Reduction Surgery
Like other surgical interventions, breast reduction surgery carries certain risks.
Bleeding and hematoma are among the complications that can be seen after surgery. In some cases, additional intervention may be needed to drain the collected blood.
Infection and wound healing problems can be seen more often, especially in people who smoke or who have chronic diseases that are not under control.
Breast asymmetry can occur when the two breasts look different in size, shape or nipple position after surgery.
Sensation changes in the nipple can be temporary or permanent. In some patients, reduced sensation, numbness or increased sensitivity in the nipple can be seen.
A decrease in breastfeeding capacity can occur as a result of the milk ducts or breast tissue being affected during surgery. This risk varies according to the technique applied and the amount of tissue removed.
Circulation problems in the nipple and areola are among the rare but serious complications. If blood circulation is insufficient, partial or complete tissue loss can occur.
Noticeable scars and contour irregularities can affect the aesthetic results after surgery.
In addition, anesthesia-related complications, clot formation and the need for additional surgical intervention are among the possible risks.
If symptoms such as increasing pain, fever, marked redness, unusual discharge or sudden swelling develop after surgery, the doctor should be contacted.
Benefits of Breast Reduction Surgery
Breast reduction surgery can help reduce the physical complaints related to large breasts in suitable patients.
A decrease in back, neck and shoulder pain in particular can be seen. Reducing breast weight can contribute to daily activities being carried out more comfortably in some patients.
In people who experience recurrent irritation and rashes under the breasts, these complaints can ease with the reduction of breast volume.
The restriction of movement experienced during sports and physical activities can decrease. In addition, more comfort can be provided in choosing clothes and bras.
In people who are satisfied with their appearance after surgery, positive changes in body perception and self-confidence can be experienced. However, physical and psychological results differ from person to person.
Life After Breast Reduction Surgery
Some changes in daily life can be seen after breast reduction surgery.
With the reduction of the feeling of heaviness caused by large breasts, physical activities can be carried out more comfortably. An increase in comfort can be experienced especially in activities that require movement, such as walking, running and sports.
However, intense physical activities should not be started right after surgery. It is important to give the body enough time to heal and to follow the restrictions set by the surgeon.
Keeping body weight stable can be useful for maintaining the surgical results for a long time.
Factors such as marked weight changes, pregnancy, breastfeeding and aging can affect the size and shape of the breasts over time.
After surgery, some patients may need a process of psychological adjustment. Getting used to the changes in body appearance can take time, and professional support can be obtained when necessary.
Conclusion
Breast reduction surgery (reduction mammoplasty) is a surgical procedure applied to reduce the volume of large breasts and reshape the breast tissue.
It can help improve quality of life, especially in people who experience back, neck and shoulder pain, skin problems under the breasts and limited physical activity.
Before deciding on surgery, it is important for a plastic surgery specialist to evaluate the existing breast structure, general health condition, possible surgical risks and personal expectations.
