You are here > TREATMENTS > BREASTREDUCTION
Why having a breast reduction?
Many women have large, heavy, and sagging breasts. Because of their weight these breasts may cause physical discomfort, such as pain in the neck, shoulder and back. Skin irritation beneath the breasts may occur, and in addition a bad bodily posture may be the result. Moreover, large and or sagging breasts may cause serious feelings of shame or low self-esteem, and may even lead to a dysfunctional social life. A breast reduction can be a solution for these women.
Who qualifies for a breast reduction according to health insurance criteria?
Principally, a breast reduction can be considered appropriate for women with breasts of a bra size cup D or larger. Weight reduction may influence the result of a breast reduction. Therefore, if a weight reduction is considered, a breast reduction is preferably carried out as soon as the weight has stabilized. Social or sexual problems are usually not solved by this intervention.
What should be done prior to the intervention?
Please inform your surgeon if you have to take medication that alters blood coagulation, such as Marcoumar or Sintrom. The use of Aspirin (acethylsalicylacid) containing medicines needs to be terminated 14 days before the day of the intervention. Smokers are strongly advised to quit smoking 2 weeks before the intervention and not to start again until 4 weeks after the operation. Continuation of smoking may have profound adverse effects on wound healing.
Patients older than 50 years or patients known to have an increased risk of breast cancer should have a mammography before the intervention. As the surgery is always carried out under general anesthesia you have to be sober no later than 12 o'clock p.m. on the day prior to the surgery.
Before the intervention begins and while you are still awake, a drawing is made on your breasts by the surgeon. These drawings are used as patterns during the intervention. Pictures of yours breasts will also be taken. Questions concerning the general anesthesia will be answered by the anesthesiologist.
During a breast reduction operation, parts of the skin of the breast are removed together with its subcutaneous fat, as well as parts of the breast gland. These tissues are examined microscopically by a pathologist.
The sagging nipple-areola complex with the remaining gland is moved upwards into the desired position. The resulting scars around the areola, those vertically connecting the areola and the infra-mammary fold, and those located horizontally at the infra-mammary fold, will always remain visible. The extent of the scars is dependent on the amount of tissue removed and on the elasticity of the skin. If no horizontal scar is necessary, the skin of the vertical scar will be wrinkled initially. These wrinkles disappear after about three months. During the same operation preoperative existing asymmetry will be corrected as much as possible. Nevertheless, it should be kept in mind that perfect postoperative symmetry cannot be guaranteed.
At the end of the surgery, a narrow tube is placed in each breast to drain excess fluid of blood into a vacuum bottle and a compressive dressing is applied. These tubes are removed on the second or third day after the intervention. During the first night after the intervention, wound pain or a tearing sensation within the breasts may be experienced. These discomforts usually disappear within a few days. As soon as the tubes have been removed, you may leave the hospital, while wearing a sports bra and a bandage. This bra needs to be worn day and night during the next 3 weeks. Showering of the wounds is allowed.
The new shape of the breast
The surgeon will discuss your views concerning the future size and shape of your breasts, and will take these views into account during the surgery as much as possible. However, the future shape and size possibilities are partly determined by the shape of the breasts before surgery. It is obvious that limitations should therefore be expected. Immediately after the intervention the breasts will be swollen and extensively lifted; the final shape will be visible after 4-5 months.
Although this kind of surgery has to be considered as a fundamental operation, severe complications are rarely seen. Smaller complications such as continued bleeding, infection, or delayed wound healing may be encountered. Consequently, the final scar may be widened in some areas. Scar revision under local anesthesia may be an option if necessary.
What else should you know?
Nipple sensitivity can be diminished or completely lost after this intervention. Most of your sensitivity will return after a few months, but full sensitivity may not be recovered.
Whether breast-feeding is still possible after a breast reduction cannot be predicted, as part of the breast gland will remain connected to the nipple. It has to be kept in mind that every new pregnancy will induce normal changes in the shape and the size of the operated breast.
How the scars ultimately will appear cannot be predicted. Besides the suture techniques, this is affected by factors such as genetical background and the occurrence of wound healing problems. Initially, the scars may appear red, sensible, and elevated. Additional treatment with a cream or silicone Band-Aid may be needed. After a few months the scars will become softer and will fade. Sun protection is needed during one year.
Generally, recovery and disability of work will take a period of 2-3 weeks. Assistance in housekeeping is recommended during the first week after the operation. Heavy bodily activities such as the lifting of heavy objects or extensive shoulder movements should be avoided. Approximately 10 days after the intervention, wound healing will be evaluated ambulatory.
A written request needs to be sent to your health insurance in order to request for reimbursement of the costs of this intervention. Usually approval is granted in case of a bra cup size D or larger, or in case of an important asymmetry. A medical advisor of your insurance makes the final decision. If you need to pay for the intervention yourself, ask clear information concerning all costs.