Large breasts can place an enormous strain on those affected due to their weight. As a result, women often can no longer sleep properly because their breasts press against their chest or are frequently sore. The weight also puts significant strain on the spine when walking and standing—which can lead to poor posture, neck pain, and back pain!
In principle, breast reduction surgery can be performed at any age. However, physical growth should be complete before the procedure, and the breasts should be fully developed.
Reasons for Breast Reduction
The reasons why women ultimately decide to undergo breast reduction surgery are very diverse. Oversized or sagging breasts can significantly affect a woman’s body image and self-confidence. Women affected by this condition may feel self-conscious during physical activities or sexual intercourse.
A change in breast shape resulting from pregnancy or significant weight loss can affect a woman’s self-esteem. For example, even breasts of normal size can lose fullness, firmness, elasticity, and tone after pregnancy or dieting.
Pain in the breasts, neck, and back is also a common reason for breast reduction surgery.
Large breasts, as well as sagging breasts, can have a negative impact on a woman’s well-being or lead to physical discomfort © vladimirfloyd | AdobeStock
What Happens During a Breast Reduction?
Breast reduction is a type of plastic surgery. Its goal is to create a smaller, lighter, and firmer breast. The procedure is always performed at a specialized clinic.
Since the female breast consists mainly of fat and glandular tissue, the surgeon will primarily remove fat during breast reduction surgery. To do this, the surgeon makes an incision along the areola, thereby gaining access to the interior of the breast. First, excess skin and breast tissue are removed from the lower part of the breast. The remaining upper portions of the breast are then used to reshape the breast.
It is essential to ensure that the patient can continue to experience normal sensation after breast reduction surgery and that her ability to breastfeed is preserved. For this reason, the nipple is typically repositioned along with the nerves and blood vessels.
To achieve optimal results, it may be necessary to
- additional excess fatty tissue be removed or
- a breast implant may be inserted
.
When is breast reduction medically indicated?
A breast reduction is medically necessary under the following conditions:
- When the weight to be removed is between 500 and 800 grams per breast.
- If the woman suffers from the strain caused by her large breasts.
This medical indication is important. Health insurance will only cover the cost of the procedure if the breast reduction is medically necessary.
How much does a breast reduction cost?
In Germany, prices for the procedure range from 4,500 to 7,000 euros.
The price range is so wide because a breast reduction is always a personalized procedure. Therefore, the costs depend on a variety of factors, such as the type of surgery required.
For some women, liposuction alone is sufficient. For others, however, the nipple must be repositioned or a breast lift performed to compensate for the removed tissue.
Preparations and Preoperative Examinations for Breast Reduction
In some cases, preliminary examinations such as
- a mammogram or
- an ultrasound examination of the breasts
may be advisable. These preoperative examinations are performed at the clinic the day before the scheduled surgery. They help identify any changes in breast tissue prior to the procedure.
Smoking increases the risk of wound margin necrosis following breast reduction surgery. Therefore, female smokers should refrain from smoking or at least significantly reduce their smoking in the four weeks leading up to the surgery.
Taking pain relievers such as aspirin is also not recommended in the two weeks before surgery. These substances can delay blood clotting. The patient should also avoid sleeping pills and alcohol consumption.
The Breast Reduction Procedure
Breast reduction surgery is usually performed on an inpatient basis during a hospital stay lasting 3 to 8 days. The procedure can be performed under either local or general anesthesia. Depending on the extent of the procedure, it takes between 1 and 2 hours.
There are various surgical methods available for breast reduction, and they differ significantly. For example, different incision techniques are possible. The method used depends on the patient’s individual preferences and physical condition.
Typically, two incisions are made during a breast reduction. The first incision runs around the areola, which is usually reduced in size. The second incision runs from the lower edge of the areola to the lower breast crease. Sometimes, an additional incision along the natural breast crease may also be necessary.
During the surgery, the excess breast tissue is first removed. The remaining glandular tissue is then reshaped. As part of this process, the nipple—including the nerves and blood vessels—is repositioned and moved upward. There, the glandular tissue is secured both by sutures placed deep within the muscle and by tightening the skin of the breast.
During breast reduction surgery, fatty tissue is removed and the nipple is repositioned © lenka | AdobeStock
Finally, the incision is closed with very fine sutures. Drains allow blood and tissue fluid to drain freely. In addition, a tight-fitting bandage is applied over the breasts.
What are the risks of breast reduction surgery?
Breast reduction, which is always a surgical procedure, carries certain risks. For example, after the surgery,
- wound healing complications that can lead to unsightly scarring, as well as
- persistent feelings of tightness,
- pain,
- bruising, and
- infections
are possible. Other possible complications of breast reduction include
- slight differences in breast shape, as well as
- loss of sensation and circulatory problems in the nipple area.
The risk increases with the size of the breasts being operated on. Experienced surgeons will explain this to you and keep the necessary incision as small as possible.
What scars remain after a breast reduction?
Even when performed by the most experienced specialist, a breast reduction is always a surgical procedure.
In many cases, however, access to the interior of the breast is possible through an incision along the areola. The scar is therefore barely visible later on. However, the larger the procedure on the breast, the higher the risk of scarring, of course.
Differences in Breast Shape
The postoperative healing process following a breast reduction can lead to changes in the skin and tissue of the operated breasts. This can result in slight differences in breast shape. However, these can be corrected through another minor procedure.
Loss of Sensation and Circulatory Problems in the Nipple
In cases where more than 500 grams of tissue is removed from each breast during a breast reduction, loss of sensation in the nipple may occur afterward.
In addition, circulatory problems in the breasts can, in very rare cases, lead to tissue rejection. The affected tissue would then need to be replaced with the patient’s own skin during a follow-up surgery.
Prevention of Complications
To prevent complications during breast reduction surgery, the patient should inform the surgeon before the procedure
- any existing medical conditions or allergies, such as to medications or skincare products
- about a tendency toward excessive bruising or prolonged bleeding following minor injuries
. In such cases, the doctor should conduct appropriate tests before the surgery to rule out any blood clotting disorders.
If the patient is planning a pregnancy or significant weight loss, she should also inform the surgeon of this. These factors could significantly impair the long-term outcome of the breast reduction and drastically alter the shape of the breasts.
After Breast Reduction Surgery
Immediately after surgery, patients usually experience
- mild pain as well as
- swelling and bruising of varying severity
, but these subside within a few days to a few weeks. In addition, sensitivity to touch and normal sensation in the nipples may be impaired for several months after the surgery.
Just a few days after the surgery, the patient is generally feeling well again. After about 3 to 4 weeks, she is fully able to return to work.
A final assessment of the breast reduction is usually possible after 6 months. The scars from the incisions and any hardening typically subside over the next 1 to 2 years. Later on, they are barely visible.
Just a few days after surgery, the patient can shower normally again, provided the suture and dressing techniques allow it. In the first few weeks following breast reduction surgery, the operated breasts should be spared as much as possible and handled with extreme care. Overexertion, such as during
- sports,
- housework, or
- sexual intercourse,
should therefore be avoided.
In addition, the upper arms should be moved very carefully during the first few weeks after breast reduction surgery. Rapid stretching and extending of the arms should therefore be avoided. It is also important to sleep on your back at night and under no circumstances on your stomach. Otherwise, this could impair internal wound healing.
As soon as possible after the bandages and sutures are removed, the patient should begin wearing a bra. She should wear it around the clock for at least 3 weeks to counteract excessive scarring through even pressure. It is important that this bra fits perfectly and supports the breast without constricting it.
To support the healing process,
- cold showers, which stimulate blood circulation, as well as
- proper skin care and massages
. Lymphatic drainage can also help reduce swelling and tension during the first few weeks after breast reduction surgery.
Which medical specialists perform breast reduction surgery?
A wide range of clinics offer breast reduction and other cosmetic surgeries, such as breast augmentation or facelifts.
First and foremost, however, make sure that the lead surgeon is a board-certified specialist in plastic and aesthetic surgery. Then you’ll be in good hands from a medical standpoint.
Results of a Breast Reduction
Breast reduction surgery can achieve a permanent change in the size and shape of the breasts. However, the shape of the breasts may change again over time after the procedure due to weight fluctuations or the natural aging process, which may necessitate another procedure.
