Breast reduction: information & doctors for a breast reduction

Some women suffer from breasts that are too large and heavy. A breast reduction may therefore be medically necessary in some cases. In this case, the health insurance company will cover the costs.

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Breast reduction - Further information

Large breasts can be an enormous burden for those affected due to their weight. As a result, women are often unable to sleep properly because the breasts press on the chest or are often sore. The weight also has a strong effect on the spine when walking and standing - posture problems, neck and back pain are a threat!

In principle, a breast reduction can be performed at any age . However, body growth should be complete before the procedure and the breasts should be fully developed.

Reasons for a breast reduction

There are many reasons why women ultimately decide to have a breast reduction. Oversized or sagging breasts can have a major impact on a woman's body image and self-confidence. Affected women may feel inhibited during physical activities or sexual intercourse.

A change in breast shape as a result of pregnancy or severe weight loss can affect a woman's self-esteem. For example, even normal-sized breasts can lose their fullness, firmness, elasticity and resilience after pregnancy or dieting.

Pain in the breasts, neck and back are also common reasons for a breast reduction.

Frau mit großen Brüsten / Brustverkleinerung
Large breasts, but also sagging breasts, can have a negative impact on your self-esteem or lead to physical discomfort © vladimirfloyd | AdobeStock

What happens during a breast reduction?

Breast reduction is a plastic surgery procedure. Its aim is to shape smaller, lighter and firmer breasts. The procedure is always performed in a specialized clinic.

As the female breast consists mainly of fat and glandular tissue, the surgeon will primarily remove fat during breast reduction. To do this, the doctor makes an incision along the nipple and thus creates access to the inside of the breast. First, excess skin and breast tissue is removed from the lower breast area. A new breast is then formed using the remaining upper parts of the breast.

It is important to ensure that the patient can feel normally even after the breast reduction and that her ability to breastfeed is maintained. For this reason, the nipple is usually moved together with the nerves and blood vessels.

In order to achieve optimal results, it may be necessary to

  • excess fatty tissue is removed or
  • insert a breast implant

be inserted.

When is a breast reduction medically indicated?

A breast reduction is medically necessary under these conditions:

  • From a reduction weight of 500 to 800 grams per breast.
  • If the woman suffers from the strain of her large breasts.

This medical indication is important. The health insurance company will only cover the costs of the procedure if breast reduction is medically necessary.

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What does a breast reduction cost?

In Germany, prices for the procedure range between 4,500 and 7,000 euros.

The price range is so wide because a breast reduction is always an individual procedure. Therefore, the costs depend on various factors, such as the type of surgery required.

For some women, only liposuction is necessary. For others, however, the nipple must be moved or a breast lift performed to compensate for the removed tissue.

Preparations and preliminary examinations for a breast reduction

Before a breast reduction, in some cases preliminary examinations such as

are useful. These preliminary examinations are carried out in the clinic on the day before the operation. With their help, tissue changes in the breasts can be detected before the operation.

Smoking promotes the development of wound edge necrosis after breast reduction. For this reason, smokers should refrain from smoking for the four weeks prior to the operation or at least limit it considerably.

Taking painkillers such as aspirin is also not recommended in the two weeks before the operation. These substances can delay blood clotting. Patients should also avoid sleeping pills and alcohol.

Procedure for a breast reduction

Breast reduction surgery is usually performed on an inpatient basis during a 3 to 8-day hospital stay. The operation can be performed either under local or general anesthesia. Depending on the extent of the procedure, it takes between 1 and 2 hours.

There are various, widely varying surgical methods available for breast reduction. For example, different incisions are possible. Which method is used depends on the patient's individual expectations and physical condition.

Normally, two incisions are made during a breast reduction. The first incision is made 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 a further incision along the natural breast crease may also be necessary.

During the operation, the excess breast tissue is removed first. The remaining glandular body is then reshaped. The nipple, including the nerves and blood vessels, is also repositioned and moved upwards. There, the glandular body is attached to the muscle with recessed sutures and the skin of the breast is tightened.

Brustverkleinerung
During breast reduction, fatty tissue is removed and the nipple is repositioned © lenka | AdobeStock

Finally, the wound is sutured with very fine stitches. Drains allow blood and tissue fluid to drain away unhindered. A tight bandage is also placed over the breasts.

What are the risks of a breast reduction?

Breast reduction, which is always a surgical operation, is always associated with certain risks. For example, after the operation

  • Wound healing disorders, which lead to unsightly scarring, as well as
  • permanent feelings of tension,
  • pain,
  • bruising and
  • infections

are possible. Other possible complications of a breast reduction are

  • slight differences in breast shape and
  • loss of sensitivity and circulatory disorders in the nipple area.

The risk increases with the size of the breasts to be operated on. Experienced surgeons will inform you about this and keep the necessary procedure as small as possible.

What scars remain after a breast reduction?

Even with the most experienced specialist, a breast reduction is always a surgical procedure.

In many cases, however, access to the inside of the breast is possible via the incision along the areola. The scarring is therefore barely visible later on. However, the more extensive the breast surgery, the higher the risk of scarring later on.

Differences in breast shape

The post-operative healing process after 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 in the course of a further minor procedure.

Loss of sensitivity and circulatory disorders in the nipple

Breast reduction of more than 500 grams of tissue per breast can result in a loss of sensitivity in the nipple.

In very rare cases, circulatory disorders in the breasts can also result in tissue rejection. The affected tissue would then have to be replaced with the patient's own skin during a repeat operation.

Prevention of complications

To prevent complications during a breast reduction, the patient should inform the surgeon before the operation

  • about any existing illnesses or allergies, for example to medication or care products
  • an existing tendency to noticeable bruising or persistent bleeding after minor injuries

inform the surgeon before the operation. In this case, the doctor should carry out suitable tests before the operation to rule out the possibility that the patient suffers from blood clotting disorders.

If the patient is planning to become pregnant or lose a lot of weight, she should also inform the surgeon. These could greatly affect the long-term result of the breast reduction and significantly change the shape of the breast.

After the breast reduction

Immediately after the operation you will usually experience

  • mild pain and
  • swelling and bruising to a greater or lesser extent

which, however, subside within several days to weeks. In addition, the sensitivity to touch and the normal sensation of the nipples may be impaired for a few months after the operation.

The patient is largely well again just a few days after the operation. After about 3 to 4 weeks, she is fully able to work again.

A final assessment of the breast reduction is usually possible after 6 months. The scars from the incisions and any hardening of the skin usually disappear over the following 1 to 2 years. Later, they are barely visible.

The patient can shower normally again just a few days after the operation, provided the suture and dressing technique allows it. In the first few weeks after breast reduction, the operated breasts should be treated as gently and carefully as possible. Excessive strain, for example during

  • sporting activities,
  • housework or
  • during sexual intercourse,

should therefore be avoided.

In addition, the upper arms should be moved very carefully in the first few weeks after breast reduction. Rapid stretching should therefore be avoided. It is also important to sleep on your back at night and never on your stomach. This could otherwise impair internal wound healing.

The patient should start wearing a bra as soon as possible after the dressings and stitches have been removed. She should wear it around the clock for at least 3 weeks to prevent excessive scarring due to the even pressure. It is important that the bra fits perfectly and supports the breast without constricting it.

To support the healing process

  • cold showers, which stimulate blood circulation, as well as
  • appropriate skin care and massages

are recommended. Lymphatic drainage can also counteract swelling and tension in the first few weeks after breast reduction.

Which specialists perform breast reduction surgery?

A large number of clinics offer breast reduction and other aesthetic operations such as breast augmentation or a facelift.

First and foremost, however, make sure that the surgeon in charge is a certified specialist in plastic and aesthetic surgery. Then you are in good hands from a medical point of view.

Results of a breast reduction

Breast reduction can achieve a permanent change in the size and shape of the breasts. However, the shape of the breasts can change again after the procedure over time due to weight changes or the natural ageing process, which may make another procedure necessary.

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