The breast reduction and reshaping
Introduction
The breasts have been the symbol of femininity and beauty since long ago. An ideal beauty differs in different cultures and it has changed during the centuries. Today´s women want to have well shaped symmetrical breasts proportional to their body. The size and shape might be altered due to ageing, breastfeeding, bigger weight loss. The breasts usually drop and as the breast is ageing the amount of glands decreases. This problem can be often solved by the breast reshaping which can be combined with an augmentation or the augmentation itself. On the other hand some women suffer from excessively large breasts. Their most common problems are the back pain, pressure sore caused by a bra strap, limited possibilities of buying underwear or clothes, intertrigo under the breasts, limited options of sports activities, inability to do sports activities and so difficulties in weight losing and etc. For these women the breast reduction surgery might be a very suitable solution.
What is the breast reduction and reshaping?
The breast reduction is a surgery which aim is to reduce the size of large pendulous breasts, to lift the breasts and to improve their shape at the same time.
Reshaping is a surgery which aim is to lift breasts and to improve their shape. Breasts gain a youthful appearance after the surgery.
What can you expect from breast reduction and reshaping?
We can consider the aim of the reduction surgery from the aesthetic point of view and from the health point of view as well – reducing the pain of the back, neck and shoulders, elimination of uncomfortable feelings and pressure sores caused by tight bra straps, making easier to keep hygiene in skin folds under the breasts and improving of the life quality in terms of enabling wider range of sports activities which were limited because of the breast size.
What is the suitable age to perform the breast reduction and reshaping?
The breast reduction surgery can be performed at any age but best when the breasts are fully developed at approximately 18-20 years. The breast reshaping is usually performed due to the changes caused by breastfeeding at the time when a woman does not breastfeed anymore and does not plan the next pregnancy. Anyway the surgery can be performed anytime in adult women.
For whom is the breast reduction advisable?
Breast reduction is advisable for patients with normal weight and with the completed development of breasts. The ideal patients are women who do not suffer from any life threatening illness, women who are well motivated with a positive attitude and clearly defined aims of the surgery which are the breast reduction, improvement of the shape of a breast, reduction of pain symptoms. Smoking can negatively affect the healing process and can cause complications.
For whom is the breast reshaping advisable?
The breast reshaping is advisable for women whose breasts have lost their original volume due to breastfeeding, ageing or bigger weight loss. Other recommendations are the same as for breast reduction.
What are the scars after the reduction and reshaping surgery like?
Scars are inevitable part of both procedures. Location of scars depends on the method of reduction or reshaping and on the extent of the surgery. Scars are always located around the nipple, from the nipple downwards and under the breast in the infra-mammary fold, if necessary. The appearance depends mainly on the healing pattern of a particular patient. The appearance of scars can vary from thin scars to wide flat scars or prominent plastic keloid scars.
What are the methods of reduction and reshaping?
There is a number of techniques by which the breast reduction surgery is performed. Particular techinques differ according to the shape of incision and a stalk, on which the areola and nipple are repositioned. The most commonly used incision is in the shape of inverted T or vertical incision. The vertical incision leaves just a vertical scar from the nipple downwards whereas the inverted T incision leaves the scar in the crease as well. The vertical incision is suitable for smaller breasts, T-incisions for larger. The alternative solution for smaller reshaping is the incision around the nipple (circumareolar incision). Sometimes we use the reduction method with the areola and nipple transplant for excessively large breasts.
Is it appropriate to combine the reshaping with other surgeries?
The breast reshaping can be possibly combined with other surgeries. There is often a discussion about performing the reshaping and the augmentation at the same time. It is possible to combine these two surgeries. The advantage is that two surgeries are performed under one anaesthesia, on the other hand it is more difficult to estimate the final shape of breasts.
Is breast reduction and reshaping performed under general or local anaesthesia?
The surgery is performed under general anaesthesia.
What is the procedure of breast reduction/reshaping surgery itself like?
Before the start of the surgery the surgeon draws patterns of the incisions on the breasts. As a first step of the surgery, the operating field is disinfected and the gauze pads are placed around it. Afterwards the incisions are made according to the pattern drawn prior to the surgery itself, in the shape of inverted T, vertical or circumareolar reduction/reshaping. The pre-surgical pattern is made according to the careful measurements of the areola height, a sternal notch-to-nipple distance, the size of the breast base and others. The areola of the nipple is stretched into required diameter. The nipple is attached to the stalk which contains glandular tissue, nerves, vessels which are providing its nutrition and it is relocated into a new higher position. During the reduction procedure required amount of the glandular tissue, fat and skin is removed according to the pattern. During the reshaping procedure only the skin is removed, the amount of fat and glandular tissue is not reduced. Vertical and horizontal incision are sutured together then by adsorbable sutures. A new shape of breast is formed this way. The elastic gauze is placed on the breasts, later a shaping elastic bra is used.
How long does the surgery take and what is the recovery after the procedure like?
The surgery usually takes 2-3 hours in average. During the surgery the drains might be inserted, they are removed usually 1st-3rd day after the surgery. It is recommended to wear the compression elastic underwear (bra) 24 hours a day for several weeks after the surgery. Elastic bra provides a support of the healing tissues, minimizes the swelling, reduces the pain when moving and it forms a good breast shape.
Is it possible to breastfeed after the breast reduction?
The ability to breastfeed can be affected (decreased) by the surgery because the part of the gland is removed. The least affection is made when using the technique of so-called “lower central stalk“. During the period of breastfeeding, cysts and inflammation can appear in the operated breast, this might lead to a shape alteration because of enlarging of a breast during the breastfeeding. Therefore it is appropriate to consider the surgery in the terms of planned pregnancies.
Is the result of the reduction surgery permanent?
The result of the surgery can be altered by the changes in the breast during the pregnancy or bigger weight change of a patient. The appearance can be also changed by the natural ageing process and sagging of tissues.
What is the post surgery care like?
The short period after the surgery may involve post-surgery pain, decreased sensitivity, swelling, contusions, discomfort. Because of this, the pain is eased by painkillers and it is convenient to wear compression underwear – elastic bra which eases the pain, reduces the swelling and provides support for the healing tissues and forms a good-looking shape at the same time. We recommend wearing of shaping bra for at least 2-5 weeks then we recommend wearing of normal bra during the daytime in order to maintain the shape of reshaped/reduced breasts for 6-12 months. After the surgery it is appropriate to keep physical rest for at least 2 weeks until the wounds heal. After the healing of wounds it is possible to resume all common activities which do not require increased physical effort. It is possible to do the sport and resume all common physical activities after approximately 6-8 weeks, not sooner. The final result can be evaluated in 3 months, not any sooner.
If you have any question or comment, do not hesitate to contact us.