Breast Reduction & Lift Surgery

Summary
Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-from back and neck pain and skin irritation to skeletal deformities and breathing problems. Besides breast reduction is an aesthetic surgical intervention, it is also an intervention performed for health reasons to improve the quality of life.
Breast reduction, technically known as reduction mammoplasty, is a reduction and lifting procedure of hormonally or congenitally large breasts. The operation is performed under general anesthesia and will last for 3 hours with a night of hospitalization.  Usually it is performed with a technique called vertical mammoplasty.

This recently worldwide used technique will leave after the operation an incision line that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast.

The scar tissue often remains lumpy and red for months, than gradually becomes less obvious within a year, sometimes eventually fading to thin white lines. Your doctor will demonstrate these scars on his computer for you. On the 4th day after the operation you'll be able to go back to work.

Detailed Information
The enlargement of the breasts according to developmental, pregnancy or weight gaining reasons is one of the frequent problems. This is not only an aesthetic problem, but also leads to a shoulder ache, a back ache, skeletal deformities, and skin irritation. Patients who are seeking solutions for such problems should read the following information:

• Investigate if the breast enlargement is due to a hormonal problem.
• Ask if the enlargement is a continuing problem.
• Investigate if there is a palpable mass with or without pain at the breast examination.
• Investigate if there is a previous breast operation or infection.

Your doctor will ask you several questions and inform you regarding the above mentioned items. Usually a surgical procedure is appropriate for enlargements not related to a hormonal problem or breast stopped enlarging for at least 6 months. For patients above a certain age and those with a mass in their breasts, a test like a mammography is relevant prior to the intervention. Afterwards, you and your doctor will decide for the appropriate technique due to the specifications of your skin and breast tissue.

Prior to the intervention you will undergo some laboratory investigations, a detailed physical examination, and a skin drawing of the operation plan according to the selected operation technique. The operation will be performed under general anesthesia. The operation period will last between 2-4 hours depending on the selected technique. You'll have to stay 1 or 2 days at the hospital. On the 4th hour after the operation you'll start to eat and walk. On the first couple of days there will be a suction bag called a drain placed into the operation area to collect excessive fluids and blood. Depending on the collected material, the drain will be removed in 1-2 days. It is appropriate to restrict excessive arm movements on the first days. At the first week you'll have a bandage wrapping your chest. This will be removed on the 7th day after the operation and replaced with only a thin strip covering the incision line, which will stay for an additional week.

Enlargement is usually together with pendulous breasts. If the shape of the breast is good but only the size is big due to fat accumulation, the breast reduction can be performed with only a liposuction method. If the surgeon has to reshape your breasts while reducing the size, the following steps are performed:

• The nipple will be lifted to the appropriate position.
• In pendulous breasts the upper parts of the breasts are usually empty and need to refill while the new contour is given.
• The underarm extended breast will be enclosed to a tighter area which will help to reshape its contour.
• During these procedures excessive glandular tissue and skin will be removed until the desired size and shape has been reached.

Usually the removed tissues are pathologically investigated afterwards.
There are some special features depending on the selected technique of the breast reduction operation. While some limited breast reduction procedures provide a faster recuperation period and the patient can immediately go back to daily life, some operations at excessively oversized breasts can lead to a prolonged recuperation period depending on the size of the removed tissues. Again the size and the length of the scars may vary due to the selected technique. While the scars are more visible in the first months after the operation, you will notice a remarkable positive change after the 6th month.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.) Your doctor will inform you in detailes about different techniques and ask you to join the decision.

Post operational problems are divided into early and late term complications. Early term complications include bleeding, infections, wound healing problems and are extremely rare. Late term complications include scar or shape related problems. 

In early phases there may be frequently redness, elevation and itching at the scar lines especially in dark skinned patients and may need medication. Shape related problems are frequently related to the size of the breasts. Therefore, talk to your surgeon prior to the operation in detail regarding the desired shape, the size and take the size and other specifications of your body into account.