Breast reduction

There is a wide range of subjective preferences in the perception of beautiful breasts. Nevertheless, there are generally valid parameters that define female breasts as well-formed. The "ideal" breast is full, firm and with good projection. Two thirds of the volume is below and one third above the nipples. Symmetry of the breasts is an additional aesthetic factor. There will never be one breast mirrored to another; this is due to differently developed glands, the shape of the rib cage and the ribs among other things.

Every operation is highly individual

With large breasts, there are other factors besides the considerable volume that must be taken into consideration: nipples that are too low should be moved upwards and oversized areolas should be reduced in size. Modern procedures for breast reduction take into account all aspects, while we conscientiously take care to maintain blood circulation and sensitivity of the nipples. Often, the mammary glands are "frayed" by the weight and there is a volume deficit in the upper pole of the breast. This is also taken into account by an experienced thoracic surgeon in surgical planning. By moving glandular tissue upwards, we can achieve an improvement of the projection in the upper breast pole.

Skin tightening in breast reduction

Excess skin must also be removed and tightened as part of this process. The resulting scars should of course be as inconspicuous and as short as possible. In addition to the extent of skin excess, the quality of the skin plays a decisive role here. If this is very elastic, a less scarring technique can be used.

As experienced breast surgeons, we apply a variety of breast reduction techniques to meet your needs exactly as required for your breasts.

During your consultation at our Nymphenburg Clinic for Plastic and Aesthetic Surgery in Munich, you describe your wishes and expectations for a surgical reduction of your breasts.

After an in-depth analysis of your breasts with measurement and photo documentation, we can recommend the appropriate surgical method for achieving the desired result.

It may be necessary to have a mammogram or ultrasound scan of your breasts prior to surgery to clarify or document any tissue changes. If desired, we can recommend some locations to have this done.

In order not to unnecessarily increase the risk of postoperative bleeding, the use of aspirin should be avoided in the two weeks prior to the operation. The consumption of alcohol and nicotine should also be reduced to a minimum.

In the first few days and nights after surgery, you should have as much support as possible for everyday activities at home. For the period of six weeks after surgery, you should not expose yourself to severe physical stress. When scheduling, consider the necessary recovery phase after the procedure.

As a rule, the patients are hospitalized on the day of the operation. In the days beforehand you will have an introductory meeting with the anesthesiologists of the Dritter Orden Clinic. There, you will be asked in detail about your medical history, such as pre-existing conditions, allergies and intolerances, and the anesthesia will be discussed with you. In most cases, one night in the clinic is absolutely sufficient.

Before the procedure, we will draw the markers that are important for the operation with you in a standing position to create the best conditions for achieving a symmetrical result. After administration of anesthesia, the operating area is sterilized and covered per hygiene protocol. As a prophylactic measure, you will receive a single dose of broad-spectrum antibiotics. These measures have been proven to reduce postoperative infections. To minimize postoperative pain, a local anesthetic is administered to the surgical site.

After removal of excess skin and glandular tissue, the breasts are placed in position with dissolvable sutures. To achieve symmetry, this is done comparing both sides. It may be necessary to drain the wound fluid. The multilayer skin closure is then done in such a way that no stitches have to be removed or cut off at the ends. After applying the sterile bandage, the upper body is dressed with elastic bandages. This will be removed the following day and a compression bra will be put on.

After being discharged, present yourself in regular intervals during our office hours. We document the success of the operation with photos.

As a rule, pain is very limited. Cooling and painkillers such as ibuprofen should relieve existing pain within a few days. Prolonged "tweaking or meteorosensitivity" are normal and no cause for alarm.

Immediately after surgery, the breasts are (deliberately) placed very high up. After a few weeks, however, they will lower again and reach their final shape. During this time it is very important to wear the compression bra day and night to avoid the breasts slipping too early. Initial swelling will also disappear within six weeks.

Sport and upper body work should be avoided for six weeks.

Initially, the breasts may be firm, but they will feel soft and natural after a few weeks.

For scar therapy, silicone gel is recommended. In the case of unsightly scarring, silicone patches may also be required.
Despite the reduced breast weight, natural aging processes will continue to work, leading to a renewed decline in breasts. However, this will not happen nearly as much as before the operation. However, a re-lift may be desired which is possible without any problems.

In our hands, as experienced breast surgeons, surgery is associated with a very low rate of complications but high levels of satisfaction. As with any other surgery, there are general and specific complications associated with the nature of the procedure.

First and foremost, we strive to achieve the desired surgical result with appealing aesthetics and broad symmetry. The more asymmetrical the breasts were before surgery, the harder it is to achieve good symmetry. However, the less symmetrical breasts are before the surgery, the more difficult it is to achieve symmetry, and if the breasts were not identical before the surgery, this will remain the case even after breast reduction. Swelling and bruising of the skin are normal and retreat within two to three weeks.

In very rare cases, bleeding (hematoma) may occur, making it necessary to reopen the surgical site and remove the fluid (hematoma removal). Otherwise, there may be wound healing disorders or hardening.

Postoperative sensory disturbances in the operating area, particularly the nipples, are normal and no cause for alarm. In most cases, the feeling normalises within a few months. However, persistent sensory disturbances can occur.

The risk of wound healing disorders is significantly higher in heavy smokers, but very rare overall.

It may happen that the new breasts appear too big even after the swelling has ceased. A further reduction operation is possible without problems after a sufficient recovery period.

If the breasts are exceptionally large, the distance by which the nipples must be moved upwards is very long which can cause a circulatory disorder of the nipples. Circulatory disorders are also increasingly possible in diabetics or smokers. Normally, the nipples heal after some time. Very rarely, dead tissue must be removed and, if necessary, a nipple reconstruction performed.

How scars develop is often unpredictable and genetic. By avoiding unnecessary tension in the skin and care, however, the scarring can be positively influenced.