Breast Reduction

What is Breast Reduction?

Breast reduction is a surgical procedure that involves the removal of excess breast tissue, fat tissue and skin in order to achieve a breast size proportionate to your body. This will also lighten the upper body and all problems that are associated with excess breast volume.

Who is a good candidate for a breast reduction?

Extremely large breasts which are disproportionate to the body frame can cause not only health problems but can also affect patient psychologically.

The weight of an extremely large breast may influence woman’s daily activities. This takes place due to physical discomfort and several times back and neck pain. For this reason, breast reduction is considered more as reconstructive surgery than purely aesthetic surgery.

Candidates for a breast reduction are the following:

• women suffering from back and neck pain, as well as posture problems due to breast weight
• women whose breast limits their physical activity
• women who have deep strap marks on their shoulders
• women with irritated skin under the breast crease
• women who are bothered by the feeling that their breast is extremely large
• women with realistic expectations

What to expect at your first appointment:

At your first appointment, you will discuss:

• what exactly is your concern in the appearance of your breast and if breast reduction is the appropriate treatment for you
• your past medical history, if you are on any medication, vitamins or other herbal supplements, if you have any allergies or any other operations in the past
• if you smoke (if the answer is yes, how many cigarettes per day).
• if there is family history of breast cancer
• mammogram or previous biopsy results

Afterwards, Dr Karmiris:

• will evaluate your general health condition and any other risk factors
• will examine you and will take all the detailed measurements from your breast size and shape and he will evaluate your skin quality, as well as the positioning of nipples
• will take preoperative photographs
• will discuss with you all the possible surgical options, depending on your case
• will discuss with you all the possible risks or potential complications, as described in the international literature and finally
• will discuss with you about the anaesthetic plan.

Preoperative check:

Preoperative check includes mainly blood tests, chest X-ray, electrocardiogram (ECG) and any other specialized tests, depending on the case.

In case of breast reduction surgery, patients should have one mammography pre-op and another one post-op for comparative reasons in case of any future changes on their breast gland.

Also, it will be necessary to stop smoking preoperatively, and immediately post-op as well as avoid taking aspirin and any anti-inflammatory medicine, since they increase the risk of bleeding.

The surgical procedure:

The surgical procedure of breast reduction takes place under general anaesthesia, usually through incisions which are made to your breast in order to remove excess fat, breast gland and excess skin.

In some cases, excess fat can be removed through liposuction in combination with the techniques described below. Although it does not happen very often, if excess skin is not significant and breast size is mainly manifested due to fatty tissue, breast reduction can be achieved only with liposuction.

Breast reduction surgery can be achieved through various techniques depending on your breast. The most appropriate technique for you is specified based on the following:

• your breast size and shape
• your nipple size and positioning
• the degree of breast sagging
• quality skin, skin elasticity, as well as the amount of excess skin

The surgical procedure is performed under general anaesthesia and there are three basic methods:

• Periareolar reduction
• Vertical scar breast reduction

• L-short scar or inverted Τ pattern breast reduction.

The ideal technique for you will be discussed in detail with Dr Karmiris.

Following the initial incisions, the nipple and nipple areolar are repositioned to a more youthful position. If necessary, the enlarged nipples are reduced by removing excess skin at the perimeter.

Excess breast tissue and fat tissue are removed and the remaining breast is lifted up and reshaped in order to improve its contour. Excess skin is also removed from the surrounding breast in order to restore breast elasticity.

After breast reshaping and removal of excess skin, the incisions are closed with sutures of different types in order to support the reshaped breast.

Scars are permanent, but fortunately will improve significantly over time and they will become nearly indistinguishable.

Post operatively:

Immediately after the surgical procedure, you will have medical gauze or bandages on the incisions which will be reduced, gradually. If drains have been used, they will be removed in a few days. You will need to wear a surgical bra following the surgery in order to support your breast and minimize swelling during recovery.

In most cases, patients are discharged on the same day. Dr Karmiris will give you particular instructions on how to take care of your incisions immediately post-op, what medication you should take and when you will be seen for a follow up.

Risks and safety information:

In general, breast reduction, is a safe surgical procedure which is performed with great success. However, like any other surgical procedure, breast reduction has some risks and potential complications that every patient should be aware of and should understand fully, before entering the operating room.

The most important potential complications are the following:

• bleeding or haematoma in about 1% of patients
• wound infection
• fat necrosis
• risk of poor scaring
• hypoesthesia to nipple, which can be temporal or permanent in about 5-10% of the patients
• asymmetry
• partial or total loss of nipple which is a rare complication but it is described in the international literature
• the ability to breast feed may be affected
• general risks from anaesthesia, such as deep vein thrombosis, cardiac or pulmonary complications.

Dr Karmiris will explain you, in detail, the whole surgical procedure and will answer any questions related to that.