Breast Reduction

Every patient with large breasts is a suitable patient for breast reduction. Some patients are young patients whose breasts grew excessively after puberty, some are patients whose breasts enlarged and sagged after childbirth and excessive weight gain, and some are patients whose breasts enlarged and sagged after gaining weight after menopause.

At the earliest, breast reduction can be performed after breast growth is complete. This generally corresponds to around the age of 18. However, in some patients with special circumstances, or where daily life is very adversely affected, intervention can be made earlier. In the older age group, it can be performed on every patient who does not have a particular health problem that would put the patient's life at risk.

Different techniques have been described for breast reduction. The amount of scarring that remains differs depending on the technique used. In cases where the position of the nipple needs to be changed, a circular scar will remain around the coloured part of the breast (areola). However, since this scar lies in the area where the colour changes, it is not a very noticeable scar. Depending on the technique used, in some patients only a vertical scar extending from the coloured part of the breast to the fold under the breast remains, while in another group of patients, in addition to this scar, there may also be a scar in the fold under the breast.

However, what is important here is not so much the amount of scarring as the final shape the patient's breast will take. After all, the scars remaining after breast reduction can only be seen when the patient lies on her back. When the person is standing upright, since lighting or sunlight always comes from above, the remaining scars are hidden in the fold or in the shadow of the breast. In addition, as time passes after the operation, the scars soften and their colour fades, so they become less visible. In this respect, choosing the technique that will give the most beautiful result and more lasting results, taking the shape of the person's breast into account, is more important than the amount of scarring that will remain.

It is the most up-to-date breast reduction technique applied today. Depending on the size of the patient's breast and the position of the nipple, a scar may remain around the nipple and running vertically downwards from there, or in patients whose nipple position does not need to be changed, the operation can be completed with only a vertical scar. In this technique, besides the scars being short, the aesthetic results are also good. The breast base is narrowed better and the breasts stand more upright. In addition, it is superior to other methods in terms of the permanence of the results.

In classical training, all breast reductions end with an “inverted T” scar. This method is still the most frequently used technique in the world. However, because of the length and visibility of the scars, it is not a suitable technique, especially in young patients. This method can be applied in those with excessively large and sagging breasts, in patients whose skin has lost its elasticity due to major weight loss, in patients in whom a great deal of skin needs to be removed, in older people and in those with excessive asymmetry.

As in all operations, in breast reduction it is necessary to stop aspirin and smoking 3 weeks before the operation. In the last 1 week it is necessary to stay away from medicines and similar substances that may thin the blood.

Things that should not be used:

Painkillers such as Apranax, Voltaren, Vermidon (when a painkiller is needed, Minoset, Novalgin can be used),

Multivitamin pills containing substances such as ginseng, ginkgo biloba, coenzyme Q,

Herbal products such as green tea, flaxseed, cherry stalk, tomato seed

Foods known to thin the blood, such as cherries and parsley

All slimming products

Before all breast operations, every patient needs to have a mammogram/breast ultrasound. Having a radiological image on hand before the procedure on the breast is very important for subsequent follow-up. When 1 year has passed since the operation, the mammogram/breast ultrasound is repeated.

Breast reduction operations are operations that must be performed in operating theatre conditions and under general anaesthesia.

Among all aesthetic surgery operations, breast reduction is perhaps the group of operations in which patients have the least pain and patient satisfaction is the highest. After breast reduction, simple painkillers may be sufficient for patients during the first few days.

There are many studies on this subject. In the studies, the breastfeeding rates of women who had breast reduction were compared with those of women with large breasts who did not have reduction surgery, and in most of them the rates were found to be similar. It can be said that the breastfeeding rates of patients who have had breast reduction are the same as those of other women. Except in excessively large and sagging breasts, reduction operations do not affect breastfeeding. However, the doctor performing the breast reduction must take care to preserve the continuity of the milk ducts between the remaining breast tissue and the nipple.

There may be temporary loss of sensation after breast reduction. In very large and sagging breasts there may also be permanent loss of sensation, but this is not frequently encountered. A few months after the operation, the nipples regain their former sensitivity. In addition, many women who have had breast reduction state that their nipples are more sensitive than before.

No, there is no relationship; on the contrary, because reduction operations reduce breast mass, they reduce the risk of cancer. Various studies report that breast reduction reduces the risk of cancer by 27-70%. It can be said that breast reduction operations halve the risk of breast cancer. All the pieces removed during breast reduction are sent for pathological examination. This provides very important follow-up information for patients for the future. In addition, incidental cancer cases can be detected in this way. In this case the patients' lives are saved.

The most common problems after breast reduction are poor scars, the breasts not being reduced enough, asymmetries, and the nipples remaining higher or lower than they should. All these problems can be overcome with careful planning and a meticulous surgical technique. A problem specific to vertical mammoplasty is that an excess of skin, a pucker, may remain at the lowest part of the vertical scar. If such a situation occurs, this excess can be removed under local anaesthesia after 3 months. Also, healing problems may be seen at the end of the vertical scar. This problem is encountered more frequently, especially in patients who smoke. Such wound problems resolve on their own with dressings and do not prevent patients' daily activities.