Borstvergroting I Parkkliniek Rotterdam Plastische chirurgie

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Breast reduction/breast lift

General information about breast reduction/breast lifts

Breast reductions and breast lifts are the most frequently performed types of breast surgery in the Netherlands. Many women are affected by unduly heavy and/or hanging breasts. This can result from both increases and decreases in weight. The breasts can sag following periods of dramatic slimming or pregnancy. Abnormally heavy breasts or low breasts can lead to back, shoulder and/or neck problems. Furthermore, the shape of the breasts can be perceived as off-putting or embarrassing. Where a woman is affected by sagging breasts although she has not put on weight, the problems are likely to be purely psychical.

Prior to the procedure

In the course of an initial consultation, a plastic surgeon will discuss your wishes and establish what cup size you would like your breasts reduced to. However, this information is used for guidance only; it is not possible to guarantee that the desired cup size can be achieved. The consultation is concluded with a breast examination and blood tests are carried out. If you are taking certain medicines (ascal, aspirin), you will need to stop doing so at least seven days prior to the surgery, since both can cause postoperative bleeding problems. Furthermore, you must not smoke in the four weeks prior to the procedure, since smoking constricts the blood vessels and can impair the healing of wounds.

The procedure

The procedure is carried out under general anaesthetic. Both breast reduction surgery and breast lifts involve the removal of some mammary gland tissue, along with a certain amount of skin, thus making the breasts smaller. With a typical breast lift, a relatively small amount of glandular tissue is removed, but a relatively large amount of skin; with proper breast reduction, the reverse is the case. The procedure also involves raising the level of the nipple. The surgery results in a circular scar around each areola; in most cases, there will also be a scar in the skin fold beneath the breast and a vertical scar running between the nipple and the fold beneath the breast. The wounds are inwardly stitched using dissolvable material. Two drains are fitted to take blood and fluid from the site. These drains are removed after a day. Immediately following the procedure, the patient is fitted for a robust sports bra, which serves as a supportive dressing.

Afterwards

Most women find the postoperative pain tolerable. However, for two weeks following surgery, you will experience impaired arm and shoulder mobility. Your breasts will immediately feel smaller and firmer. It is advisable to wear the sports bra day and night for at least four weeks. After four days, you will be able to take short showers, but it is inadvisable to take a bath in the first four weeks following the procedure. Cycling and driving are also to be avoided for a fortnight, because of the impaired mobility and possible pain.

Risks

The procedure is associated with general risks such as postoperative bleeding and infection, as well as the more specific risk of fat necrosis. The latter can lead to partial reopening of the wound. Another potential complication is nipple necrosis. Fortunately, such complications are very unusual.

Outcome

It is not always possible to make the breasts symmetrical. Furthermore, the shape and sensitivity of the nipples may not be quite as expected. It is important to recognise that the significant stresses that develop within the tissues following the procedure can mean that the breasts ultimately take on a shape that is not the same as they had immediately after correction. The final breast form is not reached until two to three months after surgery. This is because the breasts gradually become more supple and consequently sag slightly. Nipple sensitivity should return to something approaching normal after between three and six months, but may never return entirely. It should also be recognised that breast reduction or breast lifting does not involve removal of any surplus tissue under the armpits (and possibly round to the back). What is more, the procedure does not reverse the processes that caused the breasts to sag in the first place; consequently, the effect of surgery may diminish over time. General weight gain, pregnancy or use of the contraceptive pill can all make the breasts heavier again. The plastic surgeon cannot guarantee that your breasts will be a particular bra cup size after the procedure. There is additionally a risk that the symmetry and the shape of the breasts will not be optimal, or that scarring caused by surgery will be unsightly. The ultimate appearance of the scars cannot be fully predicted. The possibility of prominent, red and sensitive scars is greatest where the incisions extend further towards the armpits. Over a period of months after the breast reduction, the sensitivity of the scars recedes, and they become less prominent and whiter, but they can also become wider.

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