Forehead lift

 

Breast reduction

 

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For whom is a breast reduction?

Women with neck or shoulder complaints, or with complaints during sports whereby the weight of the breasts can be quite cumbersome. At a later stage in life larger breasts will increasingly sag and thus cause more complaints.

Photo album breast reduction

 A breast reduction where only little tissue is removed is called a breast lift

 For more information about breast reduction for men see gynaecomastia.

1. Age?

For this operation you must be at least 18 years old. Basically the breasts must have finished growing. Sometimes, after careful deliberation, I will operate on younger women, but only when normal day-to-day functioning is disturbed.

There is no maximum age, but the chance of complications does increase with age. I do take into account the vitality of the patient. A breast reduction for patients over 60 years old is quite common nowadays.

2. The surgery

Prior to the intervention I will make markings on each breast with a black marking pen outlining the place of the new nipple and the amount of skin that I will remove. Don’t use body lotion or crème so that my drawing will not rub off.

There are different techniques that I use: the “anchor-shaped incision”, the “keyhole method” and a combination of the two. All techniques will leave a scare around the nipple. The keyhole method, with a vertical coupe line in the lower part of the breast and of course around the nipple, is only suitable for breasts which aren’t too large and for the breast lift

During the procedure the nipple is moved upwards on a thick pedicle. Then, the tissue from the breast gland underneath the breast is loosened from the breast muscle, after which the excess tissue is removed to the extent necessary. Thereafter the remaining tissue will be shaped into the new, smaller breast. The operation takes 2 hours.

3. After surgery

Tape is applied to the breasts, tubes come out from both sides as drains, which are used to suction excessive blood and tissue fluid. You will stay one night in hospital or the clinic and the next morning the drains and tape will be removed. 

From that moment on you can take daily showers with soap and shampoo. After one week, on the first check-up, the continuous stitches around the nipples are removed, after two weeks the remaining stitches. After this period you can do most day-to-day activity as normal. Sport and other strenuous activities can be done after 4 – 6 weeks. Scar cream can only be applied when the scars are fully healed, so earliest after 3 weeks.

4. Scars

It is not realistic to think that they will become little lines. You really have to count on substantial scars. The vertical scars heal best and are least visible. The scars need a longer period of time to become supply and to fade; sometimes this will take over a year. Scar cream and massage will help the proces slightly: it is mostly a matter of time.

5. Influence on breast feeding

It does influence breastfeeding but it is rather difficult to predict how much. It is better to take into account that it might no longer be possible to give only breast feeding.

6. How long will the effect of the surgery last?

Breasts do not grow anymore, but an increase in weight can cause heavier breasts. The firm breasts from shortly after surgery become less firm and start to sag. This is normal. The cup-size of the bra can change, without the volume changing.

7. Position of the nipples

When you look at the photos the position of the nipple looks rather low. In the years after breast surgery the breast will slightly lower underneath the nipple which potentially leads to a high, unnatural position. So a nipple that is initially placed a little lower is eventually preferable and more natural. In between 3 months and 2 years the nipple will gradually tilt and point more upwards. 

8. Complications

A bruise is an easily treatable complication. The (partial) necrosis (loss) of the nipple is very rare and will not occur with healthy patients and skilled hands. Sometimes the wounds under the breasts will widen, which causes wound leakage for 1 or 2 weeks. Paraffin gauze and a shower twice a day will solve the problem. Smoking and overweight increases the risk of these complications. Loss or decrease of sensitivity of the nipple is a possibility in case the nipple has to be moved substantially. 

Dr. Erik J.F. Timmenga