Duration
90-180 min
Anaesthesia
General
Hospitalization
1-2 nights
Return to society
10 days

Large and ptosic breast could represent a serious problem, aesthetic, functional (affecting posture and limiting the everyday life) and hygienic (leading to skin inflammation and ulceration at the inframammary fold).

Breast reduction aims to reduce breast volume, correct ptosis, asymmetries and to restore a harmonic breast profile.

The surgical procedures are similar breast lift. The residual mammary gland can be employed as an “auto-implant” to increase breast projection and to fulfill the upper quadrants that often result hypoplastic due to glandular ptosis.

Techniques


Several techniques of breast reduction are available. Each procedure has different indications depending on the degree of ptosis and reduction:

  • Periareolar breast reduction: generally indicated in case of mild to moderate hypertrophy and. The nipple-areola complex and the gland are repositioned through a periareolar incision. This technique allows mild reduction and reshaping with limited scarring
  • Vertical reduction. This technique is able to treat moderate hypertrophy and ptosis with possibility of moderate breast reshaping. Scars are positioned around the areola and vertically from areola to infra-mammary fold.
  • Reverse T mastopexy. This technique is indicated for severe hypertrophy and ptosis. This technique allows a good breast reduction and reshaping. Compared to vertical reduction, this technique requires an additional scar in the inframammary fold (the resulting scar resembles an inverted T).
Preoperative evaluation

A full breast screening must be performed before any surgery. Mammogram and an ultrasound are performed in each case. Magnetic resonance imaging should be prescribed if necessary. Any suspicious nodule must be investigated to exclude breast neoplasms.

A careful pre-operative interview is essential to understand and collect patient’s desires. The interview should also clarify the aims, modalities and risks of surgery.

The procedure is performed under general anesthesia, duration depends on the performed technique and degree of reduction.

Post-operative


Patients should wear a post-surgical bra, able to provide for a uniform compression, reducing bruising, bleeding and edema. Post-surgical bra should be worn for 14 days after surgery.

Drains are introduced during surgery and consists in soft silicon tubes that are usually removed 4-7 days after surgery.

Patients can return to their everyday life in 7- 10 days after surgery. Sports and intense physical activity can be resumed between 3 and 4 weeks after surgery.

Immediately after surgery, breasts are swollen and display ecchymoses. These symptoms regress autonomously in 30 days. In case vertical or inverted T reduction, breast gathers the final shape in 6 months, although scars heal far earlier (usually 2-3 weeks after surgery).

Results


Breast reduction does not stop the phenomenon of ptosis and cutaneous aging. Moreover, weight oscillations, smoke and pregnancy could modify and compromise the aesthetic result.

In normal conditions, the benefits of surgery will be visible for 3-6 years (depending on the type of breast and the performed procedure).

The patient must be informed that breast reduction could lead to inability to breastfeed and to decreased/absent sensitivity of the nipple.