Breast Reduction (Reduction Mammaplasty)
A breast reduction, also known as reduction mammaplasty, can be performed for both aesthetic and medical reasons. Women with very large breasts often suffer from chronic back pain, particularly in the cervical and thoracic spine areas, tension in the neck and shoulder region, as well as sweating, skin irritation, or even skin infections in the inframammary fold. For the women affected, it is often not easy—and certainly not cheap—to find a well-fitting and supportive bra. Furthermore, they may be severely restricted in physical activities during daily life and work. While daily exercises for strengthening and mobility of the musculoskeletal system and physical therapy are helpful, experience shows that these are often insufficient to permanently prevent pain and, ultimately, chronic wear and tear of the musculoskeletal system.
The level of suffering spans across all age groups. Not only do young women sometimes struggle for years with the weight of large breasts, but women past menopause also frequently experience a significant, sudden increase in breast size. In these cases, the size of the breast can be independent of body weight if it contains a high proportion of glandular tissue.
Of course, not all patients experience medically relevant suffering. Many patients simply prefer the appearance of smaller breasts and choose to undergo a breast reduction of their own accord.
In rare cases, particularly with so-called juvenile gigantomastia, statutory health insurance providers may cover the costs of inpatient treatment. Private health insurance companies usually cover—depending on the contract—the costs or a portion of the costs for both outpatient and inpatient breast reduction if the strict criteria for medical necessity are met.
Similar to a breast lift, various surgical techniques can be used for a breast reduction depending on the size and condition of the breast. The goal is to lift the sagging mammary gland and nipples, remove excess skin, and give the breast a firmer and more harmonious appearance. In addition to the breast lift, a significant portion of glandular and fatty tissue is removed during a breast reduction to reduce the size and weight of the breast and reshape it. As part of a breast reduction, the nipples and areola can also be adjustively corrected. – You can learn more about nipple correction here.
If you are considering having a breast reduction, you are very welcome to arrange your first personal consultation at our clinic near the historic Gendarmenmarkt in Berlin. Our experienced specialists in plastic and aesthetic surgery, Dr. med. Isabel Edusei and Dr. med. Andrea Wolff, will accompany you with empathy and competence throughout the entire process of breast reduction. From the initial consultation to comprehensive aftercare, we are by your side in our clinic and ensure that you feel completely well taken care of with us.
Procedure of a Breast Reduction
The procedure of a breast reduction always begins with an individual and detailed consultation by our specialists in plastic and aesthetic surgery, Dr. Andrea Wolff or Dr. Isabel Edusei. During this meeting, the patient’s wishes are discussed, a professional clinical examination is performed, the breast is measured and photo-documented, and information is provided regarding potential surgical techniques, risks, and complications.
The choice of incision for a breast reduction depends on the patient’s individual anatomy, the quality of the skin and tissue, as well as the desired shape and size of the breast. Frequently used surgical incisions are selected according to the respective initial situation and goals. These include the I-technique around the areola combined with a further vertical incision from the lower edge of the areola over the lower half of the breast, the L- or J-incision, or—frequently for large breasts—the form of an inverted T-incision (also called the anchor method) with a hidden scar in the inframammary fold. Dr. Andrea Wolff and Dr. Isabel Edusei will advise you in detail to determine the method suitable for you and to achieve an aesthetically pleasing result.
The main goal of a breast reduction is to return the mammary gland and nipples, which have sagged due to gravity, to their original aesthetic position, to reshape the breast, and to stabilize it through weight relief. In the case of asymmetries, the shape and size can be balanced. To achieve this, excess sagging skin is removed during the breast surgery to give the breast a firmer and more harmonious appearance. In contrast to a pure breast lift, a significant portion of glandular and fatty tissue is additionally removed during a breast reduction. This not only leads to a reduction in breast size but also enables a reshaping of the breast, which can then appear more balanced and better proportioned to the upper body.
Breast reduction is often combined with adjunctive liposuction (LINK) to harmonize the tissue transition into the lateral chest wall, for example.
The breast reduction itself is performed under general anesthesia in our clinic. The duration of the operation is on average 2 to 4 hours. Following the breast surgery, you will receive extended care on-site at our facility.
In preparation for the breast reduction, it is important to thoroughly review the checklist provided by the clinic staff. This contains important to-dos such as submitting a current breast ultrasound report to the practice, providing other specialist medical certificates to confirm medical indication (e.g., from an orthopedist, gynecologist, or dermatologist), and contacting the anesthesia team.
Pack a surgical bag with necessary items such as slippers, comfortable clothing, and (essential!) your surgical folder, which you received from us during the preliminary consultation. Organize your household, shopping, childcare, and, if necessary, a driver in advance so that you can rest completely after the operation. On the day before the breast surgery, you should shave your armpits and refrain from wearing jewelry, including all body piercings, as well as makeup.
Breast Reduction and the Internal Bra Technique
For a breast reduction or breast lift, a variety of surgical techniques, such as reduction mammaplasty using the Hall-Findlay method, are applied. These can be supplemented by surgical techniques that form an “internal bra.” Such methods are particularly suitable for patients who, due to genetic predisposition, pregnancies, previous breast implants, significant weight loss, or the natural aging process, have sagging skin and soft tissue as well as severe breast drooping that could counteract the long-term stability of the surgical result. The “internal bra” is shaped during the operation from the body’s own tissue to provide the breast with more support. Creating an internal bra is not appropriate for every patient.
Our specialists in plastic and aesthetic surgery, Dr. Isabel Edusei and Dr. Andrea Wolff, are available to clarify open questions and provide individual consultation. You can also conveniently book your preferred appointment online.
After the Breast Reduction
After a breast reduction, the recovery phase is crucial for the healing process and the long-term treatment outcome. The resumption of social and professional activities depends on your individual findings and the nature of your work. While some patients can resume light professional activities after just a few days, others, especially those in physically demanding jobs, require a longer recovery period.
Early mobilization on the day of surgery is important to prevent thromboembolic events and muscular tension, and to stabilize the circulation. Usually, so-called Redon drains are placed in the surgical wounds to drain excess wound fluid. These are guided out through the skin and connected to collection bottles; they are removed depending on the drainage volume, at the earliest on the first day after the operation. This is also when the first dressing change takes place. All dressing changes are performed by the practice team and the physicians. In the first few days after surgery, showering is only possible from the waist down. The upper body areas should be cleaned with a gentle sponge bath. A compression bra must be worn for at least 6 weeks to support the healing process and stabilize the new breast shape. Further follow-up appointments and dressing changes occur regularly to closely monitor the healing progress.
Sporting activities should only be slowly resumed after 4 to 6 weeks. It is important to gradually approach physical exertion and pay attention to the body’s signals. Our practice team and our specialists in plastic and aesthetic surgery, Dr. Wolff and Dr. Edusei, will of course provide you with important recommendations in this regard. Approximately three months after the procedure, the breast should generally be sufficiently healed to withstand full exertion again, even if the healing process is not yet completely finished at that point. Until then, you should refrain from intense physical activities so as not to jeopardize the healing.
Pain after the operation varies individually, but severe pain is generally not to be expected. To minimize any discomfort, you will receive an individually tailored therapy plan with pain medication.
The timeframes listed here are, of course, only average values, and an individual consultation with our specialists, Dr. Isabel Edusei and Dr. Andrea Wolff, is crucial to guide and support the healing process in the best possible way.
Do you still have questions about breast reduction? Feel free to arrange your personal consultation appointment with our specialists in plastic and aesthetic surgery, Dr. Wolff and Dr. Edusei, conveniently online. Additionally, you can view further FAQs on the subject here.
DURATION OF SURGERY: 2 – 4 hours
TYPE OF ANESTHESIA: General anesthesia
PAIN: generally WHO Step 1
AFTERCARE: compression bra for 6 weeks
SOCIAL READINESS: after a few days
ABILITY TO WORK: depending on findings and professional physical strain
EXERCISE: after approx. 4 – 6 weeks, full exertion after 12 weeks
Ask our advice.
We’ll be glad to provide you with detailed information about this treatment. Simply get in touch with us now and obtain advice at an individual and absolutely personal level.
+49 30 - 94 041 144