Breast reduction
Stiff shoulders, sore neck, poor posture, constant headaches, and feeling down? All these symptoms can be caused by large, sagging breasts. Breast reduction is one of the most common plastic surgery procedures. When performed skillfully, the procedure is safe and your problems will be left on the operating table.
With age, fat accumulates in the breasts, tissues stretch and sag. Previously firm breasts become depressed and the nipples point downward. The breasts pull the posture down and the muscles become stiff. Large breasts can weigh several kilograms, and even small breasts can cause new problems due to the resulting torque, exacerbating existing issues. Large breasts also cause wear and tear on the cervical vertebrae, body image issues, and bulimia.
Breast reduction surgery is suitable for all ages and sizes. In some places, a BMI limit is set for eligibility for surgery. In our experience, these limits are artificial, and sometimes the desired weight loss only occurs after surgery—not before.
The surgery is performed under general anaesthesia and takes just over an hour. You can go home either the same evening or the following morning at the latest. There are several surgical techniques. The most common and traditional is surgery performed with an inframammary incision, which leaves an anchor-shaped scar. This technique is suitable for breasts of all sizes. Tissue is removed as much or as little as needed. It is essential to assess the patient's desired outcome: should a lot or only a little bit of tissue be removed? It might not be desirable to make a large-breasted woman almost flat-chested. The amount of tissue removed is not proportional to the reduction in symptoms; even a small amount of tissue removal can achieve the same result as a large amount. The amount of tissue removed can range from 100 grams to several kilograms.
The breast is overcorrected during surgery, i.e., the tissue is attached as high as possible on the chest wall.
I always say that if you wake up feeling like your jaw is hitting your chest, that's a good thing.
After the surgery, the breasts will settle into place. The final result of the surgery can be assessed after about six months, when the scars are still slightly red but the breasts have settled into place.
Breast tissue is not particularly sensitive to pain, so ibuprofen and paracetamol are usually sufficient for post-operative pain relief. If necessary, paracetamol can be replaced with a stronger combination of paracetamol and codeine. The wounds are sutured with absorbable sutures that do not need to be removed. The knots on the skin will fall off about four weeks after the surgery. A mammogram is taken before the surgery.
Postoperative wound infections and secondary bleeding are rare. Sensitivity in the nipple area may change; sometimes a numb nipple may regain sensitivity when the stretching caused by the breast is removed. On the other hand, surgery may be associated with decreased nipple sensation or, in very rare cases, nipple numbness. Scar healing is individual. Red scars fade over several months. Growing keloid scars are very rare.
After surgery, the wounds are covered with medical tape. If the scars are irritated and red for a long time, it is advisable to replace the tape with silicone tape and silicone gel.
After the surgery, a support bra must be worn day and night for at least one month, and thereafter whenever engaging in sports or physical work. You can return to desk work in a few days and to physical work in 2–4 weeks, depending on the strenuousness of the work.
The first check-up is approximately one month after the surgery, when we check that healing is progressing normally, and the final check-up is approximately six months later.
Breast reduction is a good operation. The problems are left on the operating table, and the most common comment from patients during follow-up examinations is: "Why wasn't this done earlier?"
Asko Salmi
Specialist in Surgery and Plastic Surgery
