Contact us to get a free consultation appointment.
Contact us to get a free consultation appointment.
Breasts which are sexual organs in terms of both fulfilling maternity functions by providing milk and complementing the woman image begin to grow upon the onset of puberty. It is sometimes unavoidable for some breasts to grow big due to weight gain, genetic predisposition, or pregnancy, and consequently sag down by the impact of the gravity. It has a negative effect on social life of females due to having difficulties in clothing selection, marks left on shoulders by bras, the malodor or the rash occurring under breasts especially in summer, and tiring effect of neck and back pains.
Breasts that normally need to weigh about 350-500 gr extremely vary in shape and size, but the average distance from nipples and the surrounding brown tissue (areola) to the collarbone normally measures 19-21 cm. This must fall on the fold of the breast where the breast sticks to the body from the bottom. This roughly falls on the median of the shoulder joint and the elbow joint.
Breast reduction and breast lifting operations are fundamentally quite similar. The aim to bring the saggy nipple and areola to the place where they should normally be. If we remove no or less than 350 gr tissue from the breast in doing this, it is called breast lifting, if we remove more tissue, called breast reduction.
The technique to be used must be agreed upon with the patient depending on the size and position of the breast, and the patient must be informed about the advantages and disadvantages of the technique to be applied.
Upon deciding the operation technique in consultation with your doctor prior to the operation, your pre-operation process will start.
Since your operation will be performed under general anesthesia, necessary blood tests will be conducted before the operation. Those tests are usually carried out on an empty stomach in the morning at the hospital where your operation will be performed. Anesthesiologist may require additional tests if deemed necessary. To make this decision, it is highly important if you have a chronic disease or allergies or take any medication. We will ask you all these questions following deciding to perform an operation, and additional tests and consultations can be requested depending on your situation.
Quitting smoking before your operation is very important both for your health and post-operation recovery and scar healing.
You should decide the best method for you with your operating doctor. Certain techniques are not suitable for certain patients at all and the outcome may fall short of your expectations. Therefore, you should discuss with your surgeon how much your breasts should be reduced, the consequential scars and the shape of those scars.
1. 1. Periareolar Mastopexy (Breast lifting from the areola)
In this method, the upper layer of the skin will be peeled off the areola and the excessive skin will be removed. Then the nipple will be uplifted and aesthetic stitching will be applied all around the nipple. This scar will be swollen and red in the early periods after the operation, but in time first its swelling and then the redness will disappear. This is the method also known as no-scar method. However, use of this method is very limited. It sometimes fails to meet the lift expectation of the patient. Other times the mark around the nipple extends and a revision can be needed to improve it.
2. Vertical Mammoplasty (Vertical Scar Breast Reduction)
This method is the most common one used in both breast reduction and lifting. Upon transferring the nipples upwards, a sufficient amount of tissue will be removed from the lower interior and exterior half of the breast. This method is best to preserve blood vessels supplying to the nipple, nerves to the nipple, and milk ducts in the safest way. Vertical scars going down on each breast will form by an aesthetic stitch all around the nipple as the result of the operation; these scars can be defined as lollipops. This method sometimes leaves a puckering under the vertical scar, and a minor correction might be needed to remove it. There might be a short horizontal scar right on the lower fold of the breast in addition to other scars, depending on size of your breast.
I generally describe breast reduction by this method to my patients as follows: Imagine that your breast is a round cake; when we cut out a triangular slice and close the rest, its diameter will narrow down and its conicity will increase. I consider this method as a technique to reduce and lift the breast in the most respectful way to the breast tissue, preserve nerves, vessels, and milk ducts supplying to the nipples in the best way possible, and ensure that the breasts stand like a shelf mounted on a wall with the nipples being right on the tip of the breasts following the operation.
3.Wise-Patern Breast Reduction (Reverse-T Technique)
This is the method preferred in reduction of bigger breasts, and there will be a scar looking like a reverse T starting from the nipple on each breast following the operation. Horizontal scars occurring in this method can sometimes get thicker and therefore become harder to remove, or sometimes breasts can go saggy, called as bottoming-out.
4. Free-Nipple Technique (Nipple Removal)
This is the method used in reduction of much bigger breasts. Operations performed using this method make breastfeeding impossible. Nipple-specific erogenous sense will also be lost and hardening and erection of the nipples will disappear. This method is used particularly for post-menopause excessively big breasts, even though not a must. and a Certain recovery and dressing period will be needed for nipples to hold on to their new place.
You usually stay a night at the hospital following the operation. You will not have too much pain after the operation, and the pain often responds to painkillers. If drains are used in your operation, they will be withdrawn in a few days. You also usually need to use antibiotics and painkillers for a week after the operation. In the meantime, you will need a daily dressing for 1 or 2 weeks, and then it would be important to use scar treatment creams and tapes to ensure a better improvement in scars.
You will be allowed to take shower a few days following the operation. We also recommend you to use a bra provided by us for up to 1 month following your operation.
Our patients usually return to their daily activities in 2-3 days while it takes 7-10 days to get back to work. We do not recommend our patients who come from abroad or another city to return their home in the said time period.
There are certain risks and complications associated with breast reduction-lifting operations that can be seen almost after any operation. These might include bleeding, infection, edema, opening of stitches, and stitch reaction. We can categorize the complications specific to this operation in two including early and late complications.
Early complications might include bleeding and infection while it can even extend to loss of the nipple due to the decrease or blockage of the blood supply to the nipple, called as nipple necrosis. In this case, breastfeeding and nipple sensation will be affected negatively. Therefore, your eligibility for the technique chosen for you will be important to prevent such risks, and it will be to your benefit to avoid any factor that could impair scar healing due to smoking prior to and following the operation. Nipple sensation can be temporarily affected even if the nipples has not been affected, but this will get back to normal usually in 3-6 months.
Of late complications, scars might be the most annoying one. No breast reduction operation comes without a scar nor scars be the same in each patient. The considerations here are the amount of the tissue removed from each breast, age of the patient, pre-operation sagginess of the nipple, excessive scar (keloid, hypertrophic scar) generation probability in the body, smoking, and potential post-operation infections. Some scars can be suppressed by cream silicone bands given after the operation, while others might need a minor scar correction operation after scars ripen. It would be good for you to be informed about scars ripening period before the operation to overcome this complication period healthily. Note that no scar will heal without leaving a mark, and it sometimes can exceed even 1 year for scars on the breast to ripen. Breasts can go saggy again too. Effects of breast reduction and lifting operations do not last forever as in any other lifting operation. Breasts reduced or lifted will definitely go a bit saggy depending on age, gravity, and amount of the remaining tissue.