Breast reduction for oversized sagging breasts

Dr Mathias Tremp Breast Deformities

Reduced breast size for a relaxed attitude to life

A very large and heavy breast is not only stressful for the affected women for aesthetic reasons. Physically, breast size can also cause considerable problems with neck and back pain. Postural problems or inflammation of the underbust fold are frequent consequences.

There can be many reasons for an increase in breast tissue and breast size. For example, after the menopause or pregnancy. After pregnancy, the glandular tissue of the breast shrinks very much. To restore a desired firm breast shape, a breast reduction and breast lift can be helpful.

With surgical reduction of the breast, excess breast and glandular tissue is removed. The breast size can be aesthetically adjusted to the other body size and shape. If desired, the result of the operations performed is also a significantly reduced breast that continues to look very feminine.

PD Dr med Mathias Tremp Consulting

Do you have any questions about breast reduction?

During a consultation you will be fully informed by PD. Dr. med. Mathias Tremp will fully inform you about the procedure, possible risks and the feasibility of the desired breast correction.

A detailed consultation is the first step of every operation. Before and after pictures are also important aids in the consultation for breast reductions.

Cause big breasts

Large breasts (mammary hypertrophy, macromastia or gigantomastia) can be unilateral or bilateral. In many cases there is a symmetrical increase in size, i.e. both breasts grow to the same extent.

Macromastia is diagnosed when the expected resection weight exceeds 500g per breast in a severely enlarged mammary gland. The height and weight of the affected person must always be taken into account.

For smaller and slender women, even a lower breast weight can be a great burden. Strictly speaking, there are therefore no exact guidelines for macromastia. Whether it is an oversized breast always depends on the physical conditions of the patient.

Large breasts with overweight and hormonal changes

In the case of obesity, the amount of fat in the breasts also increases. However, not only overweight women can be affected by gigantomastia. Women of normal weight can also suffer from large breasts. Sometimes there is also a genetic cause.

Overly large breasts can also be caused by hormonal changes. Puberty, pregnancy or the menopause are important life phases for changes in the oversized breast. However, the development of large breasts due to pregnancy is rare.

Physical and psychological complaints

Overdevelopment of the breast is usually an enormous burden for the women affected. Women affected by large breasts complain of neck, back and shoulder pain. In addition, overly large breasts can be a hindrance in everyday life and sports.

The physical complaints and psychological problems can reveal themselves as great stress.

Breast reduction methods

The optimal method depends on the shape and size of the breast and the patient's wishes. The incision runs around the areola and vertically below it. As a rule, the areola is also reduced slightly. Often another incision is necessary along the natural breast fold.

I incision for removal of larger excess skin

The vertical lift (Lejour method) allows a relatively large breast lift with little scarring.

The method is also suitable for large breasts and sagging breasts with medium to large excess skin.

T- and L-cut for extensive breast reduction

The T and L incision techniques differ only slightly from each other. Both are based on the I-method (according to Lejour), but the vertical incision is continued in the inframammary fold.

The two techniques allow the reduction and tightening of the breast with medium and large excess skin.

New position and shape of the nipples

The removal of mammary gland tissue and skin changes the position of the nipples. In the process, the areola is moved upwards to achieve an appealing aesthetic result. The shape and size of the nipple are also adjusted and aesthetically corrected.

Procedure, work ability, risks and aftercare of breast reduction

During the operation, skin, glandular, connective and fatty tissue is removed. During the operation, the breast is reshaped and tightened to the desired size.

The mammoplasty procedure is usually performed as an inpatient and under general anaesthesia. The exact type and procedure of the anaesthetic will be discussed in detail with the anaesthetist before the procedure.

Depending on the size of the breast, either a vertical (scar-saving) or small T-shaped incision is made. In particular, the ideal incision depends largely on your physical conditions and the patient's wishes.

The vertical incision is to avoid a horizontal scar in the inframammary fold. For large excess skin, the T-shaped incision is intended.

During breast reduction, the nipple is repositioned in an upward direction. This creates a circular scar in the area of the nipple. During breast reduction, both skin and parts of the central glandular body are removed.

Problems are very rare with this procedure. Occasionally there is infection or bleeding in the first few days after the procedure. During the healing process, there may be thickened or widened scars due to excessive stress or movement of the breast.

Such scars could be treated and corrected after 6 months at the earliest. Fine injections with cortisone, treatment with autologous blood or radiofrequency, microneedling (Genius®) help. The majority of scars heal without further discomfort.

After a few days, the pressure bandage is replaced with a sports support bra. The reduced breasts are supported with a sports bra for 4 to 6 weeks after the procedure. THE sports bra should also be worn during the night.

Sporting activities should be paused for 4 weeks after the operation. You can return to work 10 to 14 days after the operation at the latest.

Regular skin and scar care as well as sun protection are very important after the treatment for an optimal result.

Pain after breast reduction

Immediately after the operation, the breast will be tense and painful for a few days. Painkillers are usually administered to counteract this. The sensation of pain after a breast augmentation is individual. The degree of swelling, bruising and pain varies greatly.

The pain depends on the choice of surgical technique. The patient's physical condition is very important for the further healing process.

Scars from a breast reduction

After the operation, the scars will still be red. However, the scars will fade within a few months and blend in with the surrounding skin.

Absorbable sutures dissolve by themselves. The other sutures remain for up to three weeks to support fine scar formation. With a good breast shape, the scar is usually secondary.

In the healing phase immediately after breast surgery, the skin incision can be supported by sticking on special suture plasters. This can minimise scar expansion.

After the wound has healed, the scars can also be treated with caring creams. During the following six months, UV irradiation of the scars during sunbathing must be avoided at all costs.

Breast reduction costs

The costs are discussed in detail with the patient beforehand and are to be understood as a case flat rate. They include anaesthesia, use of the operating theatre, compression suits and all other associated costs, excluding sports bra and overnight stay.

The costs may only be covered by health insurance in exceptional cases. If the breast is too large and causes health problems, a medical examination can help. If the decision is positive, the health insurance will cover the costs or part of the costs of the operation.

Important: Criteria must be met for the costs to be covered. This requires a detailed medical clarification by the attending physician and plastic surgeon.

Contact us for a non-binding consultation.

Offer and prices

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