Definition and objectives

A patient may wish to have breast reduction in the case of overly large breasts, especially since this is generally accompanied by sagging the breasts. This mammary hypertrophy leads to neck pain, and shoulder and back pain in the majority of cases. This cosmetic defect is often reimbursed by health insurance.

The aim of the operation is to recreate two harmonious breasts by reducing their volume, correcting sagging breasts and any asymmetry.

Prior to surgery

A preoperative examination is carried out to examine the patient’s medical and surgical history and to verify mammary imaging from a mammograph or ultrasound. The anaesthetist will be seen 48 hours prior to surgery at the latest. Medication containing aspirin should not be taken for 10 days prior to surgery. General anaesthesia is usually used and the patient is hospitalised for 1 to 3 days. This operation is often reimbursed by health insurance.

The operation

Excess gland tissue is removed. The remaining gland volume is lifted, concentrated and remodelled. Next, to ensure good hold and a good cleavage, excess skin is removed. Sutures on the edge of the skin incised to remove excess skin are responsible for scars. It should be noted that the tissue removed is systematically sent to a specialist laboratory in order to screen for any possible disease. The operation can last 2 to 3 hours.

At the end of surgery, a support dressing is made up using elastic strips.

After the operation

In general, as the after-effects of the operation are not very painful, the patient only takes simple analgesics. It is also common to notice oedema and bruising around the breasts after the operation and the patient may have problems lifting the arms.

2 to 3 days after leaving hospital, the surgeon replaces the bandage with a brassiere providing better support and this must be worn day and night for one month. In the case of non-resorbable suture threads, these are removed between the 8th and 20th day after the operation.

Work leave should be taken for 8 to 15 days and sporting activities can be resumed after 1 to 2 months. For pregnancy followed or not by breastfeeding, it is advisable to wait 6 months.

Result

The result can only be judged after one year. During this period, the surgeon should be seen every 3 months. It should be noted that the operated breast remains sensitive, especially to hormonal variations. The patient may need a second operation one or two years later because scars are enlarged, white or brown or because the breasts are asymmetrical.

Possible complications

In the vast majority of cases, there are no complications following breast surgery. Using a qualified plastic surgeon is a guarantee against such complications or at least gives you the assurance that complications will be treated if need be. After breast enhancement, it is possible that the scar may develop abnormally in the form of thickening or retraction. Breast pain and nipple sensitivity are also possible.

Complications characterising breast surgery are :

- an infection which requires antibiotic treatment and sometimes surgical drainage.

- haematoma which can require elimination of accumulated blood matter.

- necrosis of the skin or gland, very rare, which delays healing.

- changes in sensitivity which usually reappear after 6 to 18 months.

- hypertrophic scars which are treated by specific local treatment.