Breast Reduction (Reduction Mammaplasty)

Via a breast reduction the size and the form of the breast can be enduringly changed.

Basic preconditions:
	You are over 18 years old, in good physical and psychological condition and have a realistic idea.
	You are not pregnant and not nursing your baby.

Preparations:
	About 4 weeks before the surgery, you should reduce smoking. Moreover alcohol should be avoided.
	On the day of the surgery you should not have your menstruation.
	About 2 weeks before the surgery you should not take anticoagulants (Aspirin, acetylsalicylic acid containing drugs).
	Not later than 3 weeks before the surgery the birth control pill must be discontinued.

Surgery preparations and examinations:
	For the surgery you need a blood count and an ECG. Your GP can provide both. Please bring the findings with you (it should not be older than two weeks).
	If you are older than 40 you need a complete blood count.
	If you are older than 40 a mammography is additionally required.

Length of the surgery:

Usually the surgery will take 1-2 hours. The surgery will be carried out during a stationary stay in hospital of about two to three days.

Course of action:

Before the surgery you will be informed during a detailed counselling talk on how the surgery is done, possible complications, risks, and alternatives. Maybe you want to write done your questions on the surgery. The surgery will be conducted under general anaesthesia. Before the anaesthesia you will be advised by an anaesthetist about the risks, complications and possible alternatives to a narcosis. The anaesthetist will be present during the surgery. A general anaesthesia means stress for the body. During narcoses risks or complications can occur, depending on previous diseases and your general state of health.

The type of the incision depends on your personal idea of your breast and your physiological preconditions; this will be decided during the counselling talk. Before the surgery the breast will be measured, the incisions and the new position of the breast are drawn. During the surgery superfluous skin, breast tissue and maybe fat are removed. After this the remaining glandular tissue will be shaped again and then fixed to the muscle by buried suture. A skin lift fixes the breast further. Usually the nipples as well as blood vessels and nerves are dislocated. In order to ensure a good drain off of blood and ichors you will get drainages. The wound is closed with very thin suture. After the surgery the breasts are bandaged.

Perception and possible complications:

Usually the pain in worse in the first 48 hours but they can be alleviated by pain killers that you will get in hospital. Normally pain become less and less every day. Like after every surgery secondary haemorrhages cannot be excluded. Therefore you should avoid taking acetylsalicylic acid (Aspirin) and other acetylsalicylic acid containing drugs two weeks before the surgery. Despite aseptic measures inflammations can occur. Preventively you get antibiotics.

After a surgery there can occur blood clots in the main veins (thrombosis), these can be carried further and thus block a blood vessel (embolism). As prevention it can be considered to take anticoagulant drugs (i. e. injections of heparin), however these cause an increased bleeding tendency and in very rare cases grave dysfunctions of blood coagulation.

Even when the wound healing is normal, scars can initially become red or harden. After a while they will fade, they become inconspicuous. An implant can change its length or form due to a capsular tear. In this case a correction surgery can be necessary. Due to external forces it is possible that the implant is ripped. You will be informed on further risks and possible side-effects in a comprehensive handout.

After the surgery:

Usually the drainages are removed the day after the surgery. About 2-3 days after the surgery the bandages are removed. You will have to wear the supporting bra 6-8 weeks day and night, in order to shape the breast and support the healing of the wound. Like after every other surgery, there can be complications like swelling andd haematoma which normally subside after some time. The area around the nipples will be less sensitive for several weeks.

The stitches can taken out after 2-3 weeks by your GP. Afterwards you should apply a special scar ointment in order to support the healing. As soon as the wounds are completely closed, you can take showers again. Before you go home you get a follow-up examination. You should not drive yourself.

After about 2-3 weeks you can take up your every-day activities again. In the first 4-5 weeks you must avoid lifting heavy things or raising your arms over the height of the shoulders. You should not go to the sauna, do sports, go to the solarium, or take a sunbath in the first 10-12 weeks after the surgery.


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