Facts
- Breast reduction is a primarily functional and to a lesser extent cosmetic surgery , which aims to reduce the size of the breasts in women by removing skin, fat and glandular tissue
- In this way, you can relieve the discomfort that can be associated with excessively large breasts and achieve a breast size that is proportional to the body
- If you gain weight or if you have hormonal changes, the breasts can grow again
- Over time, laxity will occur in the breast tissue, which changes the breasts
- The intervention is carried out both privately and publicly. Operation in the public sector requires certain height-weight requirements, and the reduction must be considerable, corresponding to approx. 400 g per breast
- Significant excess weight increases the risk of complications. So does smoking. If you smoke, you should stop smoking 6 weeks before an operation and 4 weeks after the operation
What is the purpose of breast reduction?
The purpose of the operation is to reduce the size and change the shape of the breasts to the desired. Large and heavy breasts in women can cause back, neck and shoulder pain. Women with large breasts may also feel uncomfortable in public and have difficulty with physical activity.
If you meet the criteria for breast reduction on a functional basis, you can have the operation covered by the public health service. These can be pronounced physical discomforts such as pain in the neck/shoulders/back, lace lines on the shoulders from the bra or skin infections under the breasts due to dampness. You must be of normal weight (Body Mass Index of a maximum of 25) in order to be operated on in the public health service.
If you are over 35-40 and have functional or cosmetic breast surgery, it is generally recommended that you have a mammogram done before the surgery. This is done to exclude that there are diseases in the breasts that require treatment.
Enlarged breasts in men
Men can get enlarged breasts (gynaecomastia) due to hormonal disorders , obesity , illness or the use/abuse of certain types of medication. The doctor will always consider the cause of the male breast enlargement and decide on any investigations.
The condition is usually harmless and quite common during puberty. However, it can be disfiguring for men to have breast formation, and surgery for male breast formation is relatively frequent.
Overweight
Before considering a breast reduction, you should note that you may have large breasts due to being overweight. Weight loss through a nutritious diet and physical exercise can also reduce the size of the breasts and thus reduce breast discomfort.
The risk of complications during the operation increases with increasing weight. You should therefore be of normal weight before the operation.
It is mainly the amount of fat that determines how big your breasts are. In a breast reduction, unwanted fat is therefore removed together with redundant skin and parts of the mammary gland.
The plastic surgeon makes an incision around the dark area at the nipple. The incision then goes vertically down and along the natural fold under the breast. The plastic surgeon removes excess skin, fatty tissue and glandular tissue from the breast. The nipple with associated nerves and blood vessels is moved up to its new position. The skin is sewn back up and the breast is lifted, reduced and given a new shape.
The doctor may place a drain in the chest during the operation. The drains are typically removed after 1-2 days.
Breast reduction takes from two to four hours. It takes place under full anesthesia.
Results
You get smaller breasts, and the result is considered permanent, subject to the natural aging phenomena that will always occur over time.
However, if you gain weight or if you have hormonal changes, the breasts can grow again. In men, abuse of anabolic steroids can increase the size of the breasts. The same applies to certain types of diuretic medicine and antihormonal preparations, which are used in the treatment of cancer.
How good the results will be depends on the shape and size of your breasts before surgery.
You should expect to take two weeks off work after a breast reduction. You should avoid heavy lifting and physical activity for 4-6 weeks after surgery. The elbows are kept below shoulder height for the first 3 weeks after the operation. It is important to have a special bra or sports bra that supports the breasts during this period. This is to provide the best possible cosmetic result. The stitches are removed after 10-14 days, if they are not self-dissolving stitches.
The scars should not be exposed to the sun for a year. Sunbathing can make the scars more visible. All breast operations produce scars to a greater or lesser extent, but with breast reductions the scars are almost always visible.
The scars look best if you use tape for a minimum of 3 months. It can take a year for the scars to fully mature and soften.
Side effects
It is common to get reddish scars on the breasts and reduced sensation in the nipples after breast reduction. Especially with large reductions, there is a high risk of reduced or no feeling in the nipple and in the dark area around the nipple.
Reduced ability to breastfeed after breast reduction is also a frequent side effect.
Possible complications
All surgery carries some risk of complications.
You may risk getting asymmetry, for example different size of the breasts or different placement of the nipples.
Decreased sensation in the nipples can be permanent. This happens with approx. 15-20% of those operated on, depending on which method is used in the operation. Losing the ability to breastfeed is also a possible complication.
Rare complications are heavy bleeding in the operated tissue, infection in the surgical wounds and tissue death (necrosis).
Complete or partial tissue death of the nipple is seen in approx. 1% of those operated on. Smoking increases the risk. This will typically require additional surgery to treat these rare complications.
