Breast reduction (mammoplasty)
Breast reduction surgery removes excess glandular, fatty and skin tissue, reshapes the breast and reposition the nipple-areola complex higher up.
Table of Contents
Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
Definition and aim of breast reduction surgery
The Breast reduction (mammoplasty) is a plastic surgery procedure in which excess breast glandular tissue, fat and skin are removed to reduce the size and weight of the breasts. At the same time, the breast is reshaped and the nipple-areola complex is repositioned higher up, in a more aesthetically pleasing position.
The main aims of a breast reduction are:
- Relief from physical symptoms: Reduction of chronic neck, shoulder and back pain, postural problems, digging bra straps and skin irritation (intertrigo) in the underbust crease.
- Improving quality of life: Comfort during sporting activities and in everyday life.
- Aesthetic harmonisation: Achieving a breast size and shape that is in proportion to the body.
- Boosting self-esteem: Reducing psychological stress and promoting a positive body image.
Indications for breast reduction surgery
A breast reduction may be medically indicated or sought for aesthetic reasons. The most common indications include:
- Macromastia/gigantomastia: Breasts that are objectively too large and heavy in relation to the woman’s height and build.
- Chronic pain symptoms: Persistent pain in the neck, shoulders and back, which has been shown to be caused by the weight of the breasts.
- Postural problems and changes to the spine.
- Recurrent skin inflammation (intertrigo) in the crease under the breast.
- Limitations in physical activity and in everyday life.
- Significant psychological strain and a negative impact on self-esteem due to breast size.
- Breast asymmetry, where one side is significantly larger.
A personalised consultation and examination by an experienced specialist in plastic and aesthetic surgery is essential in order to assess whether the procedure is appropriate.
The Operation: Techniques for Breast Reduction Surgery
There are various surgical techniques for breast reduction, which are selected depending on the initial findings, the desired outcome and the surgeon’s experience. What all these techniques have in common is that skin, glandular and fatty tissue are removed and the nipple-areola complex is repositioned higher up. Common methods include:
- T-incision technique (Anker or Strömbeck method): This results in a scar around the areola, a vertical scar running from the nipple to the inframammary fold, and a horizontal scar in the inframammary fold. It allows for the greatest reduction and reshaping.
- I-incision technique (vertical incision, Lejour method): Leaves a scar around the areola and a vertical scar. The horizontal scar in the inframammary fold is shorter or absent. Suitable for moderate breast reduction.
- O-incision technique (periareolar incision, Benelli method): Just a scar around the areola. This method is primarily suitable for minor breast reduction procedures combined with a lift.
The nipple-areola complex is usually reconstructed using a pedicled technique, which preserves the blood supply and nerve innervation. In cases of extremely large breasts, a free nipple graft may be necessary.
The procedure for breast reduction surgery
A breast reduction is a complex procedure that requires careful planning:
- Pre-operative phase A detailed consultation, examination, medical history, information on risks, selection of the surgical technique and, where necessary, preliminary tests (e.g. mammography). Discontinuation of blood-thinning medication and abstinence from nicotine.
- Anaesthesia The procedure is usually carried out in General anaesthesia carried out.
- Operation Duration: approx. 2–4 hours. Marking of the incision lines. Removal of excess skin, glandular and fatty tissue in accordance with the chosen technique. Reshaping of the breast. Repositioning of the nipple-areola complex to its new position. Careful closure of the wound in several layers. If necessary, insertion of drains to remove wound fluid.
- Post-operative phase (immediate) Application of a special dressing and a compression bra. Monitoring in the recovery room.
The stay in hospital usually lasts a few days.
Scarring following breast reduction surgery
Scarring is an unavoidable part of breast reduction surgery. The exact course and length of the scars depend on the surgical technique chosen and the amount of tissue to be removed.
- Typical scar patterns: Around the areola, vertically and horizontally in the inframammary fold — depending on the surgical technique.
- Scar maturation: Initially, the scars are often red and raised. Over the course of several months to a year, they fade and become flatter and less noticeable. The final appearance of the scars varies from person to person and depends on genetic predisposition and proper scar care.
- Scar care: Once the wounds have healed, specialised care using silicone gels or plasters can have a positive effect on scar formation. It is important to apply sun protection to the scars consistently for at least 6–12 months.
Aftercare following a breast reduction: What do you need to bear in mind?
Careful aftercare is crucial for a recovery with few complications and an optimal outcome:
- Compression bra: A special medical support bra must be worn consistently, day and night, for around 4–6 weeks.
- Taking care of your body: During the first few weeks, avoid heavy lifting, working overhead and strenuous activities.
- Wound care: Follow your doctor’s instructions. Drains are usually removed after a few days. Stitches will be removed or will dissolve on their own.
- Sleep: During the first few weeks, it is recommended that you sleep on your back.
- Review appointments: It is important to have regular check-ups with your doctor.
Recovery time following breast reduction surgery
The recovery time following a breast reduction varies from person to person, but there are some general guidelines:
- Ability to work: Depending on the physical demands of the job, full recovery usually takes 2–4 weeks.
- Sport: Light sporting activities can often be resumed after 4–6 weeks. Sports that put strain on the chest should be avoided for a longer period.
- Social skills: After about 1–2 weeks, once the worst of the swelling and bruising has subsided.
- Final result: The shape of the breasts develops over several months. The final aesthetic result is often only fully visible after 6–12 months, once all the swelling has subsided and the scars have matured.
Coverage of the costs of breast reduction surgery by health insurance
The cost of a breast reduction in Germany typically ranges from approximately 6,000 and 9,000 euros.
- Medical indication: Where there is a clear medical necessity (e.g. proven significant physical symptoms such as chronic pain, postural problems or recurrent skin inflammation that cannot be adequately treated by conservative measures), an application may be made for Coverage by statutory or private health insurance be provided. This usually requires a detailed medical report from the attending doctor and, where necessary, an assessment by the Medical Service of the Health Insurance Fund (MDK).
- Cosmetic indication: In the case of procedures carried out purely for aesthetic reasons, the costs are not covered by health insurance schemes.
Important: Irrespective of whether the costs of the initial procedure are covered, taking out a Consequential Costs Insurance Highly recommended. This can cover the costs of medically necessary treatment that may arise as a result of complications following the procedure.
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