Breast reduction

In my experience, women who need a breast reduction all have quite similar complaints. These are usually neck pain, back pain, skin conditions below the inframammary fold (e.g. fungal infections, dermatitis, etc.) and bra strap impaction in the shoulder area.

Other common reasons include difficulty finding clothes that fit, a restriction on exercise and social inhibitions (often in younger and older patients).

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Since I have been performing these operations as a specialist for over 10 years, the way in which these operations are performed has been optimized and perfected.

Operations are not subject to any standard and vary greatly from patient to patient in order to achieve an individual and long-lasting optimal result.

Dr. Thomas Scholz

Plastic surgeon

A breast reduction will reduce the volume and weight of your breasts and often lead to relief or complete, successful treatment of the above-mentioned complaints.

From a functional and aesthetic point of view, these operations are extremely satisfying and my patients often report that they wish they had had this operation years ago.

Although a symptomatic improvement of these patients with pathologically enlarged breasts can be achieved, there is a second extremely important goal – to shape a more attractive and well-modeled breast.

There are a large number of different techniques for performing a breast reduction (reduction mammaplasty). It is important to understand that all of these surgical methods leave scars on the breast, although these usually heal well and I follow many prophylactic and therapeutic treatment approaches to keep scarring to an optimum.

However, the goals have always remained the same over the years: an aesthetic and natural-looking breast, a long-term result that maintains the achieved shape and position throughout life and, ultimately, the reduction of scars as far as possible.

A very positive aspect of breast reduction is that abnormal tissue and unclear findings can be adequately treated surgically during the operation.

For example, there are many patients who come to my private practice with a specific diagnosis and who, in addition to wanting a breast reduction, also wish to have unclear tissue removed at the same time. Such a combined surgical procedure naturally requires cooperation with your gynecologist as well as detailed diagnostic examinations prior to the operation.

Reasons for this surgery

The most common reasons for having this operation are large breasts, asymmetrical breasts or breasts that cause the above-mentioned complaints due to their size and severity. The following list provides an overview.

Treatment of neck and back pain
Skin diseases below the breasts
Cutting bra straps
Inability to exercise to the desired extent
Psychosocial stress
Increasing self-confidence
Underlining your own femininity
Look perfect at work and at home
Finally being able to wear the clothes, underwear and swimwear you’ve always wanted to wear
Changes in the size, shape, position and/or firmness of the breasts
The desire for symmetrical breasts
Desire for a more natural overall appearance

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Breast reduction in Munich

A detailed initial consultation takes place in Munich in our private practice. Get to know the top doctor for plastic surgery Dr. Scholz. Fri. Dr. Scholz’s core concept includes long and detailed consultations as well as follow-up examinations after a long time in order to achieve very good results.

As soon as an operation is planned, you will get to know your anesthetist, who will also look after you during the operation. A personal and family history of breast cancer and other breast diseases is an important aspect in the run-up to these operations.

The results of any examinations such as mammography, ultrasound, MRI or BRCA tests should also be discussed in detail with the patient before the operation and possibly discussed with the treating gynecologist, etc.

This procedure, also known as “reduction mammaplasty”, is a surgical procedure that must be performed by a qualified, experienced and registered plastic surgeon. The procedure usually takes between 3 – 4 hours and is performed under general anesthesia.

An overnight stay in the clinic is only necessary very rarely and in exceptional cases. This is the only way to monitor the healing process accordingly. However, in most cases (and in contrast to a breast augmentation or breast lift) it is necessary to insert a drain into each breast.

The operation combines the incision or resection of skin and the removal of mammary gland tissue. As mentioned above, there are many and varied techniques in the field of skin incisions, breast gland resections and soft tissue displacements within the breast.

Before the operation, some measurements must be drawn on the breast and chest. During the operation, the patient is also placed in a beach chair position (on the operating table and under general anesthesia) in order to be able to analyze and shape the aesthetic shape of the breast in an upright position.

After so-called wound drains are inserted in the majority of cases, the incisions are closed with self-dissolving surgical suture material.

Breast reduction methods

Breast reduction is performed using a variety of methods. Both the incisions and the way in which the breast tissue is reduced and the nipple repositioned are very different for each woman, as the starting point and the characteristics of the breast to be operated on can vary greatly from woman to woman in the run-up to this operation.

The surgical methods that give the breast a completely new shape (reshaping) are also very different. Analytical skills and creativity are required here, which must be transferred safely and effectively to breast reduction.

Where are the cuts?

In principle, there are many ways to make incisions during breast reduction.

In order to achieve a perfect long-term result, I have specialized in the following incisions and the associated breast reduction techniques.

Various other techniques, which I generally do not pursue, have the major disadvantage that they leave very flat and not optimally shaped results 6 – 12 months after the operation.

Vertical incision: This incision combines incisions around the nipple and vertically below the nipple
Wise pattern: This incision extends the vertical incision by a vertical component in the breast crease

Both incisions (surgical approaches) are basically sensible decisions from a plastic surgery perspective. However, each incision has its own advantages and disadvantages, all of which must be discussed with you in detail during the surgical planning stage. Apart from the incision, there are various techniques for reducing the size of the mammary gland tissue and shaping the breast as an overall aesthetic and functional unit. These techniques are not specifically listed here. These details are part of our very detailed and extensive consultation before the operation.

On the day of the operation, you will be operated on in a centrally located private clinic in Munich. This is followed by immediate intensive monitoring. If desired, an overnight stay at the beauty clinic can be arranged. It is also possible that we may advise you to stay overnight in your personal case for medical reasons.

Discharge takes place on the day of the operation or on the first postoperative day. Follow-up examinations take place in our clinic at regular intervals after the operation. Wound healing is a process that takes at least 1 to 1 1/2 years.

For this reason, long-term follow-up checks are a matter of course for our patients, medically sensible, an absolute service in our eyes and a great pleasure for us to analyze the long-term results together with you. We want to make sure that you still love your esthetic result decades later as much as you did on the first day.

Costs

Prices and costs can vary greatly and you should be critical of blanket offers without a serious medical history. As I wrote above, there is no standard method for the specialist but a combination of refined techniques to create a highly individualized aesthetic breast for you.

The extent to which costs are covered by health insurance companies such as the AOK is based on a medical indication or serious problems beyond aesthetic concerns.

Breast reduction in installments

If cash is tight at the moment, the desire for perfect breasts can be fulfilled with the help of financing. We work with several German credit companies that offer financing for breast augmentation in installments. Breast surgery in installments is available from as little as EUR 99 per month. Please speak to our team about this topic during your initial consultation if you are interested.

Healing

State-of-the-art surgical techniques lead to a quick and easy recovery. To support the healing process, you must wear a special bra – affectionately known as a “granny bra” – 24 hours a day for 6 weeks.

As every patient is different, recovery times vary, but we generally expect a full recovery and return to all normal activities around six to eight weeks after surgery. Most people return to work one to two weeks after the procedure.

The surgical wound must not get wet in the first few days, so the full bath or shower should be replaced by a sponge bath. Carrying weights and one-sided strain should be strictly avoided. Sunbathing should be avoided until the scar has completely healed. This can last a whole year or more. Continuous management and care of the scars is also beneficial afterwards.

Sport after breast reduction

As the mammary gland tissue still has to firm up in position, you should avoid exercise – apart from walks in the fresh air – in the first month. Light exercises can be started after 2 to 4 weeks.

It is important to take it easy on the chest and upper body area and to avoid sweating until the incisions have completely healed. Abrupt movements lead to traction on the implants and sweat has a negative effect on wound healing. In addition, heavy lifting (>5kg) should be avoided for a minimum of 6-8 weeks.

However, you can sleep on your back or on your side immediately after the operation. If possible, it is advisable to sleep with your upper body raised (30-45°) for the first 1-2 weeks. A full body shower is possible 3-4 days after the operation. You can also lift your arms above your shoulders immediately after the operation, which enables you to wash your hair, apply make-up, etc. independently.

Sports such as tennis, jogging or horse riding should only be resumed after 6 weeks to 3 months (with a special bra). As rehabilitation can vary greatly from person to person, we have prepared regular follow-up visits for you. When sports and other activities can be resumed should always be discussed individually with the surgeon during this time.

Pain after breast reduction

The sensation of pain is a completely individual variable. While sensitive women complain of pain, less sensitive women can easily cope with the pain. However, as this is a surgical procedure, post-operative pain and soreness must be controlled with medication. Nowadays, there are a variety of very intelligent pain medications that allow a quick return to normal daily activities.

Will I have scars?

As the surgical incisions are made in very discreet places around the areola and in the natural folds of the breasts, scarring is minimal and usually almost invisible.

The scars fade over time until only wafer-thin lines are visible, which are barely noticeable. People who are prone to excessive scarring (keloids) should discuss this with their surgeon.

There are treatment options that can be used prophylactically before an operation. In addition, these patients require special attention during the postoperative course to ensure appropriate scar care and scar treatment, which can prevent the formation of wide scars or excessive scarring.

Breastfeeding after breast reduction

Yes, absolutely. It is advisable to tell the plastic surgeon if you plan to have children and are breastfeeding. This is an important topic that should be discussed in detail.

Is a breast lift also useful?

In order to achieve an optimal result, it is determined during the consultation and examination whether a pure breast reduction can be performed or whether a breast reduction with a breast lift should also be recommended during the operation.

It must be clearly stated here that a breast reduction as such also includes breast lift methods. A breast reduction without a lift can never lead to an aesthetic result.

It is therefore important to know that every breast reduction, just like a breast lift, also leads to a breast lift. The main difference is that volume is removed from the breast during a breast reduction.

Age for a breast reduction

Breast reduction is not recommended for women who are not yet fully developed, as the body and breast shape can still change. At our clinic, we only operate on patients who are over 18 years old and in good general health. Because your cosmetic surgeon has access to your medical records, they will be able to tell you whether or not the procedure is suitable for you. All patients, regardless of age, undergo a health assessment.

Risks and side effects

In addition to the risk of anesthesia, which exists with every operation, other short-term risks include secondary bleeding or infections. The occurrence is extremely rare, but to be on the safe side, regular follow-up checks should be carried out by the plastic surgeon.

As these operations generate a fairly large wound area in both breasts, it is possible that fluid accumulations (seroma) may occur after the operation despite wound drainage. If the body cannot compensate for this fluid, it may be necessary to remove this fluid during the follow-up check via a puncture in the area of the scars (and therefore without pain).

Other side effects (extremely rare!) include circulatory disorders, temporary or permanent numbness, scarring, wound separation, injury to adjacent structures, loss of the ability to breastfeed, and others.

Conclusion

For me, the first priority is perfect execution and that we find exactly how you imagine your breast through detailed discussions. There is no standard method and as a specialist you have to choose the right treatment for each patient.

Simply “taking away” volume is not effective because after a reduction you should have a beautifully shaped breast that looks aesthetic and natural.

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