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Reduction

Excessive breast volume and breast sagging is treated by this operation.

For most breast reductions both breast tissue and skin need to be removed from the lower part of the breast. This produces a scar around the areola, a vertical scar between the areola and the fold under the breast as well as a horizontal scar in the fold so-called inverted T or anchor scar). Sometimes the horizontal scar can be kept small or limited to the lateral part only (L-scar).

As an important part of the tissues is removed, blood supply and innervation of the remaining breast tissue, skin and areola are also affected. Breast and nipple sensation is generally altered by open surgery, either leading to oversensitivity, decrease or absence of sensation. Generally but not always there is some recovery, occasionally it is complete. Wound healing is delayed because of the decrease in blood supply. A possible complication of the more extensive operations is loss of tissue by lack of blood supply. In that case healing may take several months. The larger the amount of tissue to be removed by open surgery, the more important the risks of sensation disturbance or poor wound healing.

Smokers need to stop smoking completely at least three months before the operation. Otherwise the risk of complications would be too important.

Patients are admitted to the hospital for three to four days. Sutures are generally buried, so there are no stitches to remove. As for other important operations general recovery takes a few weeks. Symptoms like fatigue generally take two to three months to disappear after open surgery.

Usually these operations improve body shape considerably and patients can dress much more the way they like. The scars of open surgery remain visible, however. It is not uncommon that a smaller touch-up operation is recommended after a year in case the patient is seeking the best possible outcome.

Even when taking the scars into consideration, this operation is usually very gratifying for patients complaining of large breasts (with neck, upper back or shoulder pain or hygiene problems in the creases). For patients seeking relief of these complaints, health insurance payment may be possible. The criteria for intervention by Belgian mutualities (public health insurers) are defined by law. A written request, addressed to the medical advisor, is made by the plastic surgeon in the office. It is based on the findings, including photography, and remitted to the patient.