Breast Reduction Methods

An Overview

There are various surgical techniques for performing a reduction mammoplasty. Which method is best suited for your breast reduction in Berlin depends on the individual nature of the breast.

The Hall-Findlay method (circular cut)

Developed in the late 1990s by the Canadian surgeon Elisabeth Hall-Findlay, this method is suitable for almost all breast sizes and shapes. The skin incision is made around the areola at the transition between the pigmented skin of the areola and the skin (epidermis). The areola is circularly cut around the areola with a cutting die. The advantage of this method is that large areolas can also be reduced in size. In many cases, it is even possible to perform an inverted nipple correction, whereby the inwardly directed nipple is pulled into the desired position and fixed in the mammary gland with sutures. The actual breast reduction is performed by removing a wedge from the lower pole of the breast as soon as the surrounding skin has been removed, similar to a piece of cake. The final result here can be varied depending on the size of the removed breast piece. In addition, after removal of the excess volume, the mammary gland is sutured so that an additional tightening effect occurs. In this respect, this type of breast reduction can not only be used for breast reduction but also automatically for breast lifting. The advantage of this procedure is undoubtedly that the operation can be performed without the need for large incisions. The scar around the areola fades quickly. Due to the location of the surgical access between the pigmented skin of the areola and the less pigmented skin around it, it is hardly visible after healing. If, however, a breast reduction on a large scale is present, other procedures are more suitable for reducing the volume of the breast.

Breast Reduction According to Lejour (vertical cut)

This procedure is also largely scar-saving surgery. As with all mammary reduction surgery techniques, the nipple is incised with the areola. Afterwards it is moved several centimetres upwards as necessary. The parts underneath are removed after they have been detached from the skin. Due to an almost spindle-shaped course of the incision downwards at the mammary gland, a vertical incision results in a larger T-cut being avoided. Finally, the mammary gland can be repositioned and fixed to the breast wall with a strong suture. This also allows a breast reduction and breast lift to be performed simultaneously. Small excess skin areas occasionally remain in the area of the lower scar pole immediately after the operation, but these disappear in the medium term due to natural shrinking processes. Similar to the Hall-Findlay method, this technique is not suitable if there is a large reduction volume. Very large breasts must therefore be treated in our Berlin clinic with a more complex T-cut.

Breast Reduction with the T-cut

The T-incision is a surgical method of breast reduction in which the plastic surgeon can remove the largest volume from the mammary gland. In this method, the incision is made as if it were an inverted T with a ridge along the lower pole of the areola and the underbust crease. The excess mammary gland parts are then removed in the gland’s lower poles area. As with all breast reduction procedures, the areola is repositioned with the nipple facing the head after the excess skin is removed. This ensures the blood supply to the nipple with the areola. Only in rare cases is it necessary to place the nipple on the breast as a so-called free transplant. In case of very large breasts that have caused the nipple to fall down sharply, for example. Here the areola is completely removed and then reimplanted and repositioned. Depending on the existing findings and the patient’s wishes, a further tightening of the mammary gland in the form of a so-called ‘inner bra’ can be carried out. This inner bra consists of individual seams on the breast wall that support the gland. This allows particularly large breast to be reduced in size and held in place despite further aging at our facility in Dahlem, Berlin.

Male Breast Reduction: Gynecomastia

The term gynecomastia comes from the Greek and means something like ‘breast that appears feminine’, colloquially known as ‘male’s breasts’. In principle, gynecomastia surgery is possible under general anaesthesia. However, a thorough investigation of the causes is carried out before every intervention: if no triggering cause can be determined or if a drug therapy is not effective, only then is a breast reduction for men with this condition recommended. The result is permanent due to the complete removal of the gland. You can learn more here about gynecomastia.

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Procedure of a Breast Reduction

Consultation

As with every previous surgical procedure, a detailed consultation is held at the Sinis Clinic Berlin before the breast reduction, in which the possibilities and risks are explained and the exact surgical procedure for the breast reduction is described. The surgical technique and treatment methods are also determined here.

Before the Operation: What should be considered?

No blood-thinning painkillers should be taken for 14 days before the breast reduction. The patient should also avoid hormone-containing preparations such as the ‘contraceptive pill’. The consumption of alcohol and nicotine should be reduced to a minimum. In some cases, it is even advisable to have a mammography before breast reduction in order to rule out the possibility of breast cancer.

The Breast Reduction Procedure

Breast reduction in Berlin is a procedure that takes several hours and is performed on an inpatient basis under general anaesthesia. Depending on the technique, the operation takes about two to four hours. In general, the doctor removes excess glandular, fatty and mostly skin tissue from the lower part of the breasts during breast reduction. It then reshapes the breast from the remaining upper parts of the glandular body.

Crisalix 3D simulation

Want to see the effects of a breast reduction before the operation? This is no longer a problem with the 3D simulation software developed in 2009. With the help of two-dimensional images of the breast region, the computer can simulate which cup size best fits the rest of your body. Further information is available here.

Crisalix simulation breast reduction

Risks

Can there be complications with breast reduction?

A surgical intervention always carries the small but existing risk of complications, despite extensive preliminary examinations and the greatest care. Patients will be informed about such points in the preceding discussion in our Berlin clinic. In some patients a tumour may be discovered during the operation if no mammography is carried out beforehand. This can turn out to be malicious. Infections, blood clots or the accumulation of wound secretion or lymph fluid also occur in very rare cases in breast reductions. In vary rare cases, a so-called bottoming-out can occur. This causes a large part of the operated tissue to sag downwards and a change in direction of the mammilla-areola complex (e.g. upwards). However, such complications are not the rule.

Breastfeeding and Breast Reduction: Is that possible?

It cannot be guaranteed with certainty that you can still breastfeed after a breast reduction. Therefore, we recommend that women who really want to breastfeed should wait with a breast reduction until family planning is complete.

Do you have any questions or would you like to make an appointment? Give us a call!

030 – 678 28 181

Experience and Results

As a rule, our patients are very satisfied with the before and after effect after breast reduction surgery. You can read a detailed field report about a breast reduction with Prof. Dr. Sinis in this patient’s blog article. Here the patient describes how the procedure has significantly increased her well-being and how the breast reduction has helped her to achieve a better quality of life.

How Severe is the Scarring After Breast Reduction?

Depending on which surgical technique was used, the scarring also varies. The Hall-Findlay method, for example, results in significantly less scarring than the T-technique. Here the scar is more like an inverted T and therefore a little larger, with the scar also running along the underbust crease. The individual wound healing process of each patient also influences scar formation. Adequate scar care after breast reduction can have a positive influence on the regression of the scar.

Costs

What are the costs for a breast reduction in Berlin?

We respond to our patients individually in every intervention. In order to ensure the success of the treatment, we have to spend sufficient time and care in the consultation. The costs for a breast reduction, including careful follow-up treatment, can vary accordingly. The costs of the initial consultation always depend on the type and extent of the treatment. In principle, the scale of fees for doctors applies to the consultation hours. Thereafter, patients pay 50 euros for the initial consultation with anamnesis, collection of previous findings, physical examination and preparation of a therapy and cost plan. This fee is payable once and will not be credited towards further treatment. However, if the issue it is regarded as detrimental to the patient’s health, for example, if the female breast is so large that it affects the entire statics of the spine and joints, the costs can be covered by the health insurance company. However, not all breast reductions fall within the scope of the health insurance benefits. This varies from case to case. Further information about the costs and cost absorption of a breast reduction.

THE BREAST REDUCTION COSTS