Surgical procedure in which breast tissue, fat, and excess skin are reduced to relieve functional complaints from overly large breasts, including back, neck, and shoulder pain, postural problems, bra-strap grooves, and skin irritation.
Indication
- Chronic back, neck, and shoulder pain due to excessive breast volume (macromastia)
- Permanent grooves on the shoulders or nerve compression from bra straps (shoulder-groove syndrome)
- Chronic irritation and fungal infection in the inframammary fold (intertrigo)
- Postural disturbance, headache, and reduced respiratory comfort
- Physical limitations that restrict exercise and daily activities
- Functional impact of marked breast asymmetry (anisomastia)
Preparation
- No food or drink for 8 hours before the procedure
- Pre-operative screening with mammography and/or breast ultrasound
- Blood-thinning medications adjusted with the physician's approval
- Smoking should be stopped at least 4 weeks beforehand (critical for blood supply to the nipple/areola)
- Blood tests, ECG, and an anesthesia consultation
- Reaching a stable weight is important for healing and durability of results
How it's performed
- Performed under general anesthesia
- Incision pattern is marked in advance (lollipop or inverted-T patterns are most common)
- Excess breast tissue, fat, and skin are removed
- The nipple and areola are repositioned on a vascularized pedicle that preserves blood supply
- Remaining tissues are reshaped, and drains may be placed
- Skin is closed in layers and a supportive bra is applied
Post-procedure
- Hospital stay typically 1-2 days
- A sports bra is worn day and night for 4-6 weeks
- Drains are removed within 2-5 days
- Heavy lifting and upper-chest exercises are restricted for 6 weeks
- Nipple sensation and breastfeeding capacity are evaluated as part of long-term follow-up
Risks
- Delayed wound healing or wound separation, especially at incision junctions
- Partial or complete tissue loss of the nipple/areola (rare but important risk)
- Reduced or lost nipple sensation
- Reduced breastfeeding function — some patients may not be able to breastfeed
- Scar widening, asymmetry, and possible need for revision surgery
FAQ
Will my back and neck pain go away after surgery?
Functional improvement is reported in patients whose pain is related to excessive breast volume. If another spinal problem underlies the pain, additional evaluation is required.
Will I be able to breastfeed afterward?
The surgical technique is planned to preserve blood supply to the nipple; nevertheless, breastfeeding cannot always be guaranteed because milk ducts may be affected. If pregnancy is planned, this should be discussed with the physician in advance.
How visible will the scars be?
Incision scars are permanent and mature in color and texture over 12-18 months. Smoking, sun exposure, and tension can worsen scar appearance; regular care is recommended.
Is the surgery covered by insurance or social security?
When a functional indication (chronic pain, postural disturbance, intertrigo, etc.) is documented, partial reimbursement may apply under certain conditions. Current coverage should be confirmed with your insurance provider.
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