Breast reduction
A breast reduction ( Latin : mammary reduction plastic ) is an operation to reduce the size of large breasts .
indication
The indication , i.e. H. the occasion for such an operation can have cosmetic or medical reasons. In women with very large breasts, chronic back pain and tension, incisive bra straps and skin infections in the breast crease ( intertrigo ) can occur. They are also severely restricted in terms of physical activity. In addition to these stressful physical complaints, especially in younger women, there is often a psychological burden. A relative indication is the desire for a cosmetic improvement.
According to various specialists, the limit between a purely cosmetic occasion and a medical need for the operation is a weight of at least 500 g, which would have to be removed from each side of the breast during the operation.
Men can also have breast enlargement. This feminization of the breast in men is more common than is generally assumed and is psychologically very stressful for the patients concerned. As a rule, liposuction or breast reduction with an incision around the areola is used in men.
surgery
The operation is performed under anesthesia .
There are numerous surgical techniques, the application of which depends, among other things, on the size and texture of the breast. The incision runs along the edge of the areola and from there vertically down into the breast fold. With medium-sized and large breasts, another cut across the fold is required. The glandular tissue and fatty tissue is not only removed from the lower breast area. In addition, the excess skin is removed, resulting in a tightening effect. With all incisions, the nipple and areola must be moved to a new location. To do this, it needs a stem through which it receives the blood supply. This supply can take place via parts of the glandular tissue or via parts of the skin. In the case of extremely large breasts, this stem would be too long to ensure sufficient blood flow, in these cases the nipple must be transplanted freely.
Risk-benefit assessment
Breast reduction is a surgical procedure that must be carefully planned in order to improve the patient's quality of life. Particularly before cosmetic operations , for which there is usually no mandatory OP indication, extensive and extensive OP information is required.
The greater the weight that is removed in the operation, the greater the health benefit for the patient. Target sizes B-Cup or C-Cup can usually be achieved regardless of the initial size . As a rule, the patients are very grateful, as they experience a clear relief of their symptoms. The most common complication is wound healing disorders, especially in very large breasts and in patients with corresponding risk factors (e.g. diabetes ). They usually occur in the central area of the breast crease and can often be healed without surgery. Patients must also be aware of the possible, but very rare, loss of the nipple caused by the pedunculation described above. This also causes sensory disturbances in the nipple and a restriction in breastfeeding ability. The scars are visible after the operation and occasionally widen from the pull of the chest.
reimbursement
If a breast reduction is medically indicated, i.e. required, the health insurance company usually has to cover the costs of the procedure. However, many health insurances have recently refused and refer to other therapeutic options such as physiotherapy, weight reduction, psychotherapy and the like. Since these measures cannot resolve the cause of the symptoms in some cases, the situation is usually frustrating for those affected.
A medical indication must be proven by appropriate specialist medical reports. The attending physician must confirm that, in his opinion, the operation is inevitable to prevent / cure / relieve an illness. This can be a treating plastic surgeon, gynecologist or preferably a treating orthopedic surgeon who can issue a certificate stating that the oversized breast leads to painful complaints and complications in the cervical and thoracic spine and the complaints over a period of about two years not by physical therapy / physiotherapy or equivalent treatments could be improved.
Web links
Individual evidence
- ↑ Liposuction for Gynecomastia Magazine Health and Aesthetics
- ↑ Reimbursement of costs by health insurance companies
