Breast Reduction

Breast reduction at Brandeis Clinic surgically reduces breast volume and reshapes the breast mound for women whose breast size causes physical discomfort — chronic neck, shoulder or back pain, skin irritation, postural problems, or difficulty with physical activity. The procedure removes excess glandular tissue, fat and skin while simultaneously lifting and repositioning the nipple-areola complex. MUDr. Lucie Kalinová performs breast reduction under general anaesthesia, with the extent of the technique adapted to the degree of reduction required. Recovery involves a compression bra for 6 weeks and avoidance of strenuous activity for approximately 2 months, with final results visible once swelling resolves at 3–6 months.

Breast reduction (reduction mammoplasty) at Brandeis Clinic is primarily a functional procedure — the most consistent outcome is relief from the chronic musculoskeletal burden of large, heavy breasts — with aesthetic improvement as a secondary benefit rather than the primary indication. **Who is a candidate:** The primary candidates are women whose breast size causes measurable physical consequences: chronic neck and shoulder pain with associated muscle contracture, upper back pain attributed to the forward gravitational load, skin irritation and maceration in the inframammary fold, restricted range of motion (difficulty running, cycling, swimming), and postural adaptations — forward shoulder roll and compensatory lumbar hyperlordosis — that arise over time from carrying the weight. Aesthetic dissatisfaction alone is a valid indication, but patients seeking reduction primarily for appearance should understand that the scars from reduction mammoplasty are permanent and more extensive than those from a lift alone. **Surgical approach:** The procedure is performed under general anaesthesia. Three incision patterns are used depending on the volume to be removed and the degree of associated ptosis: - Short-scar (vertical) pattern for moderate reductions. - Inverted-T (Wise pattern) for larger reductions where more skin resection is needed in the lower pole. The NAC is elevated on a pedicle (most commonly inferior or superomedial) that preserves blood supply and nipple sensation. Excess glandular tissue and fat are removed, the remaining parenchyma is reshaped and supported, and the skin envelope is closed in layers. For cases where the reduction volume is primarily fatty (older patients with predominantly lipomatous breasts), liposuction-assisted reduction may be appropriate — reducing scarring at the cost of less precise skin excision. The surgeon discusses the most appropriate technique at consultation. **Reconstruction context:** Breast reconstruction after mastectomy is also offered, from 40,000 Kč, as a distinct procedure. **Recovery:** Hospitalisation follows the same 1–2 day protocol as other breast surgeries at the clinic, with nursing care on LINET beds. A compression bra is worn for 6 weeks. Wound dressings are changed at clinic visits during weeks 1–3. Return to desk work at approximately 2 weeks; physical activity resumes at 2 months. Scar maturation takes 3–6 months — scars fade significantly over this period but do not disappear. **Preparation:** Pre-operative examination including blood panel and cardiovascular assessment. Smoking is strongly discouraged, as nicotine impairs wound healing and increases risk of wound dehiscence in the NAC pedicle. Medications that affect blood clotting (aspirin, NSAIDs, some supplements) are paused before surgery per the surgeon's instructions. **Results and what to expect:** The reduction in upper body load is typically noticed immediately after surgery resolves. Back and neck pain improvement is documented in a large proportion of patients in the published literature on reduction mammoplasty. Breast shape continues to evolve for 3–6 months as swelling resolves and the remaining tissue redistributes. The long-term result depends on weight stability and the natural ageing process.