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Surgeon's Notes

The technique which will be used in the surgery varies
according to the size of the breasts. The technique
of the surgery can affect the short and long-term result
of the operations.

Each techniques have their own advantages and
disadvantages, the decision will be taken according
to the surgeon’s preference or by a mutual agreement
with the patient and the surgeon. However, the following
criterions must be taken into the consideration before
the determination of the operation technique.

During the operation it is in important that the placement
of the breast areola and breast nipple are moved to the
new position of the upper breast area. This must not
defect the blood circulation support or revitalization of the
structure and the technique used will still allow sensitivity
to the nipple.

The suckling functions must be kept in accordance to
the patients needs.

Any breast tissue will be removed and the new aesthetic
breast form will then be created.

One of the other techniques is the Lejour technique, this
is a safer technique in breast reduction and has better
aesthetic results. As other techniques, this too has
disadvantages like scar revision under the breast curve
and delayed wound healing. To have the planned breast
form realization is a very long process and can also
loose sensitivity in the nipple, in excessively large breasts.
Besides that, when this technique has been applied,
a vertical scar can be lengthened during the years and
can remain long term.

The preferred technique is to use the central pedicular
technique. Our aim is to form the breast tissue and breast
skin separately, by closing the skin as a cover without
tension and minimizing any scars. If the breast is not too
saggy, it will be finished with a vertical scar. If the distance
between breast nipple and the collar bone is too long,
then it is necessary to make a “T” scar, which can be
covered under a triangle formed bikini.

With this preferred technique you will achieve a longer
lasting and well shaped, raised breast figure. This is
produced without harming the nipples sensitivity and
suckling features. Using this technique the operation
will be successfully and long termed.

The breast nipple will be moved to its normal position
on the upper part of the breast, and if the areola is too
large, it will be reduced. If the breasts are not asymmetrical
(if one of the breasts is larger than the other, or they are
not at the same level) this will be corrected as much as

During the breast reduction surgery the suckling feature
is an important function of the breast tissue, that is
connected to the milk channels and breast nipple. The
nipples must be sensitive, but during surgery it is not
possible to harm the suckling features or physiological
characteristics of the breast.

When the baby attaches to the nipples, it creates
contractions on the milk glands, playing the hormonal
part of the natural cycle, and the milk will be secreted.
For having this suction reflex, the nipples must be
sensitive. If the sensitivity of the nipple lessens, it may
defects this cycle and negatively affects the milk secretion.

In the case where the breast tissue has been separated
from the nipple and an independent patch has been
applied, the sucking will not be possible. In almost all of
breast reduction methods today, a part of the breast nipple
will be kept in connection with some of the breast tissue,
and the sucking function will be protected. In this case the
amount of the sensitivity could be lessened. The element
which determines the milk amount, is the amount of breast
tissue that has been left in place and therefore the tissue
with nipple and milk channels should not be destroyed.

During the controlled studies in the recent years, it has
been determined that the insensitivity of the nipple was
higher during the first month after the operation, but will
increase during the following months and heal. It should
be advised that overly large breasts have lower nipple

Preparing for Surgery

If you are thinking of undergoing breast reduction surgery,
it is advised that you consult with a surgeon for an
examination and to discuss the best technique to be used,
depending on your breast size.

It is very important that is you are a smoker, or if you
have any health issues, such as vein or blood disease
or if you are diabetic, that you consult with your doctor.
If you are a smoker, you should stop smoking one week
before the surgery, and an additional one week after the
surgery. If you have diabetes, your surgeon will decide
whether to perform the operation or not. You should not
drink any alcoholic beverages during the last 48 hours
before the surgery, this is because the alcohol will
decrease your body resistance and will influence the

You must not eat anything during the last eight hours
and avoid taking aspirin or similar blood diluting

The drawing and plan which will be made right before
surgery will be done in a standing position, and drawn
on the patient in pencil and measuring tape. This is vital
for any surgical results. When the patient is in the standing
position, the new breast nipple position will be drawn and
will determine the amount of the tissue that is to be

All measurement and drawing will be made in accordance
with the patient’s desired breast size, form, any
irregularities, defects, size or breasts and nipples and
tissue. It is important that drawing is made when the patient
stands, because when the patient lays down on the
operation table, the breasts form perception can be

The Operation process

The breast reduction operation will be performed in the
hospital and under general anaesthesia. Depending on
the size of the breasts and surgical technique, the
operation will take 3 - 5 hours.

After the surgery has taken place, any removed tissues
will be sent for pathological examination. During this
examination it will detected any tumours or similar
existence, during the operation any removed tissue will
decrease any breast cancer risks.

After the surgery you will notice better formed breasts,
with more aesthetic proportions. A smaller, rounded
shaped and healthy breast will help the patient to accept
any scars and any insecurities about risks about
insensitivity on the breast nipple and decreased
sucking features.

Healing period after the surgery

Approximately four hours after surgery you will be
allowed to eat and after eating you may stand up.
The accommodation period in the hospital is 1 - 2 days.
During the first couple of days you will have drains for
collecting the blood and fluids from the operation area.
These drains will be removed in 3 - 5 days according
to the fluid amount. It is recommended to make limited
arm movements during the first few days. During the first
week you will have bandages around your breasts, at the
end of the week these bandages will be removed and
only the thin bandages will be used to cover the stitches.
You can take a bath after the removal of drains and

It is normal to have swelling around the operation area
and sleeping in a half-sitting position will be good for
healing and swelling, which in turn lessens any pains.
After the breast reduction surgery, a sports bra should
be used, to support the reforming breasts.

During healing you may experience, swelling and irritation
around the stitched area. After 1 - 2 months the scars will
be less visible and after 6 months to a year the scars will
be almost invisible. The possible bruises are temporary
and they will be healed in a short period according to
your skin type.

After surgery you will experience some pain, but these
can be controlled using painkillers. Four days after the
operation you can go back to normal daily life and return
to work. (Heavy activities, such as lifting and sports must
be avoided for 2 months).

The Risks of Breast Reduction Surgery

Each and every surgical procedure is bearing a certain
amount of risks. The breast reduction surgery has also
its own risks and complications and it is good to know
these risks.


Even that the drains will be placed to avoid the blood
accumulation on the operation area, some blood
accumulations called hematoma can be occurred. This
complication shows itself with bruising, swelling and pains
to the breasts.

Infection/wound healing

The risk of infection is low, the source is generally the
bacteria in the milk channels. Normally this form or bacteria
is not infectious, but can spread into the tissue where the
incision is made, during surgery. Infection rick can also be
increased with age, diabetes or anaemia.

In cases of healing some dressings may require additional
surgery, this is to remove unhealed tissue. In these cases
smokers bear more of a risk with healing complications.


Lots of women have natural breast asymmetries. The
differences between the breast and breast nipple forms,
sizes or symmetrical differences may be noticed after the
operation and will be more symmetrical then before after

Scars on skin

All surgical incisions leave scars, the size of the scar
cannot be estimated. Abnormal scars can also be
developed on the skin or in deeper tissue, but in most
cases can be corrected with additional surgical operations
or treatments.

Your total stay in Istanbul will be approx 5 - 6 days.


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