Breast Reduction

A breast reduction, therefore, does not simply reduce volume. In a reduction mammaplasty, excess breast tissue, fat and skin are removed. At the same time, the remaining breast is reshaped and lifted, so that volume, position and proportions are changed together. At Clinic Selnau in Zürich, we plan breast reductions with the aim of combining physical relief with a balanced, natural-looking breast shape.

Our Approach

Every breast is different. Breast volume, breast width, skin quality, tissue distribution, the inframammary fold, and nipple position together determine the starting point. The reasons for a breast reduction are equally varied. Some women wish primarily for physical relief. For others, proportions relative to the rest of the body, or the shape of the breast, are more of a concern. Often, several of these aspects come together.

For this reason, planning does not begin with a particular cup size or a fixed amount of tissue to be removed. Instead, we consider which breast size fits your existing anatomy, what discomfort exists, and which shape can meaningfully be achieved with the remaining tissue. The aim is not the smallest possible breast. It is a size and shape that relates in a balanced way to the body, while providing the desired relief.

Volume, Weight & Symptoms

A large breast can have various physical effects. A breast reduction may be considered for symptoms or concerns including:

• Very large or heavy breast volume
• Neck or shoulder discomfort
• A feeling of strain in the upper back
• Pressure marks from bra straps
• Skin irritation or moisture beneath the breast
• Limitations during sport or physical activity
• Difficulty finding suitable clothing or bras
• Significantly descended breast tissue
• Lower-positioned or downward-pointing nipples
• Asymmetries between the two breasts
• A wish for more balanced body proportions

Not every physical symptom can be clearly attributed to breast weight. For this reason, existing symptoms are considered carefully during consultation, and realistic expectations regarding possible relief are discussed.

Planning & Analysis

A careful analysis forms the basis of every breast reduction. During consultation, we assess breast volume, breast width, skin quality, and the distribution of existing breast tissue. We consider the position of the inframammary fold, as well as the height and orientation of the nipple and areola. Differences between the two breasts are also taken into account.

At the same time, we discuss how significantly the breast should be reduced, and what proportions you would like. A desired cup size can serve as a point of reference, but cannot be precisely guaranteed surgically. Cup sizes also vary depending on the bra manufacturer and underbust measurement. What matters, therefore, is the relationship between remaining breast volume, the chest, and the body.

On this basis, the extent of tissue reduction, the new breast shape, and the necessary incision pattern are planned.

The Procedure

In a breast reduction, excess breast tissue, fat and skin are removed. The remaining breast tissue is reshaped and brought into a higher position. At the same time, the nipple and areola are repositioned according to the new breast shape. The nipple and areola typically remain connected to the breast via a tissue pedicle. This preserves the anatomical connection to blood supply and tissue.

Which technique is used depends on breast size, tissue distribution, excess skin, and the necessary extent of reduction. A breast reduction is therefore always also a reshaping procedure. Tissue is not simply removed. The remaining volume needs to be distributed and shaped so that a balanced breast contour results.

How Much Can the Breast Be Reduced?

The possible extent of a breast reduction depends on several factors. Starting volume, breast width, skin quality, nipple position, and the necessary blood supply to the remaining tissue set anatomical limits. For this reason, the desired breast size cannot be determined independently of existing anatomy.

Planning considers how much tissue can meaningfully be removed, and what breast shape can be achieved with the remaining volume. Personal preferences also play an important role. Some women want a significant reduction. Others wish only for a moderate reduction with a stronger focus on shape and lifting. The aim is not to remove as much breast tissue as possible. It is to bring volume, relief and shape into a balanced relationship.

Breast Reduction and Breast Lift

A breast reduction includes, in most cases, essential elements of a breast lift / mastopexy as well. The difference lies primarily in the treatment goal.

In a mastopexy, reshaping and lifting the existing breast tissue is the primary focus. Breast volume does not necessarily need to be significantly reduced. In a breast reduction, by contrast, breast volume is specifically removed. At the same time, the remaining tissue is lifted and reshaped. The surgical planning of both procedures therefore overlaps in many areas. Where mainly the shape and position of your breast concern you, while you are fundamentally satisfied with the existing volume, a breast lift / mastopexy may be sufficient. Where a relevant reduction in breast volume is also desired, a breast reduction is the corresponding treatment approach. Where, conversely, insufficient volume rather than excess is the concern, breast augmentation addresses the opposite surgical goal.

What Scars Result?

The incision pattern depends on the extent of the necessary reduction and lifting. In most breast reductions, a scar runs around the areola and vertically from the areola to the inframammary fold. With greater excess skin or more extensive reductions, an additional horizontal scar within the inframammary fold may be necessary. This results in the so-called anchor or inverted-T scar.

Which incision pattern is required can only be determined based on the individual starting point. The wish for scars to be as short as possible is understandable. The incision pattern, however, must not be chosen at the expense of the necessary shape correction. A larger breast with pronounced excess skin cannot always be adequately reduced and reshaped through a small incision. The scar is therefore not simply a consequence of the operation. It is part of the planning that allows for a controlled reshaping of the breast.

Nipple & Areola

In a breast reduction, the position of the nipple typically changes as well. It is lifted according to the new breast shape and positioned so that it fits harmoniously into the reduced breast. An enlarged areola, too, can be reduced as part of the procedure.

How far the nipple needs to be moved depends on the starting point and the extent of the reduction. Sensation and the ability to breastfeed are important aspects of surgical planning. Changes in sensation can occur temporarily or permanently after a breast reduction. The ability to breastfeed, too, can be influenced depending on surgical technique and the extent of the reduction. These points are discussed individually before surgery.

Asymmetries

No breast is perfectly symmetrical. Differences in volume, shape, nipple position, or the inframammary fold often exist even before surgery. In a breast reduction, different amounts of tissue can be removed on each side to reduce existing volume differences. The position of the nipple and areola, too, can be adjusted accordingly. Complete symmetry, however, cannot be guaranteed. The aim is therefore the most balanced shape possible, one that takes existing anatomical differences into account.

Relief & Proportion

A breast reduction combines two goals that are closely connected. It reduces weight and volume while changing the proportions of the body at the same time. How significant the physical relief feels is individual. Likewise, there is no single breast size that would be ideal for every body.

A smaller breast should therefore not be considered in isolation. Shoulder width, chest, waist, height and existing tissue quality together determine which proportions appear balanced. A successful breast reduction does not simply mean less volume. It brings breast size, shape and body back into a balanced relationship.

Healing & Results

Swelling, a feeling of tightness, and changes in breast shape are normal at first after a breast reduction. In the early healing phase, the breast can appear higher and firmer. As healing progresses, the tissue relaxes and the breast gradually develops its more definitive shape. Differences between the two sides, too, can appear more pronounced during the first few weeks and change as swelling subsides.

Scars develop over several months. At first, they can appear red or firm, before gradually becoming softer and less noticeable. Sensation in the nipple and breast skin, too, can be temporarily altered after surgery. The final result should therefore not be assessed immediately after the procedure.

Long-Term Changes

A breast reduction changes breast volume and shape long-term, but does not stop the natural ageing process. Skin and tissue continue to respond to gravity, weight fluctuations, pregnancies and ageing. Significant weight gain or loss, too, can change the remaining breast volume and shape.

How stable the result remains long-term therefore depends, among other things, on skin quality, remaining breast volume, and individual tissue characteristics. A breast reduction is therefore not planned only for its immediate result. The long-term load on the remaining tissue is also considered when choosing volume and shape.

Breast reduction changes more than volume. It can rebalance proportion, freedom of movement and physical comfort.

Consultation

A breast reduction begins with the question of which change is the primary concern for you. During your consultation at Clinic Selnau in Zürich, we assess breast volume, breast shape, skin quality, tissue distribution, and the position of the nipple and areola.

We discuss existing physical symptoms as well as your ideas about future breast size and shape. On this basis, we assess what extent of reduction makes anatomical sense, and what incision pattern will be necessary for this. Where you are fundamentally satisfied with your breast volume and wish mainly to change shape and position, we also discuss the option of a breast lift / mastopexy.

An important part of the consultation also concerns possible changes in sensation, the ability to breastfeed, scars, and existing asymmetries. We discuss openly what result can realistically be expected, how the healing phase unfolds, and what limitations and risks need to be considered.

The aim is not the smallest possible breast. It is to meaningfully reduce weight and volume while creating a breast shape that fits your body in a balanced way.