Breast reduction and ptosis

Harmonie et proportion

If your breasts are disproportionate and cause pain to the neck or back or are the cause of other physical symptoms or if your breasts are abnormally “droopy”, then you might consider breast reduction.

The procedure is inevitably surgical (there is no “soft” solution) but it will bring about spectacular physical and psychological benefits.

It is essential to understand the following:

If it is obvious your breast has an excess of skin or gland, or both, then it NECESSARILY means having a scar of some size in order to obtain a pretty shape and the appropriate substance of the breast envelope.

If you have droopy breasts and it is suggested they be plumped up to make them lie higher, the result will be an aesthetic catastrophe. A prothesis will never raise breasts, on the contrary!

Why are there all these scars around the nipple and vertically on the breast, with a horizontal scar sometimes in the submammary fold?

Because it is necessary to raise the nipple to its ideal position, use the vertical scar to act upon the gland (remove some of it, roll the mammary gland, raise it) and the horizontal scar to harmoniously excise surplus skin.

The choice is simple: either you accept the scars and gain a beautifully aesthetic bust, but with scarring, or you refuse the scars and will be disappointed. In other words, your disenchantment with your current bust will be decisive for your decision. “I just can’t live with my breasts as they are” so I shall accept having scars and everything will be fine.

Finally, there are two types of ptosis:

Glandular ptosis, dominated by the gland sliding downwards, without stretching the skin, and the nipple remaining more or less in position.

Simple dermal ptosis, the more difficult to treat; skin distension dominates and the nipple is positioned low down, pointing downwards (“udder” breasts).

In certain cases of simple glandular ptosis, a prothesis may be used to give an impression of a much prettier breast; it will unfold the lower breast segment, on condition the prothesis is not too large.

Finally, with empty, very floppy breasts, it is often better during procedure to raise the breasts and add a prothesis at the same time.


During our pre-operation discussion you must be completely honest about the reasons for wanting to undergo the procedure.

We shall discuss at length your feelings and any emotional problems you may have. We shall then establish your detailed medical history (with special attention to family medical history to assess carcinological risks). We shall check your family antecedents and make sure you are both physically and mentally fit.

Then, we shall take clinical photographs of your breasts and measure them. We shall consider the amount of mammary tissue to be removed to obtain the required results and reduce breast volume or raise the breasts. I shall sketch the scar burden you will have (localisation and length) for you.

I shall explain how you must prepare for surgery and plan your convalescence.

You might have to give up smoking for a time, before and after surgery, to aid healing.

You might also have to lose weight as excess weight can increase the risks of complications after a breast reduction procedure.

Similarly, you may have to stop certain medication such as aspirin or certain non-steroid anti-inflammatories.

The Operation

You must plan for at least one night in hospital.

The procedure itself takes between three and five hours.

I shall make an incision around your nipple, then downwards on the breast in the shape of a keyhole.

Excess skin, tissue and fat will be removed and your nipple repositioned to a natural-looking position. If required, I shall insert drainage tubes.

Once the incision sutured, your breasts will be enveloped in special gauze.

If necessary, you may also wear a surgical bra.


Since you are physically fit, healing will be normal. I shall prescribe vitamins and a balanced diet (certainly not a slimming diet!)

At home you should anticipate:

      • Lots of ice;
      • Gauze and clean towels;
      • Loose-fitting, comfortable t-shirts;
      • Supple or orthopaedic bras;
      • The creams and ointments I shall suggest;
      • Your telephone nearby;
      • Magazines, videos, or any other manner of relaxation.

Anticipate one or two weeks of rest before I remove dressings and sutures.

You must not take up any physical exercise for at least a month.

There is little risk of complications; the operation is not really painful and the visual result is immediate.