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Breast hypertrophy

Asymétrie mammaire traitée par réduction mammaire
Breast asymmetry treated by breast reduction

Breast hypertrophy means having abnormally large breasts. The breasts are very heavy and sagging (known as breast ptosis) and often asymmetrical.

You can decide to have breast reduction surgery because your breasts are very large or too heavy and therefore sag or droop. Having large and heavy breasts can also cause pain in your back, shoulders, discomfort with your clothing, and sports and dermatological problems under the breasts because of maceration. There may also be an aesthetic dissatisfaction because of the breasts sagging, the areolas being too wide, and the skin having stretch marks. You can return to work or resume your normal activities after 7 to 10 days after the operation, so the recovery period is not very long (except however for sport, you have to wait two months to restart your sporting activities in general).

Causes of breast hypertrophy

Most often the enlargement is idiopathic (no cause is found) but sometimes it is related to being overweight. Hormonal or genetic causes are suspected.

When should breast reduction surgery be considered?

Breast reduction surgery can be performed either before or after having children. The chances that the breast will lose volume even when losing weight is very slim. The intervention can be performed as soon as the patient reaches adulthood; as long as possible before getting pregnant in fact. Performing a breast reduction between two pregnancies or just before a pregnancy does not make much sense because the result may be altered afterwards. After the end of planned pregnancies the operation is also beneficial and there is no maximum age as long as the state of health allows it.

Prices for breast reduction:

From 4500 euros in cases covered by health insurance (planned resection of at least 300 grams per breast operated for a reduction in volume).

Frequently asked questions about breast reduction surgery

What is the impact of having breasts that are too large?

The impact is major, both physical, functional and psychological. There can be a complex associated with clothing and the practice of sport, back, neck and shoulder pain, dermatological disorders under the breast (maceration) and an aesthetic dissatisfaction. Many patients experience the situation very badly.

Is surgery possible?

In most cases, yes. Breast reduction surgery may be considered. It aims to decrease the volume of the breasts in order to make them more harmonious with the rest of the body, to correct the sagging of the breasts (ptosis) and to restore a certain degree of symmetry to the two breasts (in obvious cases of asymmetry).

Réduction de volume des seins par réduction mammaire pour hypertrophie mammaire
Reduction of breast volume for breast hypertrophy

Is the operation reimbursed by social security?

In some cases (a significant enlargement with more than 300 grams of excess in each breast), a contribution from the social security may be possible. It is 353 euros for the surgery part and 149 euros for the anesthesia part and therefore does not cover all of the fees, a part remains at the patient’s expense. This is not the case for sagging and empty breasts (breast ptosis) without excess volume.

What are the benefits of the operation?

Reduction of pain in the back, neck, shoulders, an easier choice of clothes, easier practice of sport, subsequent weight loss, aesthetic improvement, improvement in psychological feeling and self-confidence, the disappearance of dermatological problems linked to maceration, and a reduction of the risk of breast cancer. The benefits of breast reduction are major and among the most important in plastic surgery.

Réduction ptose mammaire avec hypertrophie du volume des seins par technique en T
Breast reduction and ptosis correction by the T technique

From what age can you have breast reduction surgery?

The answer is once the breast volume has stabilized, so normally from the age of 15. The sooner the procedure is performed the better the result, because the tissues have not yet had time to stretch. There is no age limit for breast reduction surgery and Dr. Masson has often operated on patients over the age of 65.

What happens before breast reduction surgery?

One to two consultations are necessary with your cosmetic surgeon as well as a consultation with the anesthesiologist. A biological assessment (blood test) and a mammogram will be carried out to ensure the absence of contraindications to the operation (severe anemia, breast lesion etc.). A compression bra, preferably black and front opening, will be prescribed and should be worn for a month, day and night, after the operation. Medical photographs are taken systematically. In case of a patient being overweight, a prior diet is strongly recommended because the results of the operation will only be better. Smoking or tobacco use must absolutely be stopped before breast reduction surgery because it increases the rate of complications and considerably delays the scar healing process.

How long does the operation last?

Between one and two hours.

Réduction mammaire pour gigantomastie avec greffe des aréoles selon technique de thorek
Réduction mammaire pour gigantomastie avec greffe des aréoles selon technique de thorek

How long is the hospital stay?

The modern breast reduction techniques that are used by Doctor Masson allow you to go home the same evening or the day after the operation in most cases. No sutures are to be removed (they fall out by themselves) and no drainage system is necessary, unlike with other techniques.

What anesthesia is used during the operation?

General anesthesia is essential. The operation takes place in a half-seated position in order to obtain the best possible result.

How is the operation performed?

After defining with your surgeon the desired morphology and size, the excess mammary gland is removed, the areola reassembled to an ideal level and often reduced in volume and, finally, the skin is lifted up to ensure a good hold and an aesthetic curve to the breast. Preoperative drawings are made on the breasts the morning of the operation by the surgeon.

Réduction des seins par technique de réduction mammaire, photo avant après
Breast reduction, before and after photos

Where are the scars located?

There are three locations to the breast reduction scars which, themselves, are proportional to the amount of breast to be removed. There is a scar around the areola which makes it possible to lift it and reduce its diameter. Then there is a vertical scar that goes from the areola to the sub-mammary groove which makes it possible to lift the breast, to support it, and to decrease its width. Finally, there is often a scar in the groove under the breast that makes it possible to remove all that was below the groove and to properly hang the breast to prevent it from falling back. We talk about the scars being in the shape of an inverted T or marine anchor. The first scar to fade is, luckily, the vertical one because it is the most visible. Next is the areola scar (which in the worst case can be hidden by dermopigmentation or areola tattooing). Finally the last scar to fade is the one under the breast, which is not a problem because it is hidden in the groove. However, it can be a little painful at first both internally and externally (because of friction) which is normal. In all cases though, you should know that the healing process is long, for the first three months the scars are red and inflamed, then they slowly fade and end up being discreet from 12 to 18 months after the operation. There are several ways to put all the best chances on your side to heal well: no smoking, putting cream on the scars (cicaplast, cicalfate, dermatix, kelocote, hyaluset etc.), the use of silicone dressings (cerederm etc. ) and immediate post-operative laser treatment (UrgoTouch). Essential oils (rosehip, helichrysum) also work well.

Is there an increased risk of breast cancer?

No, on the contrary, reducing the size of the breasts reduces the risk of breast cancer (without removing it, however). Breast cancer monitoring continues as normal by mammography after breast reduction surgery.

Is a new pregnancy possible after breast reduction surgery?

Yes, but it is advisable to wait for at least 6 months, and ideally one year, for the results to stabilize first.

Is breastfeeding possible after breast reduction surgery?

Breastfeeding, despite what you may have read elsewhere, and whoever the surgeon and whatever the technique used, is not always possible after breast reduction. This is due to scarring of the milk ducts. In some cases, it will actually be impossible to breastfeed after breast reduction surgery. In general, the larger the volume of breast removed, the higher the risk of breastfeeding being compromised.

Réduction mammaire : réduire le volume des seins pour hypertrophie mammaire
Breast reduction for breasts that are too large

What happens before the operation ?

You will have seen your surgeon in consultation, ideally twice in order to define together the objectives of the breast reduction and the anesthesiologist, at least 48 hours before your operation. Aspirin should be stopped at least 7 days before if you take it. Smoking should be stopped several weeks before the operation. A diet should have been performed if necessary and your weight normalized. Do not forget a compression bra that will be necessary for the postoperative period. You must have an empty stomach (do not drink or eat) for at least 6 hours before the breast reduction surgery. The armpits should be shaved and an antiseptic shower carried out according to the instructions given to you in writing.

What are the post-operative effects of breast reduction surgery?

The dressing made in the operating room by the cosmetic surgeon is removed the next day. Recovery is quick and generally very simple. Only minor pain is experienced and easily controlled by conventional analgesics. Swelling (edema) and discomfort when raising the arms are common in the first few days. Showering is authorized the day after the operation, without a dressing or bra. The dressing is very simple, just put compresses on the scars after the shower and then put on the compression bra which should be worn night and day for one month. The sutures are absorbable (they fall out alone, no need to remove them).

Time off work is essential and its duration depends on your profession. It ranges from 5 to 15 days depending on the case. Sport and swimming are not recommended for 6 weeks. You will be seen regularly in consultation after the operation by your surgeon (usually at a week, a month, 3 months, 6 months, and a year).

What type of bra should you wear after breast reduction surgery?

For the first few weeks after surgery, you will be prescribed a compression bra (Medical Z, Embody etc.) because there has to be an elastic restraint and compression for the first few weeks after surgery, without reinforcement of course. This allows external and internal healing and limits pain and swelling. The main models of compression bra are breathable, antibacterial, and can be washed without any problems. The bra can of course be removed for an hour or two for it to be washed. The size will be prescribed by the surgeon before your operation. Generally, the bra is worn for the first two or even three months after the operation.

Is breast reduction a painful operation?

In general no, pain is minimal and well controlled by conventional drugs.

When is the result visible and final?

Dr. Masson’s office is the very first in Paris to be equipped with 4D Eve 4.0 scanner technology. This allows you to visualize how your new breasts will look in augmented reality during your consultation and, thus, better imagine the results of the breast reduction procedure.

Results are visible the day after the operation when the first dressing is removed, but it is necessary to wait for up to one year in order to appreciate the final result.

The results are very often spectacular and considerably improve the physical, functional and psychological discomfort that existed before.

How do the scars evolve over time?

The scars are initially red, raised and inflamed during the first 3 months, which is completely normal. They may itch at first, but you will be prescribed a healing cream. At the end of the third month, the scars become finer and finer and turn white and, as a rule, finally fade after 12 to 18 months. Please note, it is extremely important to protect your scars from the sun for the first year afterwards to prevent them from tanning.

Can there be complications?

As with any surgery, there is always a risk of complications. Breast reduction surgery is a frequent and highly controlled operation and complications are, fortunately, very rare.

Apart from extremely rare complications linked to anesthesia, the following complications can occur (all of them are increased by smoking and being overweight, however, which is why it is important to quit smoking before a breast operation and to normalize your weight).

  • Hematoma (often due to a surge in tension after the operation, appears immediately and requires reoperation).
  • Infection (most often due to a nodule of cytosteatonecrosis in very fatty breasts which becomes infected. May require antibiotic therapy and sometimes reoperation for cleaning).
  • Wound dehiscence (which is favored by smoking). A small dehiscence of a few millimeters under the areola and the vertical incision occurs very frequently and is not serious. Sometimes a larger dehiscence can occur and normally heals by itself.
  • Poor healing, which may require local treatment or reoperation.
  • Allergy and reaction to the sutures.
  • Areola sensitivity which is reversible in a few months.
  • Necrosis of the skin or areola, extremely rare.
  • Phlebitis and pulmonary embolism, which can happen with all procedures.


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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