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Breast reduction

Are your breasts too large in proportion to your body? This can lead to a myriad of physical complaints like neck and back pain, poor posture, painful grooves where bra straps have cut into the shoulders, skin rashes, and irritations. Also, very large breasts can impede your daily activities and exercise. Are your breasts different in size and position? Are you experiencing psychological and emotional complaints because of the size of your breasts? Breast reduction is a safe operation to improve your body's proportion and quality of life.

  • Reducing the volume of the breasts

  • Reducing the areola

  • Correcting the breasts after childbirth or breastfeeding

  • Rejuvenation of the body contours

  • Correcting the symmetry of the breasts

Even though a breast reduction inevitably leaves you with visible and permanent scars, most women are delighted with the results. Smaller breasts mean less pain and physical limitations, and because the natural proportion of your body is brought back, it will increase your confidence. The results of surgery are permanent. The most suitable candidates are women with realistic expectations: a (significant) improvement is possible; perfection is not.

Breasts constantly change

Breasts develop differently in different women, and their shape and size continue to change throughout life: before menstruation, breasts are often swollen and sensitive; during pregnancy and after birth, they grow in size as the mammary glands develop and milk is produced. After breastfeeding has stopped, breasts often sag and hang lower than before pregnancy. Later in life, breasts change in size again because the mammary glands become smaller while fatty tissue increases. For some women, this means their breasts become bigger, while others experience the opposite effect.

Facts about breast reduction rurgery

Genes mainly determine the shape of breasts. Extremely large breasts (macromastia or hypertrophy) can have significant physical, psychological, and emotional problems.

Many people have no idea how these extra kilos of breast tissue affect women and how much it can get in the way of many physical activities. Large breasts can lead to a myriad of physical complaints like neck and back pain, poor posture, painful grooves where bra straps have cut into the shoulders, skin rashes and irritations, and a reduced or absent sensation in the nipples.

In addition to the physical discomfort, many women with very large breasts don’t feel at ease with their bodies. They often find that people constantly stare at their breasts and make inappropriate comments. Hence, they usually wear loose clothing and avoid certain social situations. They try to visually make their breasts look smaller by walking with their shoulders pulled up, affecting their posture. Often women don’t realise the long-term physical consequences of large breasts.

Insurance coverage

In the Netherlands, breast reductions are generally reimbursed by your insurance company if provided by approved hospitals or clinics. Amsterdam Plastic Surgery is a modern private clinic focusing on highly discerning clients. We do not work with Dutch insurance companies that demand pricing that cannot be reconciled with the standards of care and attention we give to our patients. If you are insured with one of these companies and choose Dr Pirayesh as your surgeon, you must pay for the surgery yourself. Depending on your policy, your insurer may decide on an allowance. We will, of course, provide the necessary paperwork. Naturally, we will always tell you in advance what your customised operation will cost.

Breast reduction overview and timeline

Duration of the operation: 2 to 3 hours
Anaesthesia: light general anaesthetic administered by a specialised anaesthetist
Length of stay: outpatient, you can return home about 4 hours after surgery. You need to arrange transportation because you cannot drive yourself home.
Post-operation: slight swelling and tenderness. We will give you a sports bra that you have to wear, painkillers, antibiotics, and instructions on wound care.
Complications: very rare: fluid retention, infections, raised, livid scars
Recovery time: You may resume your normal activities one week after surgery, but you must refrain from lifting anything heavier than 5 kilos for the first two weeks and no heavier than 10 kilos for the next four weeks.
Results: breast reduction is a rewarding procedure that gives women with heavy, sagging breasts a beautiful, natural contour that is in proportion to their bodies, making exercising more comfortable and buying clothes more enjoyable.
Scarring: The stitches will be removed within a week, and your scars will fade after a few months. Dr Pirayesh has developed a program, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

Breast reduction surgery in six steps

On the day of your surgery, Dr Pirayesh will mark your breasts while standing so that the current size and position of your breasts and nipples can be determined when you are lying on the surgery table. In addition, photos will be taken for your medical record.

Step 1. Anaesthesia

A specialist anaesthetist will inject a light general anaesthetic into a vein through a cannula (a thin, plastic tube) in your arm or hand. The anaesthetist and his team will monitor you closely throughout the operation, ensuring you are comfortable and safe. The anaesthetist will discuss the anaesthesia before your surgery and answer any questions.

Step 2. The incision

There are three types of incisions. Dr Pirayesh has previously determined the best option for you:

  1. Around the areola

  2. Around the areola and then vertically from the areola to the crease underneath your breast

  3. Around the areola and then vertically to the crease underneath your breast and then horizontally following the crease, so the incision looks like an anchor


You will then be placed in an upright position. This ensures that your breasts are symmetrical and the nipples are in the correct position.

Step 3. Reducing the size of the breasts

After the incisions are made, Dr Pirayesh commences with the breast lift

  • The underlying breast tissue is lifted and re-shaped to enhance the contour and firmness of the breasts

  • The nipple and areola are repositioned to a more natural, more youthful height

  • If necessary, enlarged areolas will be reduced and reshaped

  • Excess skin is removed to compensate for a reduced elasticity

  • Dr Pirayesh often uses an innovative technique whereby he creates an inner bra with your tissue, which enhances and rejuvenates your breast contour. This extra procedure will be discussed with you before the surgery.

Step 4. Suturing and bandaging

When Dr Pirayesh is happy with your new breast contours, he will suture the incisions. Some incisions remain hidden in the natural fold under your breasts, and some will be permanently visible, although they will significantly fade over time. The sutures are made in the deeper layers of breast tissue and support the newly formed breasts. Dr Pirayesh used sutures and/or surgical tape to seal the skin and protect the wounds. A small drain may be inserted under the skin to drain excess blood or fluid. The results of your breast augmentation and lift are immediately visible.

Step 5. Recovery and aftercare

Dr Pirayesh provides specific written instructions about how to take care of your breasts in the weeks after surgery and the medication you should use for optimal healing and minimal risk of infection. When you come to the clinic for follow-up appointments, you will meet with him to discuss details with him and ask questions. Within a week after the operation, he will check the incisions and remove your sutures. After some time, the swelling will subside, and the scars will fade. If you have questions, you can send Dr Pirayesh a WhatsApp message, and he will happily answer your questions. Avoid the solarium or sauna for ten days before and ten days after surgery, and don’t drink alcohol or take blood thinners like aspirin (paracetamol is allowed).

Step 6. Wound healing and scarring

Dr Pirayesh is very savvy when it comes to promoting rapid healing. He has developed a customised regimen, APS Scar Care, including creams based on aloe vera, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

This regimen has ensured that many of Dr Pirayesh’s patients have hardly noticeable scars. However, it is impossible to pre-determine if patients will have problems with their scars healing.

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