Although ideas of what constitutes the ideal breast form vary widely across cultures, the disproportionately large growth of the breasts is generally regarded as abnormal. Taking into account that the ideal volume of a breast normally ranges from 250 to 300 cc, this condition, which is medically known as mammary hypertrophy or macromastia, may manifest itself in different degrees, which in acute cases can reach up to 1500 cc. This growth can be uni- or bilateral, and it may be the result of a clinical condition known as "virginal hypertrophy" (patients who have never had sexual relations), or secondary to excessive weight gain or multiple pregnancies.

Candidates. In nearly all cases patients express aesthetic discomfort due to overly large breasts, which may limit their ability to enjoy such everyday activities as exercise or perhaps simply being able to wear form-fitting clothes. In more severe cases, patients may experience breast pain (more pronounced during monthly periods), back and neck pain, posture disorders, indentations and even irritated skin in the shoulder area due to bra strap pressure. This operation may be performed on patients as young as 18, before they have had children. The surgeon and the patient will carefully select the best technique based on the patient's age, volume of the breast, and other individual characteristics.

Surgery. All breast reduction surgery involves three fundamental steps: the elevation of the nipple-areola complex, resection of the mammary gland, and a tracing of the zone where excess skin will be removed. In cases of minor hypertrophy the surgery may be performed with a vertical incision, but in more severe cases the resulting scars will always be in the form of an inverted T ("anchor-shaped"). In most cases surgery is performed under general anesthesia and takes approximately 2 hours.

Postoperative care. Following surgery, dressings and soft bandages are applied to the chest area and the patient remains overnight in the clinic or hospital. Drainage tubes are usually left in the breasts for the first 48 hours to permit the exit of any residual blood. All patients are prescribed analgesics, anti-inflammatories and antibiotics. Rest at home is indicated for the first week, with a gradual increase in activities for up to two weeks, wearing a cushioned and comfortable bandage. The stitches are removed in 12 days and a special lycra garment is worn for 6 weeks. The remaining scars fade with time and after 8 months tend to be less visible.

Actual before and after photos