Breast reduction

The presence of macromastia and / or gigantomastia (hypertrophy of the mammary gland to varying degrees) leads not only to aesthetic concerns, but also to physical complaints of a functional nature – chronic backache, shoulder and neck pain, irritation of the skin under the breasts, difficulty breathing, periodic tingling in part of the chest, as well as a potential risk of spinal curvature. Volume reduction combined with breast lift is a complex intervention in which a raised, firmer and aesthetically pleasing bust is achieved. The procedure is also done to restore breast symmetry when a congenital or acquired asymmetry of the mammary glands is present.

About the procedure

The procedure is performed under general anesthesia. The intervention is preceded by accurate preoperative marking and delineation of the planned incisions.

The large size of the breast requires the use of a surgery technique with an incision type „anchor“ (so-called „Inverted-T“) – the incision passes around the nipple, then continues vertically down and in the area of ​​the inframammary fold (the fold under the breast) passes in a horizontal scar. During the procedure, the excess tissue is removed (skin with subcutaneous fat and part of the mammary gland), the nipple and areola are moved to a higher position, the tissues are sutured and fixed in such a way as to provide both reduced volume and raised bust. The blood supply to the nipple and areola is preserved while they remain connected to a part of the glandular tissue. In these cases, a transient loss of sensation can be observed in the nipple-areolar complex area, which recovers in the following months. The size of the areolas can be reduced.

In gigantomastia (huge bust), the areolas have to be moved a long distance, which requires them to be separated from the underlying tissue as a free graft and transplanted to the new location. In this case, the sensitivity of the nipple and the possibility of breastfeeding is completely lost, because the connection with the mammary ducts and glands is cut off.

If an asymmetry in the volume and position of the breast is present, the surgeon can remove more tissue from one or the other breast. In case of significant asymmetry, a combination of two different techniques is possible regarding the position of the scars on both breasts.

The intervention ends with the removal of the aspiration drainages, an aesthetic suture and elastic bandages.

Breast reduction

At A Glance

Surgery Time

2 – 3 hours

Time off work

1-2 weeks

Hospital Stay

Day case

Washing

Shower after 1 week

Reasonably Mobile

1 day

Sleeping Position

Sleeping on back recommended for 1-2 weeks

Exercise Including Gym

6 weeks

Bras & Garments

Sports bra worn for 8 weeks

Sexual Activity

Restricted activity after 4 weeks

Full Recovery

6-8 weeks

Driving

2 weeks

Frequently Asked Questions

Consultation
  • If you are planning to breast-feed, you should discuss this with your plastic surgeon;
  •  during the consultation your surgeon will get acquainted with your expectations and the current condition of the breasts. Photographs are taken and the parameters of the bust are measured in order to refine the choice of the specific technique;
  • you will be able to discuss what you hope to achieve from the procedure and wheather it is possible given your physical characteristics;
  • you will be explained all details regarding the choice of operative equipment and the location of the scars in the specific case;
  • you will be given information about all necessary examinations before the surgery, recovery time and aftercare;
  • you will receive information about possible risks and complications related to the operative intervention;
  • the surgeon must be informed by the patient of all past and concomitant diseases, previous operations and medication
Recovery
  • the drainages are removed in the next 24-72 hours;
  • the sutures are removed on the 14th-21th day;
  • the dressings are changed on the 3rd, 7th and 14th post-operative day;
  • It is recommended to avoid intense physical activity for the next 30 days;
  • control examinations on the 1st, 2nd, 3rd and 6th post-operative month, as well as at the end of the first year;
  • final result – 6th – 7th  post-operative months;
  • in the first days after surgery you might experience mild to moderate pain, which can be controlled with painkillers;
  • over the years, under the action of gravity, breast tissue relaxes, but will not return to its position from before surgery. The degree of future sagging depends on the individual characteristics of the organism;
  • topical creams are applied in order to improve the aesthetic appearance of the scars;
  • when the breasts are very large and a large amount of tissue is removed, there is a risk of necrosis and loss of the areola, and this risk is greater in the presence of gigantomastia. In case this happens, the areola and nipple are reconstructed.
How much does it cost?

Prices are formed individually after an online consultation and depending on the patient’s personal needs. Once we know what you want, you will receive our offer within 24 hours. You also can check our PRICE LIST.

How do we work

Once you have made contact with us, we will organize a free video consultation with the surgeon we believe is best suited for your particular situation.

This consultation will be within 5 days of your request. Prior to the video consultation, we will ask you to fill out a questionnaire about your medical history and send photos of the problematic areas. 

If necessary during the video consultation your doctor will advise you to take additional photos of the problematic areas and suggestions for the angle from which to take photos.

This consultation will be combined with a detailed discussion about your wishes and the possibilities for achieving them.  We will discuss with you the expected results, possible risks and any other issues that you might be concerned about.

We advise you to make a list of all the questions you may want to ask concerning the procedure before the actual consultation. After the official request to us, and if you wish, we can arrange a meeting for you with our representative in London.

Within 24 hours of the video consultation, we will send you a costing describing the price of the procedure and the needed length of stay in Bulgaria. In the costing there will also be preferential prices offered for our partner hotels with which we work and for which we can guarantee the quality and comfort. 

You will then have 3-4 days of time to reflect, and give us your decision.

If you decide to proceed and agree with all terms and conditions , you will have 48 hours within which you must prepay 30% of the total amount of the procedure. This amount is paid directly to the clinic where your procedure will be performed and thereby you will have a reserved date and time for your procedure and a room in the hotel you have chosen. The remaining balance has to be paid by the day before the procedure itself after conducting the preliminary examination in the clinic.

If you decide or need to cancel the procedure, this must be done at least 30 days before the date of your flight in order to be able to trigger a process for returning your deposit.  

If you decide to cancel our services within the last 30 days before your flight, you must have a good reason for doing so (supported by evidence) in order to take your money back. If you cancel it within these 30 days and the reason is acceptable, your money will be returned, but you will be suspended 50 euro for an administrative fee. If you wish to change the date of the procedure, this can happen at least 30 days before.

If you wish, we can also arrange your travel from your home to the airport. We are partners with a transport company and you can use our preferential prices. This also applies to your return flight. To do this, you will need to send us the details of your flight one week in advance.

Upon arrival in Bulgaria, you will be greeted at the airport by one of our employees who will take you to your hotel.

On the day before the operation, you will have a preliminary examination, where some necessary tests will be performed (e.g. blood tests) and we will specify all the details related to the operation (treatment plan, proposal for some additional or adjacent procedures for a better outcome, recovery plan etc). Our employee will take you to the clinic and after that to the place where you are to be accommodated.

Before the surgery, you will need to sign an informed consent document (i.e. a document certifying that you have been informed by the doctor about all potential risks and complications and that you understand them) and agree to proceed with the procedure).

On the day of the operation our employee will bring you back to the clinic. Depending on the procedure, you may need to have one or several days of hospital stay. After the completion of the procedure and the hospital stay, our employee will take you back to your hotel.

During the entire stay, our employee will be at your service throughout. 

If you wish, and if the procedure allows, we can arrange your stay according to your requirements but this must be specified in advance.

On the day of departure, you will be accompanied by our employee back to the airport.

If you wish, we can arrange your stay according to your requirements. This must be specified in advance.

You will be provided with a detailed plan on the recovery process. 

Online consultations in the recovery period will be arranged with your surgeon, but if you have stayed in the hospital after your procedure, the doctor will give you post-operative examinations on the first and third days.

On the seventh and fourteenth days, preventive online consultations will be made to track how the recovery goes.  

Online consultation reviews are also done on the 1st, 2nd, 3rd and 6thmonths.You will be able to contact us at any time!