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Breast reduction

YOU WANT A BEAUTIFUL, FIRM BUST THAT SUITS YOUR OWN BODY.

When breasts become a burden. Breasts that are too big can cause psychological and physical problems. Whether in everyday life or during sports, neck, shoulder and back pain as well as spinal problems and posture problems can arise and the soul can also suffer.

Before and After Pictures

Breast reduction
Breast reduction
Breast Lift
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WHAT HAPPENS BEFORE THE OPERATION

Many women suffer from their large breasts. The breasts are large, heavy and sagging, the patient no longer feels comfortable with her breasts, suffers from back pain and the breasts are a nuisance in everyday life and during sports. After more than a thousand operations in breast surgery, Dr. Bartsch has gained a lot of experience. He makes an exact analysis of the surface changes, lack of volume or loss, gravity and proportions.

After a comprehensive initial consultation, in which wishes and possibilities are discussed with the patient, the “desired bust” can be depicted by means of 3D planning. The patient sees in the 3D scan exactly what her breast could look like after the operation, gets certainty and can thus better imagine the result. You can see exactly which implant fits your own body best and see how your own breast could look after the operation. It is also important for me to tell the patients honestly and also to show them what is possibly “not possible” with their physical condition. Honesty is our top priority so that no false hopes are raised.

There are findings that show a medical indication, for example, if the large bust is proven to cause significant physical discomfort. If this is the case, the costs for a breast reduction are partly or completely covered by the health insurance. For many health insurance companies, the minimum amount of fat and glandular tissue to be removed is 500g per breast.

THIS HAPPENS DURING AND AFTER THE OPERATION

To reduce the volume of the breasts, glandular fat tissue is removed and the breast is reshaped. In most cases, a breast reduction is performed with a T-incision, as both skin and glandular tissue must be removed. Breast reduction is performed under a light general anaesthetic. The operation itself takes 1.5 – 2 hours.

The breast reduction procedure takes place in Vienna as a day clinic and under general anaesthesia. An overnight stay in the clinic is rarely necessary nowadays for medical reasons. On discharge you will be given a support bra to wear for 6 weeks. You will be able to work again after 1 to 2 weeks, but you should refrain from sporting activities for the first 6 weeks. After 2-3 days, the plaster will be changed and after approx. 2 weeks, the stitches will be gently removed.

Our team and we doctors are always available for you should you have any questions. In case of emergency, you can always reach us on our mobile number.

Dr. Rolf Bartsch: +43 69911222000

Further check-up appointments in our surgery are important in order to optimally accompany the healing process and will be arranged with you before the procedure.

Proper scar care is important. If you are prone to increased scarring, we can treat this with laser and medical needling (cost € 90,- per session).

After a successful operation and waiting for the healing process, you will have no pain, can breastfeed and do any sport without any problems.

Testimonials

Dr. Rolf Bartsch

The female breast is the most individual and personal thing of all. Patients who suffer from the weight and size of their breasts want a breast that is proportionate to their body. In a comprehensive consultation and a 3D scan of your breast, we can simulate the “desired breast” together and see how it could look on your own body.

Solution in steps

You are also welcome to contact us by phone at: 01 353 55 55 or use our contact form. Please note that the next available online date may not necessarily be the next available date. Please feel free to call us if no suitable online appointment is available.

The most important questions and answers

We offer you the all around safety service.

  • Safety, through my many years of experience, because I have already performed over a thousand breast operations.
  • Safety, through the Privatklinik Währing – a renowned clinic with perfectly trained staff.
  • Safety, through my 24h availability. If you have any questions or uncertainties, you can reach me at any time by phone or messenger.

Ask to see before/after pictures, research reviews online in forums and on Google, and find out about the doctor’s experience and the satisfaction of his female patients. In the end, the most important thing is that the gut feeling must fit.

The procedure of breast augmentation takes no more than 60 minutes. You can go home the same day. No more overnight stay is necessary, unless you have the special request. You should take it easy for the first few days after the breast augmentation. If you do not have a physically demanding job, you can usually return to work after one week. Sports are not allowed for 6-8 weeks, as the implants need to heal in position while you rest.

We work with a gentle surgical technique with radiofrequency, which means that there is less tissue damage. Result: faster healing, less pain. Drains are also no longer necessary. Scars that are placed are always visible. Breast augmentation can result in scars in the underbust crease, 99% of which fade very well. I have personally cared for 2 patients in 10 years who developed very noticeable scarring. The scar around the areola, which is done mostly in tubular breasts, is also usually less noticeable because there is a difference in contour between the darker skin of the areola and the skin of the breast so and so. However, we see scarring in about 10% of cases that can be red for several months and must be treated with laser and cortisone.

The breast augmentation procedure takes place in Vienna in a day clinic and under general anesthesia. It is a light anesthesia during which you are completely asleep, but wake up immediately after the end of the surgery. Nowadays it is not necessary to stay overnight in the clinic for medical reasons. Our patients are happy to stay overnight if the journey is long or if you simply want to have a night’s rest from everyday life.

No. The risk of anesthesia is determined individually for each patient by our team in the anesthesia outpatient clinic. We use a very short-acting anesthetic, which allows the patient to be awake again a few minutes after the anesthesia and to leave the clinic a few hours after the procedure, pain-free and alert. In principle, our anesthesiologists are in close contact with the AKH Vienna, which is located right next to the Privatklinik Währing, should a complication occur during anesthesia after all these years.

Yes! After about 1 hour of care in the recovery room, all patients come to the ward, where they can then receive visitors in their room.

The waiting time for a surgery appointment is usually about 4 weeks. Normally, the patient comes to the initial consultation and, should she decide for an operation, an operation date is reserved. At least 15 days before the date of the operation, a consultation with the anesthesiologist and with Dr. Rolf Bartsch personally takes place in order to explain the operation again in detail and to answer any questions. The official documents must also be signed at this time.

Further control appointments in our office are important to optimally accompany the healing process and will be arranged with you before the procedure. After 2-3 days, the plaster is changed, and after approx. 1-2 weeks, depending on the technique, the stitches are removed. Until the stitches are removed, you should avoid sports and do not let the stitches get wet.

The possibility of capsular fibrosis is very rare. The rate of capsular fibrosis in our patients is less than 0.5%. Whenever it affects a patient, the question “why me” arises? The reasons for capsular fibrosis are not exactly clear. Neither you nor the doctor is to blame. What is important is that action must be taken depending on the severity of the fibrosis – this is divided into 4 stages according to BAKER. The costs for a necessary implant change are about 3.900€ and are not covered by any public health insurance.

Yes, the ability to breastfeed remains. You can normally breastfeed your baby without any problems. If you wish to have a child within the next year, we advise you to wait with an operation. Especially with tubular breasts, the ability to breastfeed is impaired even without surgery. With some techniques, such as the incision over the areola, the ability to breastfeed may be more affected. The connection of the nipple to the mammary gland tissue is never cut in modern techniques.

The technique depends on the initial situation. If the breast is round but simply too small, it is usually enlarged via an incision in the underbust fold. In tubular breasts, access via the areola is often useful because the focus is on changing the shape and not just enlarging it. The location of the implant is usually under the muscle. This creates an internal bra that supports and protects the implant. Precise preparation of the implant pocket results in less tissue damage and faster healing. The cavity is thus customized for each patient.

In the beginning yes. The first 6 – 8 weeks the breasts are swollen and harder after each breast augmentation. Over time, the tissue swells and thus the initially stronger projection in the upper half of the breast disappears. The implant is basically placed so that the maximum projection is exactly behind the nipple.

We have a state-of-the-art 3D simulation. With the help of an infrared camera, your own breast is scanned and simulated. Software can be used to determine only the size and type of implant and its location. The 3D simulation can make static and moving images. The simulation can be rotated in all directions and one can estimate exactly how the desired bust might look. Whether from the side, front or top – from any angle we get a good pictorial idea whether the breast will fit you or not. You will get an online access to the breast augmentation simulation and you can look at everything at your leisure at home.

Normally, stretch marks do not appear on the breast after surgery, because we choose the implants in such a way that we respect the anatomical limits and also the stretching ability of the skin. If strong stretch marks are already present in advance, in rare cases they can turn red. In this case, we should not plan together “too big” augmentation.

One should avoid weight fluctuations of more than 5kg after breast augmentation, as these can cause the breast to begin to sag more quickly. When gaining and losing weight, the supporting tissue of the breast is stretched and thus the shape of the breast can change.

I use the latest generation of silicone implants from the German company Polytech, the company Motiva and B-Lite Implants. This new generation of silicone implants is lighter, more sensitive, made of a more dimensionally stable gel and are more robust. They are characterized by a high standard of quality and safety. The latest implants integrate better with the female breast, the silicone gel adapts to the natural movement of the body.

The advantages of Polytech implants:

Premium implants produced in Europe
High lightness and shape stability
Good wearing comfort and excellent tolerance
No “expiration date” – however, regular control by ultrasound is recommended. After 20-30 years, replacement may be advisable even if the implants have a long shelf life.

The company Motiva offers implants with a transponder (chip) – with this a registration on the Motiva homepage is possible: should problems like a capsular fibrosis or an implant rupture occur after the operation, an insurance protection for further 4 years can be bought for a unique insurance premium of 200€: this includes the exchange of both implants as well as a reimbursement of costs of 1000€ per side. This insurance can optionally be taken out online by yourself up to half a year after the surgery.

The mixture of microspheres and silicone gel makes the implants not only 30% lighter, but also firmer. This prevents an undesirable “rippling” effect. This effect occurs when implants create ripples that can be seen through the surface of the skin. The firmer material of the B-Lite implants prevents this annoying “rippling” effect. However, the changed structure in the silicone gel also means that the breasts feel firmer and slightly less natural.

Breast implants differ not only in their shape – round, semicircular or anatomical – but also in the firmness of the gel that is used. The softer the gel, the more likely it is to ripple. Especially if the patient is particularly thin or the breast tissue is very loose. Especially after pregnancies and the subsequent breastfeeding period, the breast tissue becomes less and thus the risk of rippling is higher with soft implants. Modern implants have less rippling. Anatomical implants usually less than round ones because they are made of a firmer gel. B-Lite implants show almost no rippling, but can be perceived firmer.

There are implants for more push-up effect (round implants) or anatomical implants for very natural results, creating a flatter décolleté and a more bulbous lower pole. Above all, the projection of the implant is crucial in determining whether the breast looks large or very large. Round and also semicircular implants (these are simply round implants with less projection) have 50% of the volume above the tip and 50% below. Anatomical implants have 60-65% of the volume in the lower pole and 35-40% in the upper pole, depending on the manufacturer. This simply makes the décolleté look more natural.

Yes – it is possible. Therefore, when choosing implants, we make sure that we respect the anatomical limits of the breast. Implants that are too wide have another disadvantage: over the years, high pressure is exerted on the adjacent mammary gland tissue. This restricts blood flow and causes mammary gland tissue to die. The effect is that after a few years you can only feel the skin and implant between your fingers. The edge of the implant can often be felt in the crease under the breast if there is little of the patient’s own tissue. This is no cause for alarm, but can be explained by the fact that the implant is not covered by the muscle at the bottom and is therefore easily felt.

Depending on the anatomical conditions, we select the appropriate preparation technique: as a rule, this is often the dual plane method, which provides a particularly natural result: here, the implant is covered by the pectoral muscle in the upper area, while in the lower area it lies loosely embedded in the glandular tissue. What is the 4-muscle technique? This is a position completely under the muscle. Since the mammary gland and the implant are completely separated, the result often feels fake.

No, we prepare the implant pocket in such a way that the implant fits in exactly and does not slip – on top it is always covered by the muscle, and thus sits stably in the right place. It is important to sew the layers together again correctly after the surgery, thus creating an inner bra in the underbust fold. In the past 10 years we have already seen that implants give way downwards even years after breast augmentation. In this case, the underbust fold must be reconstructed in a small operation.

No. We choose the implant so that the natural base of the breast is not exceeded – so the underbust crease does not need to be moved. Only in very rare cases, where there is hardly any of the patient’s own tissue, is it necessary to lower the underbust crease. In recent years, we have corrected many patients in whom the underbust fold was set too low.

We discuss the final size during our surgical consultation and again directly on the day of surgery during marking. Since we only have the actual starting position in front of us intraoperatively, it is possible that we select a smaller or larger implant size – but the differences are so minimal in the projection that this has no objective effect on the final result discussed or shown in the 3D scan. If we make changes during the operation they are in the range of 5-10% of the volume. So do not worry about a surprise. What happens is exactly what was agreed upon.

Approx. €5,700.- for access via the underbust crease. €6,500.- for tightening around the areola.

Round implants €1,000.- for both sides.

Anatomical implants €1.500.- for both sides

Bi-Lite implants €2,000.- to €2.300.- for both sides

The social insurances in Austria do not pay for breast augmentation due to “size desire”. There is an insurance against e.g. capsular fibrosis. If you choose implants from Motiva, you can take out an insurance policy online for 200€ for another 4 years up to 6 months after the procedure: this reimburses 1000€ surgery costs per side, as well as a free exchange of both implants.

Corrective surgery after breast augmentation is very rare. If capsular fibrosis occurs, the cost of new implants is reimbursed and only the cost of hospital stay is incurred. In the last 10 years, we have found an individual solution for each patient in case of need, which has never turned out to be as high as the primary intervention.

All operations take place in the 18th district in the private clinic Währing in Kreuzgasse 17, as this hospital has an operating room with special clean room ventilation. This is unique to this clinic in Vienna. The anesthesiologists are anesthesiologists specially trained for these procedures, and you will meet them personally in the anesthesia outpatient clinic in our office before the procedure.

Breast augmentations are usually performed in our clinic on a day-case basis. This means that the patients come to the clinic in the morning for registration, are operated on during the day and are allowed to leave the clinic again in the evening between 17:00-18:00. If the patient expressly wishes, or if she is traveling from another state for a longer period of time, she can also spend a night in the clinic for an additional charge of approximately 400€.

This is known as “gel bleeding”. This was an issue especially with silicone implants of the old generation. We only use quality-tested and modern brand implants where this occurs after years, if at all. We therefore recommend having the implants examined by ultrasound every 2-3 years.

The hormonal fluctuations due to the menstrual cycle can change the size of the breast or the glandular tissue for a short time, but this does not play a role in the choice of implants and the time of surgery.

During pregnancy and breastfeeding, the breast will naturally increase in size, even with silicone implants. In particular, prolonged breastfeeding can cause the breast to sag more afterwards, which may necessitate a new operation and possibly tightening of the breast. The more own breast tissue is available and the longer the breastfeeding period lasts, the greater the changes in the breast can be.

No, a mammogram is not usually necessary before breast augmentation. We only recommend it to those patients who would like to clarify painful lumps or similar in the breast before the operation. However, you should definitely have a mammogram if you are over 35 years old. This is part of the classic breast cancer screening.

If you have a family history of breast cancer, we recommend a blood test to rule out a genetically increased risk of breast and cervical cancer (BRCA 1 or BRCA 2). After that, we can make the right decision for you individually. For patients over 35 years of age, we recommend an ultrasound and a mammography of the breast before the procedure.

No, you do not have to. Immediately after surgery, a narrow tape bandage is applied over the breast to reduce swelling. This should remain on for 5-7 days.

At discharge, you will be given a support bra to wear for 6 weeks. After that you can leave it off, the implants will be completely healed.

Since the pectoral muscle is only loosened at its lower edge, no permanent loss of strength is to be expected – after a 6-week break following surgery, all sports activities can be resumed.

Direct sunlight and solarium should be avoided as long as the scars are red. It could lead to dark scars.

On the side after a few days, on the abdomen after a few weeks.

No, our anesthesiologists administer the antibiotic during the operation so that no antibiotics need to be taken afterwards. In rare cases, such as second operations, it may be advisable to administer the antibiotics for several days afterwards.

No, since you are not bedridden after breast augmentation, but may (and should!) move normally, no thrombosis injections are necessary.

No, you do not need to take any wound-healing agents after the operation. However, you should stop smoking one week before the surgery and up to 3 weeks afterwards, as this has a negative effect on wound healing.

No, we do not normally use drains in breast augmentations because we already stop bleeding very carefully and conscientiously intraoperatively. Even internationally, drains are rarely used in breast augmentations. The reason for this is that they do not prevent postoperative bleeding, can cause severe pain after the operation, and can cause bleeding when the drains are removed. Proponents believe that the vacuum allows contact between the implant and tissue to be established more quickly, thus reducing the risk of seroma (formation of tissue fluid). We almost never see seromas in our patients during breast augmentations due to the gentle surgery. Even without the successful use of drains for over 3 years.

After 2-3 days the plaster is changed. In case of the technique over the areola, the sutures and also plasters are removed after 7 days. In the case of the incision in the underbust crease after 14 days.

In the case of breast augmentation via the underbust crease, we remove the sutures after 14 days. In the case of tubular breasts, we often tighten using a special technique over the areola. In this case, the sutures are removed after only 7 days and you can start showering.

After 6 weeks without hesitation. This is the time when the implants have healed with a delicate capsule and the risk of “slipping” is thus very low. Within these first 6 weeks of healing, you can perform everyday activities, but should not engage in sports that put stress on the upper body.

Suture removal takes place between the 7th and 14th day after surgery, depending on the suture technique used. Only now are you allowed to shower completely again with the doctor’s consent. Please use ph-neutral shower gel due to the sensitive scars.

Further check-up appointments in our clinic are important in order to optimally accompany the healing process and will be arranged with you before the operation. The first control appointment usually takes place directly on the day after the surgery. Then after 1-2 weeks for suture removal, further 6 weeks after the surgery and the last 3-6 months after the surgery.

After the surgery you will receive a prescription from us. Please follow the instructions we give you exactly. The perfect pain management is also one of the reasons why our patients usually report almost no pain after breast augmentation.

We recommend AND Repair and Protect scar ointment and Bionect Hyaluron Gel. It is important to take care of the scars until they fade and are no longer red. When the scar has turned white, it will not change much. This means that from this point on, even with scar care, no great changes can be achieved.

Yes, of course, always when the wish does not match the possibilities. Mostly, however, it is not a “refusal”, but the patients also understand why something is not possible.

The waiting time for surgery with me is about 2 weeks. For the surgery date about 2-3 weeks. It depends on the time of the year. In winter it can be a little longer.

The cost depends on the duration of the procedure and starts at € 7,200 for a lift. This includes the hospital, anesthesia and all controls afterwards.

We always treat scars as soon as the stitches are removed. Scars NEVER disappear, but usually become less noticeable. Lasers, silicone preparations, creams, etc. can accelerate this. We also recommend a special scar ointment.

Motiva implants have been on the market for a short time, I see a particular advantage in these so-called “Ergonomix” implants when there is a desire for anatomical implants but there is a risk of rotation. For example, if certain sports are practiced or if there is a very soft tissue in the patient. Then Motiva implants can be a good alternative.

A bra with underwires should not be worn until 6 weeks after surgery, as the implant can still be pushed up.

A tubular breast is caused by the fact that the breast has not completely unfolded. Therefore, the focus of the operation is less on enlargement than on a change in shape. If the shape has been changed from a pointed breast to a round breast, it can be enlarged. However, this is usually done with a smaller implant.

A lift cannot be usefully combined with autologous fat in the same procedure. Since the breast also requires incisions in the gland during a lift. The fat can then not heal there.

Yes, there is an insurance that you can also take out with us, it is called “Medassure”.

Yes, we also have the option of payment by installments. During the personal consultation you will receive all the documents for financing, if desired.

Silicone implants do not have an “expiration date”. An alternative to this is ONLY own fat. Mostly the women who want more volume in the breast are very slim, which means that there is little own fat and therefore this method is not possible.

We recommend placing the implant in front of the muscle if there is a lot of own tissue, because you do not have to hide it.
If there is little own tissue, we recommend to place the implant behind the muscle, because otherwise you can see the edge of the implant through the skin.

The breast implant should never be wider than the base of the breast, if only higher. The larger the implant, the greater the likelihood of complications.

A breast lift and new, round implants cost about € 7,200, – including hospital, anesthesia and all controls. The extra charge for anatomical implants is about € 750,-.

After breast augmentation with autologous fat, most of the fat cells grow. After 3-6 months the final result is visible. Through sports or weight loss fat cells can become smaller, but do not disappear.

We advise to wait 6, better even 12 months after weaning for breast surgery. Especially an increased risk of infection due to the active mammary glands can become a problem.

Breast implants do not have an expiration date. I think you may have to think about changing them after 20-30 years. But with modern ultrasound you can check from the outside if the implants are intact. As often stated in the past, a change after 10 years is no longer necessary.

Yes in any case. In the tubular breast, the change in shape is in the foreground. An implant is only necessary if volume is also missing after the lift. It is this operation that leads to an enormous improvement in the quality of life.

Important: Apart from any checklist, listen to your gut feeling about the procedure and the attending surgeon.
Why Dr. Bartsch?

We always say: “your gut feeling must be right”. Let your instinct be your guide. But there are also a few hard facts that can make a possible decision easier for you:

  • Experience: more than 1,000 breast procedures in the last 10 years
  • Safety: thanks to a professional team, anaesthesia outpatient clinic and a specialised clinic
  • Accessibility: Dr. Rolf Bartsch can be reached 24 hours a day by messenger at +4369911222000
  • Technology: surgery planning using 3D scan
  • Innovation: Dr. Bartsch is a trainer for breast surgery at the European College of Aesthetic Medicine & Surgery and a speaker at international congresses.