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Breast reduction

Breast reduction in Munich and Starnberg with PD Dr. Max Geishauser

Less scars. More sensitivity. The nicer breast

Are you suffering from large breasts and would like to have a breast reduction? Let private lecturer Dr. Max Geishauser advise you.

If the volume of the breasts is too large in relation to the body, this can be associated with considerable physical impairments for the affected woman, such as back, head and neck pain, through to posture problems and even skeletal deformities. In this case, a surgical procedure to reduce the size of the breasts is often medically indicated, for example, if the enlargement of the mammary gland is outside the norm (macromastia) or if the weight of the breast has an unfavourable effect on the body statics and therefore causes discomfort.

Reasons for breast reduction

Aesthetic considerations are rarely the only reason why women decide to have breast reduction surgery. Aesthetic aspects nevertheless play a large and increasing role in surgical breast reduction. The focus is on an attractive shape, but also more and more on the avoidance of externally visible scars.

Nowadays, the aim should be to achieve a beautiful breast shape with few visible scars.

PD Dr. Max Geishauser is one of the pioneers of scar-saving breast reduction and nerve-preserving surgical methods for better preservation of the feeling in the breast.

If the breast is too big, too heavy, sagging…

Then this can be a great burden for affected women. If the volume and weight of the breasts is too large in relation to the body, this leads to considerable physical impairments such as back, head and neck pain, through to postural defects and even skeletal deformities.

We have the longest experience in breast reduction in Munich

PD Dr. Max Geishauser is one of the pioneers of breast surgery with few scars. And with preservation of the nerves and targeted preservation of the feeling in the breast.

Breast shaping according to the wishes of his patients. With time-giving discussions, attention to individual needs and the scar-free operation.

Relief from the burden of the breast – to a well-shaped breast

Aesthetic considerations alone are rarely the reason why women decide to have breast reduction surgery. Aesthetic aspects nevertheless play a major role in surgical breast reduction. The focus is on an attractive shape, but also more and more on the avoidance of externally visible scars.

While it was common for a long time that an aesthetic shape and the preservation of the function of the breast was only achieved by accepting longer scars, patients in Mediterranean countries and in South America attached just as much importance to the avoidance of visible scars.


Reasons for the operation – breast reduction in Munich

Breasts that are too large can lead to poor posture and orthopaedic problems in the area of the cervical and thoracic spine due to the increased weight load. The sagging of the breasts can also lead to skin changes. In addition, there is almost always a considerable psychological burden on the women affected. In addition, asymmetries of the breasts can be corrected or a large breast can be adapted to the smaller breast on the opposite side after breast reconstruction.

The aim of surgical breast reduction is therefore to achieve a weight and volume adjustment of the breast. The ability to breastfeed, the sensitivity and the motor function of the nipple should be preserved. In addition, an aesthetically pleasing shape should be achieved and the externally visible scars minimised. A modern surgical method must therefore take into account anatomical and physiological conditions and allow for a safe and predictable aesthetic result.

We have been using the technique of breast reduction with a vertical scar since 1995. The surgical techniques described by Marchac and Lejour have been further developed, especially with the techniques of liposuction described by Ilouz and the principles of nerve preservation developed by Wühringer.

What do our patients say about breast reduction surgery?


Principles of the technique

The incision is usually made around the areola and then vertically downwards to the inframammary fold (I or vertical incision technique). In the case of very large, particularly soft or very pendulous breasts, an additional horizontal incision (T or anchor incision) is made. In total, up to 30 different techniques can be used for breast reduction – depending on the shape of the chest and the desired reduction effect.

In contrast to the methods propagated since the beginning of the 1960s, the breast is not shaped with the skin mantle, but the breast tissue is shaped directly. The skin is prepared in the lower quadrants of the breast in a similar way to a facelift and can thus adapt to the underlying shape.

This allows the skin to be relieved of pressure and to continuously adapt to the new breast shape.

The “inverted T incision” or “anchor scar” often used in the past for breast reduction because of the shape of the scar results in a long scar running under the breast, which often becomes thickened and thus conspicuous especially in the highly visible areas.

Techniques that avoid scars as much as possible have been known for a long time in breast reduction: The vertical scar technique described by Dartigues in France in 1925 was further developed by Arie and was widely used, especially in South America. However, these techniques were only applicable for small resection volumes. It was only with the modern surgical procedures that were refined and propagated between 1970 and 1989 that scar-saving surgical techniques became applicable to the reduction of larger breast volumes.

Combination with liposuction of the breast

We often perform the combination of the vertical breast reduction technique with liposuction. Not in the décolleté, as here there is a reduction in volume in the upper parts of the breast. Here, volume replacement with micro-fat grafting is more commonly performed.

However, we often use liposuction to shape the breast and the lateral breast extensions on the ribcage and in the armpit, as volume can be a problem here.

The “inner bra” only brings short-term advantages – in the long term rather disadvantages

Often propagated, the surgical technique with the formation of a separate “inner bra” initially brings advantages. The breast appears firmer. In the long term, however, it does not improve the shape. And unfortunately, the “inner bra” often remains unpleasantly palpable.

We would be happy to explain the principles and our experience to you personally in a consultation.

Possible complications

Due to our procedure, which is particularly gentle on the breast structure, complications have become rare.

The sensation of the breast, the sensitivity and the mobility of the nipple (“nipple motor function”) can usually be well preserved. This is especially true for the ability to breastfeed. Blood circulation to the nipple seems to be better than with conventional procedures.

Advantages – Breast reduction in Munich

With the scarless breast reduction, anatomical and physiological conditions of the female breast are taken into account. The main axes of blood supply to the breast, especially to the nipple complex, remain undisturbed. For this reason, this technique can also be considered very safe. For the same reason, the sensitivity, the contractility of the nipple and the ability to breastfeed are preserved to a very high percentage.

In addition, with the correct indication and careful planning and surgery, a beautiful shape is achievable, with only a few fine scars.


This technique requires experience in breast surgery. The number of necessary follow-up corrections can be minimised. An aesthetic breast shape is only achieved 2-3 weeks after the operation. This must be discussed with the patient before the operation, but is then well accepted, especially as there is still a certain amount of tissue swelling during this time and the removal of the sutures also falls within this period.

Brief overview Description
Initial consultation 30 – 60 minutes
Surgical preparation Surgical capability (general practitioner – internist)
Outpatient/inpatient according to localisation and quantity Outpatient or briefly inpatient
Type of anaesthesia Regional anaesthesia, depending on localisation and amount also general anaesthesia
OP duration  30 minutes to 2.5 hours
Bandage change after 7-10 days
Bra no bra, just top, no “Stuttgart belt”!
Controls in the practice  after 1 week, 4 weeks, 3 months
Sport immediately after localisation and quantity
Social activities  usually hardly restricted in small amounts, otherwise restricted for a few days
Incapacity for work 1 – 6 weeks depending on the extent of the operation and activity

Summary – Breast reduction in Munich

A new technique only gains acceptance if it offers significant advantages. However, this means that the known standards are met or surpassed.

Breast reduction with a vertical scar leads to an equally good breast shape as the known procedures with inverted T-shaped scars if the indication and technique are correct. The visible advantage is the avoidance of scars. In addition, the more anatomical resection shape, especially in the area of the nipple, has improved blood circulation and thus increased the safety and reliability of the operation.

In its increased complexity compared to the previous standard procedures, this method requires increased experience in breast surgery in order to lead to consistently good results. However, due to its great advantages, it has become widely accepted in a very short time.

Less scars. More sensitivity. The nicer breast

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