Plastic surgery for breast reduction. Breast reduction surgery - everything you need to know about it

The operation involves preliminary selection of a breast reduction method and marking. The duration of the operation depends on the method and takes on average from one to three hours. In general cases, operations are performed using general anesthesia. Local anesthesia can only be used in exceptional cases.

The choice of anesthesia or anesthesia depends on the chosen method of surgery.

There are the following types of breast reduction surgeries:

• standard breast reduction;
• vertical mammoplasty;
• breast reduction with nipple transplantation;
• breast liposuction.

Procedure process

Preparation

Before the procedure, the patient must:

• consult a doctor;
• undergo a medical examination;
• pass the necessary tests (blood test, ECG).

In general, the patient undergoes a consultation with an anesthesiologist and mammologist. Immediately before the operation, you need to stop smoking, drinking alcoholic beverages and taking medications.

Plastic surgery procedure for breast reduction

A standard breast reduction is performed using three incisions (anchor shape). The doctor removes excess tissue and lifts the nipple area. Vertical mammoplasty involves 2 incisions (lollipop shape) through which the excess is removed. After such an operation, the patient may experience glandular tissue accumulation under the breast. In this case, another corrective operation is necessary. Breast reduction with nipple grafting requires the nipples to be transferred to new glandular tissue. This method is unsafe for the patient's health. Most often, after the operation, significant scars remain, the nipple loses its color and shape. Partial or complete loss of sensitivity is also possible. Breast liposuction is not suitable for all patients. If your breasts are very saggy and have an irregular shape, the procedure will not help. During surgery, fat cells are removed using any method: ultrasound, vacuum or laser. Vacuum (classical) liposuction is considered the safest and most suitable. After the operation, small scars remain, which disappear after several months.

The choice of liposuction as a means of breast reduction must be approved by a physician.

Rehabilitation course

Reducing breast size requires wearing compression garments. It must be worn for at least 3 weeks. Discontinuation of the use of such underwear must be carried out with the permission of the attending physician. Lingerie perfectly helps to fix the breasts and contributes to the formation of the correct shape. In the first days after the operation, the patient experiences slight pain, which is relieved with painkillers prescribed by the doctor. It is prohibited to take warm baths, as well as visiting baths, saunas, and gyms. For a year after surgery, you can sunbathe only if the stitches are covered.

Indications

Breast reduction surgery can be performed on patients who have:

• problems with breast elasticity and sagging;
• too large breasts;
• ugly breast shape.

Also, such an operation is resorted to by those who:

• experiences discomfort;
• suffers from severe diaper rash and irritation under the breasts;
• wants to get rid of pectoral stretch marks (stretch marks);
• limited in movement due to weight and breast size.

Contraindications

Breast reduction should not be performed on patients who have:

• cardiovascular, immune and chronic diseases;
• diabetes;
• diseases of the endocrine system and blood;
• weight problems and disorders.

The operation is also contraindicated for nulliparous and pregnant women and nursing mothers.

Complications

Breast reduction surgery can lead to the following complications:

• the appearance of bleeding or inflammation at the suture sites;
• development of skin necrosis;
• loss of nipple sensitivity or ability to lactate;
• breast asymmetry.

Severe complications can occur in smoking patients and older women.

Prices and clinics

Breast reduction surgery is performed by a plastic surgeon at a plastic surgery clinic.

Large breasts are often the envy of others, but for the owner of this “wealth” it often means health problems, discomfort, and problems with choosing clothes. In addition, the shape of large breasts is not always ideal.

Breast reduction (or reduction mammoplasty) is largely a health-improving operation, and, of course, an aesthetic one.

There are several methods of reduction mammoplasty. The choice in favor of using one or another method of breast reduction is made depending on the individual characteristics of the patient and the experience of the plastic surgeon.

Breast reduction surgery involves removing excess breast tissue, excision of excess skin, shaping a new breast shape, and repositioning the areola and nipple. On average, the volume of tissue removed is 400-600 g (from each breast). The final volume of breast tissue to be removed can only be determined during an examination during a face-to-face consultation, taking into account the patient’s wishes about the desired breast volume.

Operation

Breast reduction surgery is performed under general anesthesia (intravenous or endotracheal). Depending on the complexity, the operation lasts 2 - 3 hours.

After the operation, the patient remains in the hospital for 1-3 days, under the supervision of a doctor.

The first month after breast reduction, wearing compression garments is recommended. During the rehabilitation period, you should follow all the instructions of your plastic surgeon, including taking medications.

Most often, the appearance of the breasts in the early postoperative period is not aesthetically attractive, but this is not a reason for grief. It will take time for the breasts to return to normal. Over time, the scars smooth out and become less noticeable, and the breasts acquire a more beautiful shape.

The final result is assessed 6-8 months after surgery.

Result

The postoperative result of breast reduction is usually better in young women, because their mammary glands are more elastic and dense, and the volume of resection is significantly less than in older women, who have much more adipose tissue than glandular tissue.

The result of the operation is permanent. In the long-term postoperative period, most patients note that the result is excellent or satisfactory. It should be borne in mind that all people are subject to natural aging, regardless of the fact of performing any corrective surgery. All other things being equal, breasts after surgery will eventually look more aesthetically attractive than the same breasts without surgical correction.

Contrary to popular belief, not all women want breast enlargement. There are those who want to reduce it.

This is not always connected only with the aesthetic side of the issue; often changing the size of the breast is necessary for medical reasons.

Breast reduction surgery. called reduction mammoplasty.

A little history

• In 1905, the method of discoid resection of the base of the mammary gland was used.
• In 1922, a method with free movement of the nipple-areolar complex was described, which is successfully used to this day. Before this, surgeons often had to remove the nipple because they could not maintain blood circulation in the area.
• In 1960, a method was proposed for the formation of a dermal stalk, which provided nutrition to the nipple-areolar complex. In this way, two problems characteristic of the free movement of the nipple and areola were solved: cutting off nerve fibers, which led to impaired sensitivity in this area, and damage to the milk ducts.

Reduction mammoplasty can eliminate the following disadvantages:

• breast ptosis,
• asymmetry of the mammary glands,
• hypertrophy of the mammary glands.

Hypertrophy (excessive development) of the mammary gland is the main indication for reduction mammoplasty. A pronounced form of hypertrophy is gigantomastia.

Breast hypertrophy causes the following problems in women:

• pathological disorders of the skin caused by the large size of the mammary glands (diaper rash, marks from bra straps);
• pain in the spine;
• development of osteochondrosis;
• labored breathing;
• slouch;
• psychological complexes;
• everyday problems: it is difficult to choose clothes and underwear.

The main causes of mammary hypertrophy:

• Puberty period. The mechanism of its occurrence is not fully understood.
• Disturbances in the endocrine system.
• Pregnancy.
• Obesity.

Reduction mammoplasty methods

With a T-shaped (anchor) cut

This is a classic method in which the incision extends from the nipple downwards and connects to the inframammary incision. Used to eliminate significant amounts of breast tissue.

With vertical cut

With slight prolapse of the mammary glands and unexpressed volumes, a vertical technique can be performed. The incision goes from the nipple to the inframammary groove; the central part of the gland, consisting of skin and glandular tissue, is resected.

In the early postoperative period, such a gland has a convex upper slope and a flat lower one. After about 4-6 months, the gland takes on its final shape.

How is the operation performed?

Reduction mammoplasty is a rather complex operation, so it is performed under general anesthesia for 1.5-4 hours.

The main stages of the operation were formulated in 1928:

• Resection of excess breast tissue
• Relocation of the nipple-areolar complex
• Excision of excess skin tissue covering the mammary gland

Attention!

In case of gigantomastia, if it is necessary to remove more than 1 kg of breast tissue or if the position of the nipple on the surface of the chest does not allow the creation of a nourishing dermal pedicle, only the technique of free movement of the nipple-areolar complex is necessary

What you need to know about the operation

Rehabilitation period

• Within 3-5 days swelling persists.
• In a week bruises persist.
• In 10-13 days the stitches are removed.
• Within a month You must wear a compression bra.
• Within a month Physical activity, visiting the bathhouse, sauna, and solarium are prohibited.
• The final effect will be visible in 2-3 months after operation.

Complications

• Hematomas.
• Suppuration of the wound.
• Dehiscence of wound edges.
• Necrosis of skin/fat tissue.
• Necrosis of the areola and nipple.
• Pronounced scars.
• Impaired sensitivity of the areola and nipple.
• Deformation of the mammary glands, nipple or areola

To reduce the risk of complications, you must follow your doctor's recommendations.

Attention!

• Breast reduction often leads to damage to the milk ducts, which may interfere with breastfeeding. For this reason, reduction plastic surgery is recommended after children are born.
• It is impossible to achieve 100% symmetry of the mammary glands.

Breast reduction, or reduction mammoplasty, is a surgical procedure performed to reduce the size and correct the shape of the mammary glands. This technique allows you to improve the overall appearance of the female body and get rid of physical discomfort and complexes associated with an overly large and disproportionate bust.

Which breasts are considered large?

To date, there is no accurate diagnosis of normal breast size, since in many cases the size and volume of the bust depend on the individual characteristics and age of the patient. But there is a classification of mammary gland parameters to identify hypertrophy:

• Norm. Breast volume is 275-300 cubic centimeters.
• Slight hypertrophy. Breast volume is 400-600 cubic centimeters.
• Marked hypertrophy. Breast volume is 600-800 cubic centimeters.
• High degree hypertrophy. Breast volume is 800-1000 cubic centimeters.
• . Breast volume is 1000-1500 (or more) cubic centimeters.

Indications for reduction mammoplasty

• age over 18 years (ideally from 25 years, when breast formation and growth is completed);
• constant problems when purchasing new clothes of the required size;
• the presence of emotional problems and complexes due to too large a bust;
• absence of serious diseases (especially in the acute stage), absence of contraindications to surgical intervention;
• sufficient elasticity of the breast skin (so that the bust quickly comes into shape after surgery;
• pain in the neck, shoulders, back, skin irritation in the area of ​​the inframammary folds;
• difficulty breathing, a constant feeling of heaviness in the chest, the presence of grooves on the shoulders from pressing bra straps;
• poor posture, numbness in the chest/upper chest due to excess weight of the mammary glands;
• moral stability and readiness for plastic surgery and the rehabilitation period, absence of mental disorders and pathologies;
• the feasibility of performing a bust reduction operation (when mammary gland hypertrophy is actually diagnosed, requiring correction);
• lack of plans for a new pregnancy (and breastfeeding period) in the future, as they may negatively affect the results of the intervention.

In some cases, women decide to undergo reduction mammoplasty, knowing that they are planning to have a child later (and that this can lead to unforeseen complications and minimize the effectiveness of the operation). If you are planning a pregnancy in the future, you should consult a plastic surgeon about this issue.

Contraindications for reduction mammoplasty

• age under 18 years;
• period of pregnancy and lactation, planning pregnancy in the near future;
• the presence of breast diseases, infectious pathologies, diseases of internal organs (especially the endocrine system);
• slow and difficult wound healing;
• smoking;
• obesity in an advanced stage;
• impaired blood clotting;
• mental illness, emotional instability,
• diabetes;
• the presence of cancer and neoplasms (including breast).

Benefits of breast reduction surgery

• harmonization of the figure by improving the proportionality of the bust in relation to the body, increasing breast elasticity;
• eliminating problems associated with the difficulty of choosing suitable clothing;
• increasing self-confidence, eliminating inferiority complexes and physical discomfort;
• reduction of pain and feeling of heaviness in the shoulders and spine, easier breathing and movement due to the reduced weight and size of the mammary glands.

Disadvantages of breast reduction surgery

• decreased sensitivity of some skin areas (including areolas/nipples);
• the appearance of minor changes in the uniformity of the breasts and nipples;
• the possibility of problems with breastfeeding.

The above-mentioned disadvantages of reduction mammoplasty do not arise in every case, but it is worth preparing for them in advance and assessing the feasibility of the operation for each individual patient. Before the intervention, you should consult with a plastic surgeon, who will take into account all the individual characteristics of the woman and assess the need for plastic surgery.

Preparatory period before surgery

Before breast reduction surgery, the patient visits a plastic surgeon for a consultation. He will answer all questions, make sure there are indications and no contraindications for reduction mammoplasty, and prescribe a chest x-ray, mammography and electrocardiogram as part of the examination of the woman’s health.

The doctor may give recommendations for lifestyle changes that must be followed. This allows you to achieve the most favorable outcome of the intervention and minimize the likelihood of any complications, facilitating the rehabilitation period. Before surgery, you should adhere to a number of rules:

• refusal to take blood thinning medications (aspirin and medications based on it), some anti-inflammatory drugs;
• quit smoking at least 1.5 months before surgery for quick and high-quality postoperative recovery of the body/wound healing;
• timely replenishment of water balance in the body before and after surgery in order to facilitate rehabilitation and prevent the occurrence of negative consequences;
• refusal to consume alcoholic beverages for the period specified by the doctor;
• normalization of the diet (consumption of foods high in protein, fresh vegetables and fruits, lean meats and fish, cereals, drinking clean water, green tea and other caffeine-free drinks, avoiding salty, fried, fatty foods);
• advance placement of all necessary items and things, household appliances and other devices in easily accessible places, otherwise it will be difficult to use them due to the patient’s limited mobility after reduction mammoplasty;
• preparing the patient’s resting place after surgery (place everything you need near the bed in advance: books, control panels, headphones, books, films, magazines, and so on);
• completing all important tasks and obligations in advance before the operation begins (during the recovery period, the patient will not be able to return to them for the first 15 days; if the woman has children, it is necessary to decide who will look after them);
• rest and sleep lying in an inclined position (at an angle of 25-45°), for this you can use folding chairs and wedge-shaped pillows;
• refusal to visit the sauna, steam bath, hot shower and bath in the first 15-20 days;
• preparing shoes and clothing that are easy to put on and take off (without complex lacing, locks and fasteners).

Reduction mammoplasty in most cases is performed on an outpatient basis, so it is worth agreeing in advance with relatives or friends who will take the operated patient home, help her sit in bed and stay overnight.

How is reduction mammoplasty performed?

Breast reduction is a complex of surgical procedures that involves a number of external changes. In many cases, mastopexy is performed (an operation to lift the bust, change the shape and appearance of the mammary glands by moving the areolas and nipples upward). On average, breast reduction surgery takes no more than 3 hours.

Reduction mammoplasty is performed sequentially and involves the following stages:

1. photographing and taking measurements of the patient’s breasts (this will help evaluate the changes and results obtained from the operation);
2. creation of special markings using a marker for the correct application of incisions, sterilization of the mammary glands before intervention;
3. administration of anesthesia (endotracheal/intravenous general anesthesia);
4. making vertical/perpendicular incisions (their size and location are determined by the doctor based on the volume of excess tissue and the shape of the patient’s breast);
5. applying self-absorbing sutures to minimize or completely disappear incision lines, installing drainage to drain excess fluid and blood, covering the sutures with a gauze bandage.

To minimize the risk of postoperative scars, the patient can be referred for hardware procedures.

The effectiveness of the procedure (bust reduction and tightening) is noticeable immediately after its completion. To maintain the results obtained, wearing a compression bra is required.

Immediately after surgery

Immediately after completion of the intervention, the doctor gives the patient and the assistant accompanying her detailed instructions on how to care for the surgical area during the rehabilitation period, informs about the intricacies of using drainage tubes, reports on the expected sensations and possible symptoms, and talks about the signs of possible complications.

The patient may experience confusion and nausea immediately after surgery performed under general anesthesia. The doctor puts surgical bandages and special compression sleeves on the operated woman (for normal blood circulation). There will be drainage tubes in each of the mammary glands. If the patient is experiencing severe postoperative pain, painkillers may be prescribed.

For several hours after the operation, the patient remains in an inpatient setting under the supervision of medical personnel. If no unforeseen difficulties arise, the woman can go home accompanied by a relative or friend. Before this, a medical professional will show you how to properly care for the sutures and change the drainage.

Pain during the first days after surgery is normal. If it lasts for too long a period, you should seek help from your plastic surgeon.

Changes in the parameters and appearance of the mammary glands become obvious immediately after all manipulations, but within several weeks (sometimes months) there will be pronounced swelling of the soft breast tissue. If skin redness or acute pain occurs during the recovery period, medical attention is necessary.

Rehabilitation period after surgery

During the recovery period after surgery, you must follow all medical instructions and recommendations. The plastic surgeon must warn the patient in advance about all possible signs of postoperative complications and negative consequences. The final duration of rehabilitation cannot be determined in advance, since much depends on the individual characteristics of the woman’s body.

During the rehabilitation period, it is worth preparing for a number of circumstances and necessary actions:

Drainage care. The patient wears tubes to drain blood and other fluids until they are removed, which usually occurs at the first visit to the doctor (during the first week).

Caring for seams. The doctor informs the patient about the rules for caring for the incision sites. The seams must remain dry. Contact with liquids or cosmetics/detergents can lead to difficult wound healing and infection. Removal of sutures, if rehabilitation proceeds normally, occurs 1.5 weeks after surgery.

Regularly measuring body temperature. This is necessary to monitor the condition of the body and timely detection/elimination of wound infection.

Soreness. In the first days after surgery, the patient may feel severe pain, which will gradually become less pronounced. It is necessary to take all prescribed medications and follow all medical recommendations. The doctor can install a catheter to deliver painkillers to the wound area (this point should be clarified in advance with the surgeon individually).

Swelling. Surgical manipulations imply interference with the integrity of the tissues of a living organism, so it responds to them with the appearance of edema. Normally, swelling persists for 3-4 months, and at the end of this period it becomes barely noticeable. After surgical correction, the mammary glands will decrease in size and take on a new shape, so swelling is not noticeable in every case. If the problem persists for a long time, moderate activity and drinking plenty of fluids are recommended.

Hematomas. Their appearance depends on the technique of performing the intervention and the individual characteristics of the patient’s body. Other expected side effects include itching in the incision area, numbness/loss of sensation in the nipples, and hardening/swelling of one of the breasts. These symptoms gradually subside over a few weeks, but residual effects may persist for a couple of months.

Rest and sleep. During sleep or rest, you must maintain an inclined position. To do this, you can place soft pillows under your head and back, or use folding chairs. This helps to quickly cope with swelling and reduce the severity of pain. To maintain a supine position and avoid chest injury, you can use pillows placed on the sides of the body and under the knees.

Water treatments. Before the stitches are removed, the patient will have to replace hygiene procedures with wiping with a wet sponge. At this time, it is also forbidden to raise your hands above your head, so you will need the help of loved ones to wash your hair.

Physical activity. During the recovery period after reduction mammoplasty, doctors recommend that patients take regular walks in the fresh air to prevent thrombosis and minimize swelling. But intense physical activity and activity should be avoided in the first 20-30 days after surgical breast correction. It is necessary to refrain from lifting heavy objects and raising your arms above your head until your doctor removes these restrictions. The rehabilitation period should take place with comfort for the patient. In total, it will take from 1.5 to 2.5 months, depending on the health condition and individual characteristics of the woman. A return to increased sports loads and usual physical activity will occur in approximately 6 months.

Scarring. The type and visibility of scars depends on the type of incisions made by the surgeon. Some post-operative sutures will be hidden in the natural contours of the mammary glands. Of course, scars after incisions cannot be eliminated in a short time, but over time they become less noticeable and merge with the skin. Modern plastic surgery creates all the conditions and makes efforts to minimize this problem.

Possible complications after breast reduction

Like any surgical intervention, reduction mammoplasty is associated with a number of possible complications (including normal variants), negative consequences and side effects. In many cases, serious complications from this surgery are absent/rare.

The risk of any negative manifestations can be minimized by carefully choosing a responsible and qualified surgeon and following the rules of rehabilitation. But it is impossible to completely exclude the possibility of some complications:

• a negative reaction to pain relief, which often occurs when there are contraindications to the administration of general anesthesia;
• the appearance of hematomas, seromas (subcutaneous accumulation of biological fluid that requires removal);
• bleeding, wound infection resulting from improper application or care of sutures, penetration of pathogenic microorganisms into the sutures;
• deterioration of sensitivity, numbness of the chest that occurs due to the individual characteristics of the body (or as a result of negligent performance of medical work);
• the formation of noticeable scars, which occurs due to rough incisions, their infection with complications, and lack of scar care;

• allergic reactions arising due to the individual characteristics of the patient’s body;
• damage to the deep layers of soft tissue due to improperly performed intervention or non-compliance with the rules of the recovery period;
• unsatisfactory results of the operation, which require additional manipulations/re-correction;
• formation of blood clots in the lower extremities or lungs, requiring immediate medical attention.

The outcome of breast reduction surgery depends on both the quality of the doctor’s work and the patient’s actions after the operation. For reduction mammoplasty, contact only a highly qualified, trusted doctor and follow all recommendations.

Prices

The price of breast reduction surgery depends on the rating of the clinic, the qualifications and experience of the plastic surgeon, the complexity and volume of the planned work. Often the total amount includes all examinations necessary for reduction mammoplasty.

The minimum cost for surgical breast reduction in Russia and abroad is approximately 150,000 rubles, maximum cost – approx. 400,000 rubles.

Photos before and after

Liposuction as a method of breast reduction

Liposuction is an excellent option for women who have a large bust without ptosis (drooping) that needs correction. The essence of the procedure is to remove excess adipose tissue from areas of high content (in this case, the breast area).

Liposuction is suitable for patients who need breast reduction without loss of sensitivity and postoperative scars, but this technique will not eliminate sagging.

In the initial stages of menopause, the soft tissue of the mammary glands is transformed into fat, so the technique is often used to correct the bust of women after menopause.

Liposuction for breast reduction is not recommended for patients with minimal fat content and the presence of connective fibrous tissue in the mammary glands. The technique is contraindicated in cases of inelasticity of the skin, ptosis of the bust, and low localization of the nipples.

Liposuction can be used to reduce the bust by one size, especially if it is asymmetrical. After the procedure, it may be necessary to change the shape of the breast along its contour.

Exercises to help reduce breast size

Reducing very large breasts usually requires more radical methods than special gymnastics. But if you want to slightly adjust the volume, position and appearance of your bust, making it smaller, use the following exercises:

1. Raising arms to the sides. You need to lie on your back, take a dumbbell weighing a kilogram in each hand, then move your arms together and spread them to the side. At first, 2 sets of 10 repetitions are enough, gradually and without sudden transitions you can increase the load.
2. Push ups. Spread your arms as wide as possible, then perform up to 15 push-ups. If it’s a lot at once, do as much as you can, gradually increasing the number of actions.
3. Hand squeezing. Bring your palms together at chest level and squeeze them forcefully. After freezing in this position for a few seconds, exhale and relax. Repeats – up to 10-15 times.

Nutrition for breast reduction

All women have certain problem areas that are prone to the accumulation of fatty tissue due to a sedentary lifestyle, poor nutrition, pregnancy and other reasons. If you want to get rid of excess subcutaneous fat in problem areas, you should know that you lose weight only or the whole body at once, starting from the upper part, or weight loss does not occur at all, so it will not be possible to get rid of fat only in specific areas.

Diets are not the best option for losing weight if you want to stay healthy. They lead to disruption of metabolic processes and contribute to increased accumulation of fat in the body.

It is better to adhere to a balanced diet, which heals the entire body and significantly reduces all body parameters to normal. Follow the following dietary rules:

• refusal to consume too fatty and salty, fried foods, confectionery and bakery products (except whole grains), packaged juices (in favor of freshly squeezed fruit and vegetable juices), carbonated drinks, alcohol;
• introducing into the daily diet a large amount of vegetables and fruits, lean meats and fish (steamed, boiled, baked), fresh herbs;
• fractional meals (4-5 meals a day in small portions);
• consuming a sufficient volume of fluid (from a liter per day), drinking water when you feel hungry after a recent meal (a person may confuse hunger with thirst);
• control over consumed calories (you can use special applications on your phone or computer), proteins, fats and carbohydrates, use kitchen scales to weigh products and portions of food consumed;
• refusal to consume food shortly before bedtime (if necessary, a glass of kefir and an apple are allowed, but it is better to get by with just a glass of water).

Clothing for visual breast reduction

The correct selection of underwear and clothing allows you to emphasize the advantages of your figure while hiding its flaws. Here are some tips for breast reduction using clothing:

• Wearing a minimizing bra. Currently, there are special bras that are designed to visually reduce the bust by 1-2 sizes. They are usually equipped with comfortable wide straps and side corrective inserts. Suitable for very large breasts Minimizers with deeper cups.
• Avoid wearing single-button double-breasted jackets. Wearing jackets buttoned to the middle visually makes already large breasts even larger.
• Avoid wearing high-waisted dresses. Ladies with an impressive bust are recommended to wear dresses with a loose fit at the top. Avoid outfits that are tight around the chest; they will accentuate the problem area of ​​the chest.
• Avoid wearing tight bottoms. It is worth giving up tight jeans and trousers, pencil skirts in favor of bottoms with a looser cut.
• Avoid wearing tops with a square neckline or pronounced cleavage. Such blouses, sweaters, dresses place maximum emphasis on the chest (especially large ones). Choose loose-fitting clothes with minimal neckline.