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Too Big or Too Small?

October 30th, 2017

Eye Picasso-esque

During my 30 + years as a cosmetic plastic surgeon, one particular observation has proven to be true: Never guess why a patient has chosen to see you for a consultation. So whether it is the size or shape of someone’s nose or their breasts, desirable appearance is a personal choice and as they say, beauty is in the eye of the beholder. I believe that informed consent includes offering a patient their options and information about choices, allowing you to make the best decision for yourself. A strong physician/patient partnership is important in providing healthy expectations with a safe and speedy recovery. Are your breasts too big or too small, read on.

Breast surgery is one of the most common elective plastic surgery procedures, with almost 600,000 women choosing breast reduction, breast enlargement, or breast lift surgeries last year. Our readers find our patient guest blogs especially helpful to understand cosmetic surgery from a rather personal perspective. Michelle has been kind enough to write about her breast reduction surgery. Her candid diary includes reasons why she considered a breast reduction, and she writes about her experience from the 1st surgery consultation, concluding with recovery and reflections. We appreciate Michelle’s willingness to share her experience with us and we are pleased that she is happy with her decision. In case you missed Michelle’s series, here are all the links to her complete story.

Diary of Breast Reduction #1: Intro to My Story,  #2: Why I am Considering Surgery,  #3: My Pre-op Instructions,  #4: Day Before Surgery,  #5: My Surgery Day,  #6: My Recovery,  #7: My Reflections

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Breast Reduction: Ranks High in Patient Satisfaction

March 30th, 2015

breast reductionJust as some women may experience a decrease in breast size over time, some will notice an increase in breast size, others simply want a change. When a woman is uncomfortable with having too much breast tissue, there are several options to correct this condition. A  dramatic  increase in size may have resulted due to an increase in overall weight gain or a pronounced sagging of the breast tissue. As we’ve discussed in earlier posts, overly large breasts may cause physical discomfort, including  symptoms like neck pain, back pain, shoulder grooving and irritation beneath the breasts. Patients routinely turn  to breast reduction or breast lift surgery to reduce their symptoms, along with their breast size and or position. Patient satisfaction rates are particularly high for this cosmetic surgery. Reducing breast size can be done with direct surgical removal of breast tissue or by using liposuction. Liposuction is effective only when there is a significant amount of fat in the breasts. Liposuction does not adjust nipple position, which requires removing and re-positioning the nipple.

Traditional breast reduction surgery reduces breast size through excision of breast tissue, while repositioning the  nipple and areola (pigmented skin around the nipple). The size of the areola  can also be reduced. Breast reduction scars, which are similar to breast lift surgery, are placed around the nipple and beneath the breast as well. Scars will be less noticeable as they continue to heal. I recommend any breast tissue that is removed should be sent for examination by a pathologist. This laboratory examination includes a  visualization under a microscope after tissue  staining, to determine the presence of conditions or abnormalities which might increase chances of breast cancer. On rare  occasions, breast cancer is diagnosed this way.

Our patients choose of their desired final breast size, based on decisions made during our office consultation, unless insurance is being considered. A range of implant “sizers” are helpful in this regard. The appropriate time to schedule reduction surgery following pregnancy is determined by normal involution of breast tissue and the end to breast-feeding. Generally this takes six months to a year after delivery or three months after ending breast-feeding. There is a possibility that some women will not be able to breast feed again after breast reduction surgery. Therefore, if breast-feeding  is an important consideration, we advise our patients to postpone breast reduction surgery until they are finished having children. According to statistics provided by the American Society of Plastic Surgeons (ASPS), more than 120,000 patients have chosen breast reduction/ lift surgery last year.

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