(310) 275-4513 FacebookTwitterRSS BlogYouTubeGoogle Plus
Dr. Oz 20/20 ABC The Style Network Entertainment Tonight Extra The View Extra Discovery Health Channel E! News Live The Learning Channel BBC Women's Entertainment MTV

Dr. Linder's Blog


Category: Breast Reduction

Explantation & Breast Reduction With Lift

Pre-Op & Post-Op (day one)

Pre-Op & Post-Op (day one)

The female patient presented was looking to have her breast implants removed and wanting to improve her breast appearance without placing new implants. During her examination, she expressed she was hoping to have a breast lift and reduction. After discussing her expectations, we agreed to perform an explantation (implant removal), mammoplasty (reduction), and mastopexy (breast lift).

The video below shows the pre-op marking where I go over the implant removal, breast reduction, and a full breast lift (mastopexy)  using a wise pattern anchor approach.

During her surgery, I removed the high placed breast implants and performed a breast reduction (removing some tissue and skin to reshape and reduce the size of the breast) and a lift to bring the breasts to a higher and more youthful position.

The post-op (day one) photo shows a drain placed to help decompress the space around the pedicle that was created as well as wearing a Linder Bra to provide support after surgery.  The patient is happy, and she has achieved a nice shape and symmetrical balance.

To schedule your consultation with Dr. Linder and learn more about breast implant removal, breast reduction, or breast lift, call our office at (310) 275-4513 in Beverly Hills or fill out our online contact form today.


Male Breast Reduction Procedure

gynecomastiaI was presented a 23 year-old male who was self-conscious about the size of his breasts. During the consultation and examination we discussed how to remove the excessive glandular breast tissue and fat by performing gynecomastia surgery. The procedure was performed under general anesthesia supervised by a board-certified anesthesiologist.

The photo to the right shows three weeks post-op, and as you can see the enlarged breast has been reduced and are well balanced. The patient is extremely happy with his appearance and will continue to follow my postoperative instruction for a few more weeks (light actives can be resumed – no heavy lifting).

To schedule your consultation with Dr. Linder or learn more about gynecomastia surgery or male breast reduction, call our office at 310-275-4513 or fill out our online contact form today.





Breast asymmetry can be associated with normally congenital, developmental or even traumatic or associated with breast cancer which may require breast reconstructive surgery causing breast asymmetry. Breast asymmetry is associated with one breast looking larger or smaller than the other. It can also be associated with one breast being saggier or having more ptosis than the other side. Correcting breast asymmetry can be very difficult, if not impossible. The correction of breast asymmetry may require creative thought, which may include different surgical procedures on one or both breasts in order to create similarities.

Technique #1: Using implants of different sizes to create symmetric breasts. This is most often associated with breast when the nipple areolar complex is above the fold and there is no degree of sagginess (ptosis).


Technique #2: Performing a breast reduction on a larger breast and simply a breast lift on the contralateral breast if both show sagginess, but one breast is significantly larger than the other.


Technique #3: Placing an implant on one breast and/or an implant and a lift on the other breast if the contralateral breast has a degree of sagginess or ptosis.



Technique #4: A breast reduction or lift on one breast alone to even it out with the left breast if the left breast shows no degree of sagginess and similar sizes in volumes can be created with a lift and implant on contralateral side.

Technique #5: A culmination of these multople procedures including breast lifts on both sides with different size implants if there is asymmetry of volume and/or both breasts show a significant degree of sagginess with a nipple areolar complex which may be below the inframammary fold grade III ptoris.

Double H Breast Reduction Procedure

Pre-OP & 6-Month Post OP Photos

Pre-OP & 6-Month Post OP Photos

One of the most rewarding procedures that I perform in my Beverly Hills practice is Breast Reduction or Reduction Mammoplasty. This is a procedure to remove excess breast fat, glandular tissue, and skin to achieve a breast size that is in better proportion with a woman’s body. It also alleviates the discomfort associated with overly large breasts and allows women to feel better.

I evaluated a 52-year-old female a few months ago who had breast hypertrophy (enlargement of breast tissue) and desired to have a breast reduction. Like many women with overly large breasts, she was having neck, back, and shoulder pain and was unhappy with their appearance. After listening to her expectations and agreeing on our approach, we set a date for surgery.

During her breast reduction surgery, I removed well over 1,000 grams of breast tissue from each breast and performed a formal mastopexy using a wise-pattern technique. The frontal and oblique view of the post-op photo is six months out, and she has gone from a 42 HH to a 42 DD. She is extremely happy with the outcome and is so excited to be able to wear a size large sports bra.

To schedule your consultation with Dr. Linder or learn more about breast reduction surgery, call our office at 310-275-4513 or fill out our online contact form today.





Downsizing & Breast Reduction Surgery

I evaluated a 29-year-old female who, after a previous breast augmentation in Mexico, was looking to improve the appearance of her breasts. During her consultation and examination, she expressed that she was hoping to correct the asymmetry of her breasts and the size of her nipples as well as downsize their overall shape. After listening to her desires and agreeing on the expectation, we scheduled her for breast revision surgery.

During her surgery, I removed the breast implants from the previous surgery and discovered that they were CUI silicone implants, which are not available in the United States. After I removed the CUI implants, I performed a breast reduction (mammoplasty), nipple reduction (areola reduction), and breast augmentation using 350 cc high-profile saline implants.

As you can see from the four-week post-op photo, the revision surgery has achieved a nice symmetrical balance , well-defined cleavage, smaller nipples, and a slightly smaller overall size.

To schedule your consultation with Dr. Linder and learn more about breast revision or breast reduction surgery, call our office at (310) 275-4513 in Beverly Hills or fill out our online contact form today.







Areolar Reduction


Areolar Reduction Before and After PhotoPatients who undergo both formal mastopexies as well as breast reduction procedures usually will have a reduction in the areolar size. In general, areolas are made between 3.8 and 4.4 cm in size. I prefer to make them approximately 4.2 cm or 42 mm.

We have what are referred to as cookie cutter patterns in the three sizes, 38, 42, 44 to 46 mm. I use 4.2 cm cookie cutter patterns on both my breast lifts and breast reduction procedures in the majority of cases. The areolar reduction is considered a part of a breast reduction or breast lift procedure if the areolar is enlarged. Areola enlargement can be seen as large as 8 to 10 cm on large women’s breasts who undergo large reduction mammoplasties or women who have had significant stretching of the breast tissue after breast feeding or postpartum. As a result, the areolar reduction can be made with skin removed in a circumferential fashion around the areola.

Areolar Reduction Techniques

Different techniques can be performed, including the round block or Benelli technique, which is simply an areolar reduction with skin removed circumferentially as in a donut mastopexy. This, however, has significant problems with stretching of the scars, widespread scars and pin cushioning which can look very, very poor. Scarring, in other words, can be very poor with the Benelli lift. As a result, I prefer not to use this approach whenever possible. A vertical mastopexy can be performed where skin is removed along the vertical plane and around the areola which will reduce the tension around the nipple areolar complex, bringing it below the 6 o’clock position of the areolar down along the vertical or midline plane of the breast. This helps to dissipate tension from the areolar scar and the results I have found to be much better in general.

Finally, a formal mastopexy using the inferior pedicle Wise-pattern technique can be performed in an anchor scar-like fashion, where the skin is removed again around the areola vertically and along the inframammary fold. This greatly reduces scarring, stretching and tension along the nipple areolar complex and has led to beautiful scarring around the nipple areolar complex.

In our practice we use Kelo-cote once the sutures are removed, usually on day 14 to 17. The Kelo-cote silicone gel spray or cream can be used twice a day for three to six months which greatly reduces scarring, spreading, hyperpigmentation and telangiectasias and blood vessels within the scar.

Natural Breast Reduction

dr-linderWhat is a natural breast reduction? In my opinion, a natural breast reduction is breast reduction performed using native breast tissue, reducing the size of the breast by removing tissue centrally and along the medial and lateral aspects of the breast, repositioning the inferior pedicle without placement of an implant. In general, patients who desire to have combination breast reduction with augmentation will get more of a rounding shape to the upper pole of the breast and an excellent result as well. However, the more natural breast reduction is simply using native breast tissue.

A natural breast reduction in Dr. Linder’s practice is performed using the inferior pedicle Wise-pattern technique (Dr. Linder’s preferred technique). Tissue is removed from the superior portion of the inferior pedicle as well as from the medial and lateral aspects of the breasts. I like to remove more tissue laterally as well as liposuction the lateral breast to debulk the breast and narrow it while taking less tissue from the medial portion of the breast in order to increase cleavage and allow for a more natural parasternal angle.

Natural breast reduction surgery simply means using the natural tissue of the breast to recreate upper pole fullness. By keeping the inferior pedicle or the base of the pedicle bulky, 10 cm or more, we are able to allow for a more central increase fill volume of the breast by allowing more of the tissue that remains to be repositioned superiorly centrally which allows for almost the appearance of a breast enhancement without the use of an implant.

For more information regarding breast reduction or to set up a consultation with Dr. Linder  call us at 310-275-4513 or contact us by email.


The effects on the nipple from breast augmentationbreast revisionbreast lift and breast reduction can be significant. They can include loss or gain of increased sensitivity to the nipple areolar complex. The nerve supply is the 4th lateral intercostal nerve that supplies the nipple areolar complex coming from the side of the chest around the muscle, the peck major, and underneath the nipple. If this is damaged, you could have obvious complete loss of the nipple sensitivity.

Sensitivity is associated with preservation of that nerve. This nerve can be stretched with neurapraxia or cut completely or blunt traumatically torn during lateral dissection of a breast augmentation procedure with either saline or silicone implants.


The loss of sensitivity ranges throughout the United States somewhere between 4 and 5 percent, by reports, for breast augmentation. The number greatly increases with breast lifts and breast reductions which can reach up to 10 to 14 percent. Hypersensitivity can also occur to the nipple areolar complex with new neuronal regrowth of nerves underneath the periareolar incision which could lead to hypersensitivity.

In general, after eight weeks usually the sensitivity returns to a normal state as baseline preoperative. However, it can take 12 to 18 months for complete sensitivity to return or at least partial. Breastfeeding can also be lost with all three procedures and again similarly the numbers increase as you go from breast augmentation to breast reduction.

Any patients who will undergo a breast implant, breast lift or breast reduction, must be cognizant of the fact that they may certainly lose sensitivity and/or the ability to breast feed or lactate. Certainly, the technical skill of the surgeon being Board Certified with the American Board of Plastic Surgery should reduce the incidence of these deleterious effects.

Male breast reduction

Over the past year, I have seen an increase in the procedure gynecomastia. Gynecomastia surgery is a procedure to reduce enlarged male breasts. I believe the stigma for cosmetic surgery for men has disappeared, and men are excited to correct the size and shape of their breasts.

male breast reduction To the left is an example of a  25-year-old male patient that I performed gynecomastia surgery on about 3 months ago. The patient is very happy with the results, and his confidence is extremely high.

For men who feel self-conscious about their over  sized breasts, this procedure can help restore self-confidence and appearance. For more information, contact our office at 310-275-4513 or fill out our online contact form.


Reasons for Breast Reduction Surgery

Breast Reduction Beverly HIllsI am presented weekly in my Beverly Hills practice patients that are considering breast reduction surgery.  Most of these women are experiencing a range of physical issues due to overly large breasts, including:

Back Pain: when breast are excessively large, pulling forward on the woman’s body puts tension on her back muscles

Neck Pain: weight of the breasts affects a woman’s posture by pulling her shoulders and chest forward

Headaches: large breasts can lead to pain in the back of the head, known a occipital headaches

Rashes: skin folds of the breasts that rub together can cause a rash known as intertriginousdermatitis

Breast reduction surgery eliminates excess breast tissue and skin to reduce the size of the breasts and can alleviate many of these concerns. For a consultation regarding breast reduction surgery give us a call at (310) 275-4513