Reasons for Breast Reduction Surgery
I am presented weekly in my Beverly Hills practice with patients who 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: The 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 intertriginous dermatitis.
Breast reduction surgery eliminates excess breast tissue and skin to reduce the size of the breasts and can alleviate many of these concerns. Below are two case studies:
Case Study 1
Using Inferior Pedicle Wise-Pattern Technique
The patient example shows a woman with 40GG breasts, presenting with significant symptomatology of breast hypertrophy and gigantomastia, including neck pain, grooving along the shoulder blades, rashes under the breasts and massive pendulous breasts with inability to wear normal brassieres. The patient’s frontal and oblique views are notable.
The patient was brought to the operating room and after administering general anesthesia via laryngeal mask airway, the chest was prepped with Betadine solution. The de-epithelialization of the base pedicle was maintained with a 10-to 12-cm base along the inframammary fold to the pedicle to maintain vascularity. The next photograph shows the inferior pedicle with excellent blood supply. It’s a bipedicle flap with only a small portion of the superior central wedge removed. Notice the inner and outer breast tissue have been removed and the dissection was carried out just above the level of the fascia of the pectoralis major muscle. The tissue removed is weighed at well over 600 grams per breast to bring her down to a “D” size breast. This is proportional for her size. The blood supply is maintained to the nipple areolar complex through the inferior pedicle, even better if some of the superior pedicle can be maintained, leaving it as a bipedicle flap.
Case Study 2
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.
Case Study 3
Triple F to Small D
I was presented a female in her mid-forties that was looking to reduce her breast size. During our discussion, she explained to me that due to her triple F breast, she was experiencing back and neck pain, deep shoulder grooves, and skin irritation under the breast. After listening to her expectation, we agreed to perform a breast reduction procedure.
During the surgery, I performed a breast reduction using the inferior pedicle technique (wise pattern). An anchor-shaped incision so I could remove excess breast tissue, skin, and then lift and reshape without detaching the nipple-areolar.
The photo to the right is only one day post-op. We were able to reduce her breast to a small D, and she is very happy.