Thursday, March 12, 2009

BREAST REDUCTION - What to Expect?

A breast reduction is a wonderful procedure and is one of the MOST satisfying operations a Plastic Surgeon offers!

What is a breast reduction?
  • Breast reduction is also called "bilateral reduction mammaplasty" (BRM)

  • A breast reduction will relieve symptoms from excessive breast size and weight (hypermastia)

  • Following breast reduction, breasts are more proportional to the rest of the body, and clothes fit better

  • Breast reduction has tremendous psychological benefits!

What are the symptoms of hypermastia?
  • Breast pain

  • Back pain

  • Shoulder pain

  • Shoulder grooving from bra straps

  • Rashes beneath breasts (intertrigo)

  • Poor posture

  • Inability to do sports or physical activities

  • Self-consciousness about breast size

  • Inability to fit into clothing

How is a breast reduction done?
  • Breast reduction surgery takes around 3 hours and is done in the hospital under general anesthesia (GA). An overnight stay is usually recommended.
  • During surgery, excess breast tissue, some skin and fat are removed. The nipple and areola are often reduced in size and are moved to a higher, more aesthetic position on the breast.
  • A good blood supply, nerve supply and ductal supply is maintained to the nipple so that it retains as much sensation as possible and to encourage the ability to breast feed in the future.
  • All stitches (sutures) are dissolving.

Who is a good candidate for a breast reduction?
  • Women who have breasts that are very large in proportion to the body frame

  • Heavy, pendulous breasts with nipples and areolas that point downward (breast “ptosis”)

  • One breast much larger than the other

  • Symptoms of hypermastia

  • Dissatisfaction or self-consciousness about breast size

What is the recovery like after breast reduction?

  • After surgery, avoid lifting more than around 5 pounds for 2-3 weeks. You can expect some swelling and bruising that will gradually resolve.
  • You will likely have IMMEDIATE relief of your symptoms of hypermastia! Most women feel immediately lighter and often exclaim, "Why did I wait so long?!"
  • You will have a temporary decrease in sensation that will take months to years to recover. You may not regain full sensation, depending on the amount of tissue removed and the original size ad shape of your breasts.
  • The incisions will initially be bumpy and raised, and flatten within 6 weeks. After this, they form scars that take up to a year or more to "mature".

What are some of the potential risks of breast reduction surgery?
  • Sensation change

  • Scars

  • Breast asymmetry

  • Ability to breast feed

Things to remember about breast reduction:
  1. Breast reduction will make your breasts smaller, lifted and firmer.
  2. Reduction of breast size often enables greater enjoyment in playing sports and engaging in physical activity.
  3. This procedure often makes a dramatic change in appearance. It can take some time to adjust to your new body image. Be patient and allow your body to heal for up to one year until you accept the results as 'final'.

For additional information, please visit:

Thursday, March 5, 2009

Ask The Expert - Breast Augmentation

Karen Horton, MD, MSc
Plastic and Reconstructive Surgery
California Pacific Medical Center

Dr. Karen Horton is one member of a unique all-woman Plastic Surgery practice in San Francisco. She specializes in breast reconstruction after cancer and cosmetic surgery for women.
She is one of very few Micro-surgeons performing state-of-the-art reconstructive techniques for the breast, including the DIEP flap, SIEA flap and TUG (inner thigh) free flap. Dr. Horton regularly performs “mommy makeover” surgery to rejuvenate the breasts and bodies of women who have completed childbearing.

Visit for more information.

See Dr. Horton's profile

Question of the Week:

I’m considering breast implants. What should I look for (beyond board certification) in selecting my plastic surgeon?

Karen Horton, MD, MSc answered:

For any surgical procedure, you should do your homework!

This includes breast augmentation. Your Plastic Surgeon should be Board-Certified in Plastic Surgery. Remember that any surgery, cosmetic or not, is a major procedure!

Your Plastic Surgeon should get to know YOU. The doctor-patient relationship is very intimate, and your surgeon needs to know all about your past medical history, your home life, exercise schedule and your goals for surgery.

There should be a good “fit” in personality between you and your surgeon. If necessary, visit a number of doctors until you feel you have found the very best fit for you!

Ask to see before and after photographs, both of the very best results, and average results as well. Ask to see images of scars and make certain you understand what the healing period and expected down-time will be like.

Talk to other patients who have had the procedure you are thinking about. Your Plastic Surgeon can give you a list of names and phone numbers of their patients who have had surgery and who are willing to share their experiences – good, bad, and ugly – with you.

Aim to become an informed, educated and empowered patient, even before you have surgery! This will enable you to have the best possible outcome.

Wednesday, March 4, 2009

What is Plastic Surgery, anyway?

What is “Plastic Surgery”?

The word “plastic” derives from the Greek word “Plastikos”, which means "to mold or change form".

There is actually no connection with modern-day plastic, a synthetic polymer that is moldable when heated. And despite many misconceptions, Plastic Surgery does NOT involve using plastic in the body!

The first known Plastic Surgical procedure, reconstruction of the nose, was documented in 18th Century B.C. A man's nose was literally cut off "to spite his face" for punishment, and it was reconstructed using a flap of skin from his arm.

See the image with the contraption used to keep the arm attached to the face for approximately three months!

Refer to and for more information on the history of Plastic Surgery.

Plastic surgery involves both reconstructive and cosmetic procedures. Common reconstructive procedures include breast reconstruction after cancer, burn surgery, cleft lip and palate surgery, hand surgery, pressure sore reconstruction, facial fracture correction, skin cancer surgery, and the list goes on...

What is Cosmetic Surgery?

Cosmetic surgery is plastic surgery designed to improve the appearance of the body or counteract the effect of aging.

Cosmetic surgery can often improve body image, self-esteem and help to restore a more youthful appearance to the face, breasts and body.

Most of us are familiar with cosmetic surgery in the media - movie stars, celebrities, reality TV shows...

Cosmetic surgery is enticing in that it can dramatically change the appearance of the body, usually for the better, but sometimes for worse. We are all familiar with individuals in the press who have had TOO much cosmetic surgery!

Examples of common cosmetic procedures include facial rejuvenation (facelift, necklift, eyelid lift/blepharoplasty, rhinoplasty), breast surgery (reduction, lift or augmentation) and rejuvenation of the body (tummy tucks, liposuction).

There are also non-invasive cosmetic procedures such as Botox, fillers, lasers that are often an alternative to invasive surgeries.

Future blog posts will feature details on each of the major Plastic Surgery procedures - who are good candidates for surgery, details of procedures, what to expect during recovery, downtime, risks, and representative before and after photos.

Stay tuned!