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Will Breasts Remain Full After Breast Reduction Surgery?

Posted on: April 14, 2015
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

Breast Reduction Goals

As noted on this website, there are several different breast reduction procedures. The amount of fullness will depend on the technique used, the talent of the surgeon, the quality and firmness of the breasts prior to surgery. Usually when the nipple maintains its blood supply, fullness for the upper pole tends to be maintained.

By definition, a breast reduction surgeon’s goal is to reduce the volume of the breast. However, Miguel Delgado, M.D.’s objective, in addition, is a natural appearing shaped breast.

Avoiding “Bottoming Out”

The inverted T is usually for larger breasted women, but over time the skin may stretch out resulting in “bottoming out.” There are techniques surgeons use to try to prevent bottoming out such as positioning the breast pedicle to a more superior position. Some surgeons use internal sutures.

The short scar technique, also known as the lollipop, or vertical breast reduction, maintains fullness better with less bottoming out. The short scar technique is a very popular procedure for women with moderate sized breasts.

Breast Reduction Vertical

CASE DESCRIPTION: This is a 32-year-old resident of San Rafael, California who is seen in the Novato office in Marin County. She is 5 feet 4 inches, 130 pounds, and underwent a short scar vertical breast reduction at the Marin Cosmetic Surgery Center. Her size was reduced from a size F to a size C. The photographs are seen approximately nine months after surgery and the incisions are starting to fade quite nicely.

Some techniques can leave the breast looking boxy and flat. Other techniques rely on internal shaping to give the breasts projection and natural looking fullness. The surgeon’s goal is not to remove tissue above where the nipple will be placed, maintaining maximum fullness in the upper pole.

Patience for Patients

The patient must be “patient” and allow time for the breasts to settle into their new position. Unfortunately, for some women, over time gravity may cause their breasts to sag, or they may lose fullness due to pregnancy, weight fluctuations, and aging. Breast reduction patients need to have realistic expectations.

Communication with your surgeon as to your goals is most important. Be sure to view before and after pictures so you can get a clear idea of what results you might expect.

Board Certified Plastic Surgeon Miguel Delgado, M.D. has been performing breast reduction surgery since 1988. His reduction mammoplasty results are excellent; making breast reduction one of the most pleasing procedures he performs according to his patients, whose only complaint is that they wish they had the surgery sooner.

Schedule a Consultation!

Call today (415 898-4161) or email (info@dr-delgado.com) for a consultation or to answer any questions you may have.

Breast Reduction Surgery Statistics Announced

Posted on: March 14, 2015
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

30,000 Questionnaires Sent

Each year the American Society for Aesthetic Plastic Surgery (ASAPS) that was founded in 1967 publishes statistics for both cosmetic surgical and non-surgical procedures. Board Certified Physicians from many different specialties contribute to ASAPS statistics.

A questionnaire was sent to 30,000 Board Certified Physicians, including; 7,500 plastic surgeons, 10,500 otolaryngologists, and 12,000 dermatologists. The questionnaires were compiled and analyzed by an independent research firm, Industry Insights, Inc. from Columbus, Ohio. The survey results were plus or minus a 3.45% error and a level of 95% confidence.

$12 Billion a Year on Cosmetic Procedures

For the past two years, Americans have spent $12 billion a year on cosmetic procedures; this is more than any year since 2008.

For 2014, breast reduction remains a very popular procedure with 114,470 cases reported, just slightly less than 2013 but with an increase of 139.1% since 1997.

Breast Reduction Most Patient Pleasing Procedure

Miguel Delgado, M.D. states that breast reduction or reduction mammoplasty remains one of the most patient pleasing procedures that he performs.

Before and After Breast Reduction

This is a 58-year-old San Rafael resident who was seen at the Novato office in Marin County for breast reduction. She is 5 feet 4 inches, 148 pounds. She underwent an inverted -T breast reduction at the Marin County Surgery Center. She had 400 grams removed from her right and 600 from her left side. She went from a size DDD to size C. The photographs are seen eight months after her surgery, note the scar to be fading nicely.

For non-surgical procedures, Botox remains number one, year after year! Botox has an astounding increase of 6407% since 1997.

Call Today!

If you have been considering breast reduction surgery, you are invited to call (415 898-4161) or email (info@dr-delgado.com) for a personal consultation with Miguel Delgado, M.D.

Choose a Board Certified Plastic Surgeon for Your Breast Reduction Surgery

Posted on: February 16, 2015
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

Breast Reduction by a Dentist?

As unbelievable as it sounds, state laws allow any licensed physician to call themselves “cosmetic” or “plastic surgeons,” even if they do not have training as a surgeon! If a doctor is wearing a white coat, it does not mean he/she is qualified; this is referred to as “white coat deception.”

There areConfused doctor numerous incidents of botched plastic surgery cases by unqualified doctors. See for yourself and Google “botched breast reduction” and you will see multiple horror stories of women who ended up with; misshaped breasts, horrific scars, nipple loss, infection and more. Fox News reported a few years ago about a dentist from Oregon, who was sued for a disfiguring breast reduction done on a 15 year old girl.

Choosing Your Breast Reduction surgeon

Dr. Delgado states that this can be avoided if you do your homework when choosing your surgeon. In order to avoid a doctor who advertises as a “plastic surgeon” ask this specific question, “is the doctor Board Certified in Plastic Surgery?” If you feel uncomfortable asking, you can go online to the website for American Society of Plastic Surgeons (ASPS) and go to “find a Plastic Surgeon.” All plastic surgeons that are members are Board Certified. Another thing to check online is your state medical board, see if there are any complaints or lawsuits filed.

Board Certified Plastic Surgeons have had extensive training and must complete a minimum of 5 years of surgical training after medical school. They must complete a residency program in plastic surgery which gives them “in-depth” training of the face and body.

Safety for the Breast Reduction Patient

Plastic surgeons are trained to handle all types of emergencies including; circulation, ventilation, electrolyte balance, etc., which are all critical to the safety of the patient.

Schedule a Consultation Today!

With all the years of training, plastic surgeons develop outstanding technical skills and aesthetic judgment. Dr. Delgado has been a Board Certified Plastic Surgeon since 1990 and is a breast reduction specialist. Call today for a consultation at (415 898-4161) or email (info@dr-delgado.com).

Husband Upset About Wife’s Breast Reduction Surgery?

Posted on: January 18, 2015
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

Breast Reduction Obstacles

San Francisco, CA-Some women in need of breast reduction surgery may find some difficult obstacles they need to overcome before proceeding. There may be issues in getting insurance approval, getting time off work, arranging for help with children and household duties, someone to pick them up after surgery and give post-operative care for 24 hours.

Dr. Delgado says the most challenging complication may be a husband or significant other who is against the surgery. Many men like their wives the way they are and are very fearful of them having surgery.

Before and After Breast Reduction Mammoplasty Surgery

Before and After Reduction Mammoplasty Surgery

This is a 23-year-old resident of San Francisco and seen in the Marin County Office for a breast reduction. She is 5 feet 2 inches, 167 pounds. She underwent an inverted T breast reduction at the Marin Cosmetic Surgery Center. She went from a size DDD to a C cup in size. The photographs are approximately nine months after surgery. Note the nicely fading incisions.

Getting support from your husband can be a big help, so being sensitive to his feelings is definitely something to consider. Here are some suggestions of what you can do to bring him around:

1. Take him to meet your surgeon, let the surgeon explain how the surgery is done.
2. Have your husband see before and after pictures of other patients
3. Be sure he feels comfortable to ask the surgeon any questions he may have
4. Have you explained why you want the surgery?
5. Back and neck pain?
6. Rashes under the breasts?
7. Difficulty in fitting into clothes off the rack?
8. Inability to participate in sports and/or exercise?

Remember the unknown can be scary, the more your husband understands, the less apprehension he may have.

The New You

If you decide to proceed without your husband’s support, as many women do, be patient, give him time to adjust. You may want to wait until most of the healing has taken place before revealing your new breasts. Perhaps you could buy some sexy new nighties and clothing that will show off your new figure.

In any case, he will probably appreciate the new you, a woman who is happy with herself and pain free for the first time in many years.

It’s Easy to Schedule a Consultation!

If you are considering breast reduction surgery, you are invited to bring your husband to a consultation with Dr. Delgado, who will explain exactly what can be expected from surgery and answer all your questions. Dr. Delgado will show both of you many before and after pictures of women just like you that say their only misgiving is that they did not have the surgery years ago. Dr. Delgado, a Board Certified Plastic Surgeon, has been performing breast reduction surgery for men and women since 1988.

Call today for an appointment (415 898-4161) or email (info@dr-delgado.com), you’ll be glad you did!

Breast Reduction Surgery and a Free Nipple Graft

Posted on: December 19, 2014
By: DrDelgado

Breast Reduction Options

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

Breast Size Matters

Dependent on how large a woman’s breasts are will determine which type of breast reduction surgery is recommended. It is imperative that a woman seeks a Board Certified Plastic Surgeon that specializes in breast surgery. The surgeon will be able to help her determine which procedure will give her the results she desires.

Women with extremely large breasts are divided into two groups, gigantomastia and macromastia. Gigantomastia is where more than 1500 grams needs to be removed from each breast and macromastia refer to women that need just less 1500 grams removed from each breast during breast reduction surgery, also known as a reduction mammoplasty.

Free Nipple Graft Versus the Pedicle Method

Dr. Delgado explains to his breast reduction patients that when such a large amount of tissue needs to be removed it may be necessary to perform a free nipple graft. A free nipple graft (FNG) is when the nipple areola complex is completely removed and transposed without a blood supply, skin and glandular pedicle.

The pedicle method is the preferred method for breast reduction; this is where the nipple areola complex remains intact and is moved higher on the breast mound, typically preserving sensation and function. However, a woman with gigantomastia and many with macromastia will be limited to how much the breast can be reduced. It is very difficult to protect the pedicle when large amounts of breast tissue are removed. Shaping a breast around a pedicle is very challenging, and the resulting shape may be disappointing.

Risks of the Free Nipple Graft

Some of the risks with a free nipple graft are:
• The graft might not look natural
• The color of the nipple areola complex may fade
• Loss of the ability to breast feed
• The graft might not survive
• Probable loss of sensation

Dr. Delgado has observed that some of his patients have regained sensation, but it could take up to six months. As far as the viability of the graft, he states his results have been excellent. In some cases they may have partial take but less than 1 percent loss.

Breast Reduction Free Nipple Graft

This is a 45-year-old San Francisco resident seen in the San Francisco office. She is 5 feet 5 inches, 220 pounds, with size GGG breasts. She underwent an inverted T free nipple breast reduction due to the extreme size of her breasts. She is seen four months after surgery with early healing, but note the nice size and shape of her breasts. She went from GGG to a D cup.

As a guideline, a woman who has over 20 cm from the inframmary fold to the nipple may be a candidate for the free nipple graft. Older women seem less concerned about loss of nipple sensitivity and will opt for the FNG in order to have a smaller size. This is a highly individualized procedure where an expert breast reduction surgeon needs to be consulted. Patient input is very important for the surgeon to help guide her in the right direction.

Dr. Delgado, a breast surgery specialist since 1989, has been performing breast reduction surgery for both men and women. The procedure for breast reduction for men is referred to as gynecomastia. Anyone suffering from large breasts is invited to call (415 898-4161) or email (info@dr-delgado.com), for more information or to schedule a personal consultation.

Can Breast Reduction Surgery be Combined With Other Procedures?

Posted on: November 14, 2014
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

For San Francisco Bay Area women who decide to proceed with a reduction mammoplasty surgical procedure, it is not unusual for them to ask if other procedures can be done at the same time.

Dr. Delgado does multiple procedures frequently as long as the patient is healthy. For example, the popular Mommy Makeover can include a tummy tuck, liposuction and breast augmentation, breast lift or breast reduction. Men who elect to have male breast reduction surgery, known as gynecomastia, also frequently combine additional procedures.

Mommy Makeover

This is a 35-year-old resident of Mill Valley, California who presented to the Novato office in Marin County for evaluation of a tummy tuck (abdominoplasty). She had a large weight loss due to diet and exercise. She underwent a full tummy tuck, breast reduction and liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California.

Breast reduction is usually done as an outpatient procedure, however, if additional procedures are going to be added, an overnight stay will most likely be necessary. It is not surprising that many women choose to add procedures so that they can take advantage of their time off for recovery, and to save time and money. The amount of surgery to be done will depend on the patient’s health and Dr. Delgado’s evaluation of what is appropriate.

Dr. Delgado has his own private surgery center that offers his patients the best concierge care. Marin Cosmetic Surgery Center (MCSC) is accredited by Medicare and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (Quad A), meaning it meets the highest of standards. In the rare event of a medical emergency, Novato Community Hospital is just steps away.

Patients who stay overnight will have a registered nurse who is certified in “advanced cardiac life support” (ACLS) and an additional staff member for further comfort and safety. The surgery center has its own entrance providing privacy for Dr. Delgado’s patients.

phoneDuring your initial consultation, Dr. Delgado will be glad to discuss any and all of your cosmetic surgery goals and determine what combination of procedures is feasible and safe. Call today (415 898-4161) or email (info@dr-delgado.com)for your personal consultation with Dr. Delgado and find out what options are available to you.

Medical Insurance Denied my Breast Reduction Surgery, Now What?

Posted on: October 30, 2014
By: DrDelgado

Trying to get coverage for breast reduction surgery can be very challenging. Health insurance companies have lots of different guidelines that patients have to meet. It is important to know what coverage your particular insurance has as some policies have an exclusion for breast reduction surgery altogether.

If your policy does not exclude reduction mammoplasty surgery some of the requirements you might have to meet may be:
a minimum of breast tissue to be removed
• a report from a physical therapist for treatment
• a letter from your doctor describing symptoms and attempted treatments, such as prescribed analgesics
• Use of special bras

Even when all of the above criteria have been met, some insurance companies will still deny surgery. Possibly they are hoping you will give up. At this point Dr. Delgado requests an appeal. He has been very successful in getting an approval with this approach. Most insurance companies respond to an appeal by having a medical doctor call your surgeon to discuss the case. This is when it is imperative that your surgeon understand the ins and outs of the insurance companies and how to present your case.

Before and After Reduction Mammoplasty Surgery

Breast Reduction Before and After Reduction Mammoplasty Surgery

If you discover that your breast reduction surgery has been denied because it is not a covered procedure under your policy, none of the above conditions will make a difference. A solution might be to consider changing your insurance coverage during an open enrollment period. If you have your insurance through your employment perhaps your Human Resources representative can help you find a better policy.

Having insurance cover breast reduction surgery for men is even more frustrating. Insurance companies do not cover cosmetic surgery and there needs to be a lot of evidence that surgery is a medical necessity. Gynecomastia can be psychologically devastating for men, but unless there is physical pain involved, applying for coverage can be a fruitless endeavor.

Dr. Delgado has had many years of experience in helping patients obtain medical insurance coverage for breast reduction surgery. After an evaluation by Dr. Delgado, he will be able to tell you how likely it will be for you to get approval, and if you hit roadblocks he will be there to support you!

phoneCall (415 898-4161) or email (info@dr-delgado.com)today for a consultation for your breast reduction or breast revision needs.

Can Uneven Breasts be Corrected During Breast Reduction Surgery?

Posted on: September 26, 2014
By: DrDelgado

vertical breast reduction

This is a 52-year-old patient who resides in San Francisco. She was seen in the San Francisco office at Union Square for a breast reduction. She is the mother of two children. She is 5 feet 5 inches, 140 pounds. She underwent a vertical short scar breast reduction in which her size was reduced from a DD to size C. In addition she had a tummy tuck and liposuction at Marin Cosmetic Surgery Center at the same time. This is also termed a mommy makeover. The photographs show her at approximately six months after surgery.

It is quite common for women to have uneven breasts. They may be uneven in volume or different nipple shape or size, or uneven nipple position or the breasts may be different shapes. Some women choose to live with their asymmetry while others seek options to even them out. Especially if the woman has a hard time finding bras to fit without having to pad one side, and/or finding clothes to fit properly.

Today there are many ways to achieve symmetry and have the breasts nicely contoured. During a consultation with Dr. Delgado, he will explain all options and determine what the patient wants her breasts to ultimately look like.

There are several reasons that the breasts may be asymmetric, including; location of the nipples, location of the breast fold, amount of breast tissue, previous biopsies, congenital deformities such as Poland syndrome.

For the woman that has uneven breasts, it is common to reduce one or enlarge one to achieve symmetry. There can be quite a combination of procedures to achieve this such as; a breast lift, breast reduction, breast implants and fat transfers.

In a study done by the American Society of Plastic Surgeons, women who have had surgery to correct breast asymmetry and/or breast reduction, have a significant increase in self-esteem. Dr. Delgado has found this to be true with his patients, over and over again.

Breast reduction in many cases is covered by medical insurance, depending on what procedure or combinations of procedures are done, it is possible that part or all of the surgery may be covered.

At the time of your consultation with Dr. Delgado, his patient coordinator, who is very experienced in dealing with insurance companies, can help you request coverage from your medical insurance.

If you have asymmetric breasts and/or are in need of a breast reduction, you are invited to call (415 898-4161) or email (info@dr-delgado.com) for a consultation with Dr. Delgado, who is a breast surgery specialist.

Dr. Delgado, a breast surgery specialist, has been doing all types of breast surgery; breast augmentation, breast lift, breast revision, breast reduction and male breast reduction, since 1988.

The Purpose of Drains After Breast Reduction Surgery

Posted on: August 11, 2014
By: DrDelgado

JPdrain

San Francisco, California-Drainage tubes are placed at the end of several different major types of cosmetic plastic surgery, including but not limited to: gynecomastia (male breast reduction), tummy tuck surgeryand breast reduction, also known as reduction mammoplasty.

The purpose of a drain is to remove blood and lymphatic fluid from the operative site. This will help prevent infection and eliminate dead space created by removal of fat and breast tissue. Removing the accumulated fluids will also promote healing and recovery.

Jackson Pratt is the type of drain used after breast reduction surgery. It has a clear tube that runs from the surgical site to a bulb or reservoir. When the bulb is emptied it is gently squeezed when reattaching to the drain tube causing a low negative pressure suction that helps remove fluids. You will be asked to keep a log to measure output and color of the fluid.

Creating Suction

Prior to surgery, Dr. Delgado gives his patients a detailed instruction booklet with extensive pre and post-operative instructions. In addition, prior to being released from Marin Cosmetic Surgery Center, in Marin County, California, the nurse will review all post op care, including a demonstration of measuring and emptying the bulb to you and your overnight caretaker. The amount of drainage and color of the fluid will determine when the drain can be removed, usually within 3 to 5 days.

If the patient notices: an unusual increase of fluid collection, bright red blood, fever and/or tenderness it must be reported immediately. It is possible for the drain tube to get blocked with a small blood clot. This can be remedied by pinching the tube above the blockage and sliding with a pinching of the thumb and forefinger of the other hand down the tube to the bulb. This will also be demonstrated.

The removal of the drain may cause some discomfort of a burning or stinging nature. Taking pain medication prior to removal is possible as long as the patient has someone to drive her home.

After removal of the drains, the small incision site will close up within 24 to 48 hours. Once they have closed up they are now waterproof and the patient may resume regular showers. However, while the drains are still in place, only sponge baths are allowed, and the incision site must remain dry to avoid infection.

Even with the minor discomfort that the drains may cause, they serve a great purpose in not only reducing the chance of infection, speeding up healing and recovery; they prohibit the buildup of fluids in the surgical site which would be much more painful.

Call today at (415) 898-4161 for a personal consultation with Dr. Delgado for breast reduction surgery.

Breast Reduction Approaches, How to Choose the Best

Posted on: July 18, 2014
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

The woman who has decided to proceed with breast reduction surgery is faced with other important decisions such as; when to have surgery, who will she depend on for assistance, how to pick her surgeon, and what breast reduction procedure will she opt for?

Dr. Delgado presents this blog to help women understand what their options are for the different approaches to breast reduction surgery.

The traditional (also known as the anchor or inverted T) breast reduction is considered the “gold standard” and is most often used for a woman with very large breasts. The incision goes around the nipple areola complex (NAC), then vertically down to the breast crease and continues horizontally along the breast crease. The resulting scar would be in the shape of an anchor or inverted T. The amount of breast tissue that needs to be removed will determine how the nipple is to be treated. Preferably, it will be what is referred to as the inferior pedicle technique. The inferior pedicle technique allows the NAC to remain attached by a bridge of breast tissue called a pedicle and is moved up on the breast mound after the reduction. This technique keeps intact nerve and blood supply and, therefore, in most cases the woman will have preservation of her nipple sensation. Unfortunately, a woman with very large breasts may not have this option and may need what is called a Free Nipple Graft; in this case the NAC is completely removed and after the reduction, is grafted back into the desired position. The downside to this procedure is that sensation and the ability to breast feed are lost.

T incision breast reduction, before and afterT incision after breast reduction surgery

This is a 57-year-old, female resident of Santa Rosa, California who presented to the Novato office in Marin County for an evaluation for a breast reduction. She has size DD breasts. She underwent a breast reduction using an inverted-T technique. In addition, she also had a tummy tuck with liposuction of the flanks for improvement of her post-childhood years. She underwent the inverted-T breast reduction and tummy tuck with liposuction at Marin Cosmetic Surgery Center in Marin County, California. Note the nice shape to her breasts and her overall improved body proportions. These photos were taken one year after surgery.

The short scar (also known as the vertical) breast reduction is a popular procedure for women with moderately sized breasts. There is less scarring as the horizontal incision at the crease of the breast is avoided, resulting in what is referred to as a lollipop incision. This incision goes around the NAC and then vertically from the base of the nipple to the crease.

Scarless (liposuction) breast reduction is becoming increasingly popular as the technique for reduction with liposuction continues to improve. The advantages are many, scarring is minimal, recovery is much easier and the possibility of complications is greatly reduced. This option is usually for a woman with mild to moderate breast tissue that has a high fat ratio. However, if a large amount of fat is removed the skin will only contract to a limited extent and then will sag. When reducing the breasts by liposuction alone, there will not be any lifting of the breasts as can be achieved with traditional breast reduction.

This information is not meant to further confuse a woman as to what procedure is best for her, but to point out that there are various options and decisions to be made. A Board Certified Plastic surgeon that specializes in breast surgery will be able to inform a woman as to which choices she may be a candidate for and what results she can expect. It is a very individualized procedure; a consultation and exam will provide answers to your questions.

As an expert in breast surgery since 1989, Dr. Miguel Delgado has a vast amount of experience in helping women choose the best reduction mammoplasty procedure. His reviews speak for themselves as this video portrays.

If you are seeking more information about breast reduction and want to know what your options are, call today (415 898-4161) or email (info@dr-delgado.com) to schedule a consultation with Dr. Delgado at his San Francisco or Marin County office. If you have medical insurance, Dr. Delgado and his staff will be able to assist you in obtaining authorization.

Can the Breasts be Reduced to Any Size with Breast Reduction Surgery?

Posted on: June 18, 2014
By: DrDelgado

Breast Reduction 45

This is a 45-year-old San Francisco resident seen in the San Francisco office. She is 5 feet 5 inches, 220 pounds, with size GGG breasts. She underwent an inverted T free nipple breast reduction due to the extreme size of her breasts. She is seen four months after surgery with early healing, but note the nice size and shape of her breasts. She went from GGG to a D cup.

It is very possible to achieve the desired size breasts with breast reduction surgery.

For most women, the main goal is to have enough tissue removed to alleviate the symptoms caused by large breasts, i.e., shoulder, back and neck pain.

Another issue women have is that they want to be able to buy clothes “off the rack.”

In addition, another major concern is how shapely will the new breasts be and how visible are the resulting scars?

Some women are so frustrated with their large breasts they ask for the extreme of having them removed, as in a mastectomy. However, it needs to be stated that for a drastic reduction there is more potential for complications. When huge amounts of tissue are removed, consideration must be given to the effect of blood supply and nerve supply of the breast.

Every patient is unique and needs to have excellent communication with her surgeon to understand what is possible in reaching her goals.

Looking at many before and after pictures with your surgeon can help you understand what results you might expect. There are different techniques for breast reduction surgery, and each will give different resulting shapes.

For the various options available to each patient, it is of utmost importance that a woman chooses a Board Certified Plastic surgeon that is an expert in breast surgery.

Dr. Miguel Delgado has been perfecting his breast surgery skills since 1988 with such procedures as; breast augmentation, breast lift, breast revision, breast reduction for women and male breast reduction also known as gynecomastia.

phoneToday, Dr. Delgado is considered as an expert breast surgeon, and he invites you to call (415 898-4161) or email (info@dr-delgado.com) to schedule a consultation at his San Francisco or Marin County office. At the consultation, Miguel Delgado, M.D. will perform a detailed examination after which he will be able to give you his expert advice as to what procedure will give you your desired result. If you have medical insurance, Dr. Delgado and his staff will be able to assist you in obtaining authorization.

Breast Reduction, Why Bigger Isn’t Always Better

Posted on: December 30, 2013
By: DrDelgado

breast reduction b&a

This is a 32-year-old resident of San Rafael, California who was seen in the Novato office in Marin County. She is 5 feet 4 inches, 130 pounds, and underwent a short scar vertical breast reduction at the Marin Cosmetic Surgery Center. Her size was reduced from a size F to a size C. The photographs are seen approximately nine months after surgery and the incisions are starting to fade quite nicely.

San Francisco, California-There are many things that Americans notoriously deem “the bigger the better” such as; houses, boats, swimming pools, food portions, drinks, and women’s breasts.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), in 2012 there were over 330,000 women that had breast augmentation surgery and over 112,000 women that had breast reduction or reduction mammoplasty surgery. So while many women are going bigger, a third as many are going smaller.

Breast enhancement surgery is a wonderful procedure for the woman who feels out of proportion with small breasts. There is no doubt that breast augmentation can raise a woman’s self-confidence, especially for filling out her clothes or a bathing suit. It may come as a surprise to learn that breast reduction can bring the same rewards and even more for many women.

Breast reduction surgery is rated one of the highest in patient satisfaction of all elective surgeries performed for women, as gynecomastia (male breast reduction) is for men. Many women have been surveyed, and the unanimous results showed the top reasons they agreed that bigger is not better are:

1. The immediate relief from back, neck and shoulder pain. Women with large breasts that are carrying extra weight on their chests find that if they do not have enough support from surrounding muscles it becomes very difficult to maintain good posture, which can lead to spinal deformity. Many women who are self-conscious about their large breasts tend to roll their shoulders forward in an attempt to hide their breasts, which can make their back pain even worse.

2. The ability to participate in more physical activities and exercise. Women have reported that working out in a gym or jogging was almost impossible for any length of time. Participating in sports events can be embarrassing with large bouncing breasts. After breast reduction surgery, many found that they were able to get into better physical condition and lose weight.

3. No longer having long sagging breasts that made a woman appear 20 years older. Reduction mammoplasty gives a woman more youthful perky breasts.

4. More clothing options. Most post-surgical breast reduction patients love to go shopping for clothes they can now buy off the rack and not just from specialty shops that sell unflattering extra-large tops.

5. Having eye contact with the opposite sex was a new experience and highly rated among breast reduction patients. No longer did men focus on their chests causing them great embarrassment.

6. The end of chafing and uncomfortable red rashes caused by breasts rubbing against each other and under the breast fold was a huge relief for many women.

The benefits of breast reduction surgery aren’t as widely known as breast augmentation surgery as many people think having large breasts is a blessing. Even insurance companies understand the medical necessity to the point that many will cover the procedure. Not to say that getting insurance to cover the procedure is easy, on the contrary, insurance will make the patient jump through many hoops for the patient to get approval. Therefore, the patient should seek out a Board Certified Plastic Surgeon that specializes in breast surgery to assist the patient in obtaining approval. The effort is well worth it as most women will agree.

Call today for a consultation with Dr. Delgado, a specialist in breast reduction surgery at (415) 898-4161 or email.

Physical and Psychosocial Well-being Improvements for Breast Reduction Patients

Posted on: November 30, 2013
By: DrDelgado

Before and After Breast Reduction of Miguel Delgado,MD

This is a 23-year-old resident of San Francisco and seen in the Marin County Office for a breast reduction. She is 5 feet 2 inches, 167 pounds. She underwent an inverted T breast reduction at the Marin Cosmetic Surgery Center. She went from a size DDD to a C cup in size. The photographs are approximately nine months after surgery. Note the nicely fading incisions.

San Francisco, California-The American Society of Plastic Surgeons (ASPS) is the largest plastic surgery specialty organization in the world, representing more than 94% of all Board Certified Plastic Surgeons in the United States.

“Plastic and Reconstructive Surgery” is the medical journal of ASPS where a recent study was reported on the health benefits (both physical and mental) for breast reduction patients. This study was done to justify the necessity of breast reduction surgery to the insurance companies. For purposes of evaluation, “Breast Q”, which is a well validated questionnaire, was used in this study.

The study included 49 patients that were preparing to undergo breast reduction surgery. Of the 49 women, there were 78% who completed the questionnaire either before or after their reduction mammoplasty surgery. Satisfaction with surgery and quality of life issues were evaluated in four areas; appearance, psychosocial, sexual and physical well-being. Not surprisingly, the study showed significant improvement in all four areas. Based on a scale of 100, the improvement for each area was reported as follows:

1. Satisfaction with breast appearance went from 20 to 80 after surgery

2. Psychosocial well-being was 41 and increased to 84

3. Sexual well-being went from 40 to 78

4. Physical well-being was 43 and increased to 81, noting great relief of pain in the breast, back, neck and shoulders.

Appearance of the breasts showed the greatest satisfaction with the overall outcome of the surgery. Women stated they slept better and had greater ability to exercise, in addition to the reduction of pain.

Medical insurance companies notoriously have many conditions the patients must meet in order to get coverage for surgery. For example, many insurers require that the patient has documented proof that they have tried; physical therapy, good support bras, analgesics, and most require the need of a minimum of 500 grams of breast tissue to be removed.

The study also determined that for many, improvements occurred for women that had small reductions, which disputes the insurance coverage guidelines for a mandatory amount to be removed. Researchers plan to continue with additional studies with more patients and a longer term follow up.

Presently, the only way to know if your insurance will cover reduction mammoplasty surgery is to call them. Have your I.D. number available. Don’t be surprised if the answer is “that depends”, at this point it is recommended that you see a Board Certified Plastic Surgeon that specializes in breast surgery, to help you with the ins and outs of obtaining approval for surgery.

The Affordable Care Act, also known as “Obama Care” is probably going to continue to change as it moves forward, with Congress arguing over each detail. It is impossible to know how the Affordable Care Act will affect breast reduction surgery approvals in the future.

In addition to breast reduction, many patients are now choosing to have some areas of fat reduced by CoolSculpting which is now available to Dr. Delgado’s patients. CoolSculpting is a non-surgical treatment that can reduce stubborn pockets of fat that resist reduction by diet and exercise. For a consultation call today at (415) 898-4161 or email.

Will Exercise Reduce and/or Lift My Breasts?

Posted on: October 21, 2013
By: webtools

San Francisco, CA-There are several reasons that women look for alternatives to breast reduction other than surgery.

Some women are fearful of surgery, some are fearful of anesthesia, while others are concerned about the time that they would need to take out of their busy schedules for recovery. The financial expense for women who do not have coverage by medical insurance can be prohibitive. Then there are women who worry about what their breasts may look like after a reduction mammoplasty surgery.

For all of these reasons and more, women look for ways of reducing their large breasts that does not involve surgery.

The breast is composed of fat and breast tissue, the ratio varies greatly among women. For those with a greater degree of fat, weight loss can make a big difference. If the woman does not have good skin elasticity, the breast may end up looking deflated and droopy after significant weight loss. woman lifting weights

There have been a great number of inquiries asking if exercise can make a difference in breast reduction and possibly help to lift the breasts. As mentioned the breast is made up of fat and breast tissue, not muscles. Exercise may strengthen the underlying pectoralis muscles, but the breast is supported by a network of suspensory ligaments which are not affected by exercise. Due to gravity and the loss of integrity of the connective tissue support over time, the weight of the breasts will diminish the ligament support to the chest wall, and the breasts will droop.

Men with gynecomastia (male breasts) hope to reduce their man boobs through exercise. They find the same thing that women do, it doesn’t work. In some cases, the development of the pectoralis muscle may even make the breast more prominent by pushing the breast out further beyond the muscle.

The breast gland sits on top of the muscle and is not affected by how strong the underlying pectoral muscle is and strengthening the pectoral muscle will not alleviate back and neck pain. Weight loss and exercise are helpful for tone but not tightening. Exercise could help strengthen the back muscles which could help support the extra weight of the breasts on the chest.

In the search for alternative methods of breast reduction, women may find expensive pills, creams and lotions advertised on the internet. Some state they are granted “GRASE” status by the FDA, which means the herbal ingredients are safe, not that the product works, if it worked, no one would have surgery.

Getting the right support bra from a specialty store is not a permanent solution, but with good support some of the heaviness and back pain may be alleviated.

Many women have gotten good results from a less invasive procedure, liposuction, but not all women are candidates. The best candidate for liposuction breast reduction is the woman who has minimal to moderate breast enlargement, a larger fat to breast tissue ratio, with minimal sagging; usually it is the younger woman with normal skin elasticity. Liposuction can significantly reduce the breast size for this patient with less pain, a shorter surgery and faster recovery. However, when the fat is removed the skin may not contract fully, and the breast may sag. In addition, the breast will not be lifted as in a traditional breast reduction. With all this being said, breast reduction surgery remains one of the most patient pleasing surgical procedures.

Breast Reduction; Before or After Bariatric Surgery?

Posted on: September 25, 2013
By: DrDelgado

San Francisco, CA-For the severely obese patient, the question is sometimes posed; “is it a good idea to have breast reduction surgery before or after bariatric surgery?” The result of a study on this very question was published in Plastic and Reconstructive Surgery, which is the official journal for the American Society of Plastic Surgeons.

Obese women find it almost impossible to exercise when they have large pendulous breasts. Many hope that by having a breast reduction mammoplasty that they will be able to exercise and lose weight on their own and avoid bariatric surgery.

Mommy Makeovee

This is a 35-year-old resident of Mill Valley, California who presented to the Novato office in Marin County for evaluation of a tummy tuck (abdominoplasty). She had a large weight loss due to diet and exercise. She underwent a full tummy tuck, breast reduction and liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California.

Bariatric surgery is a catch-all phrase for weight reduction surgery for obese patients. There are two main ways that this is done. The first would be Malabsorption such as gastric bypass surgery which restricts the amount of food going into the stomach and small intestines thereby limiting absorption of calories. The second would be Restriction where there is a surgical reduction of the size of the stomach and the small intestine, limiting the physical amount the stomach can hold.

In the study reported in the Journal, 29 women with a body mass index of about 54, 15 of the women had breast reduction surgery first and felt that their breasts looked much better; however even though exercising was easier, all 15 of the women still needed bariatric surgery in order to reach their weight loss goals. Most of the women were not sorry that they had breast reduction surgery because of the immediate relief from back, neck and shoulder pain, but they said that they would recommend to other women to wait until after their bariatric surgery so that an additional reduction mammoplasty surgery may be avoided. The women found that, with the weight loss provided by bariatric surgery, their breasts were reduced further in size, causing more sagging breast skin. Most of these women said if the cost of secondary breast reduction was something they could afford or if insurance would cover it they would proceed.

71% of the 14 women who had bariatric surgery first thought that their breasts looked worse after the weight loss and half of them planned to have breast reduction surgery, with more of them wanting it if they could afford it. So the conclusion of the study reports that women are dissatisfied with the appearance of their breasts after massive weight loss with or without breast reduction surgery prior. So it is recommended that a woman waits for their breast reduction after completing bariatric surgery. Now available at Dr. Delgado’s “Non-Surgical Center of Excellence”, is “CoolSculpting” which is a non-invasive treatment for pockets of remaining fat, this can be addressed at the time of your consultation.

Even though this study was for women, men have similar issues after massive weight loss. Men will find that they have a lot of redundant loose skin hanging from their chest requiring surgical excision, or gynecomastia surgery. Due to the skin being so stretched, it is very likely that the man will need a second stage male breast reduction surgery.

For both men and women, in addition to their breasts needing a reduction after bariatric surgery, most will also need an abdominoplasty or even a total body lift. This can be very disheartening to the patient that has been through massive weight loss only to find that the remaining loose skin leaves them feeling as disappointed in their body as before the weight loss. Hopefully the bariatric surgeon will explain thoroughly to the patient exactly what they can expect after their weight loss so that additional surgeries involving great amounts of skin tightening can be planned on both emotionally and financially. Depending on the patients, specific insurance policy, they may find they have coverage for the bariatric surgery and the breast reduction surgery; however, they may have to pay out of pocket for the body lift. The body lift generally includes the abdomen, arms and thighs, which most insurance companies would consider cosmetic surgery. Every case is individual and needs to be addressed with the insurance company by a top cosmetic plastic surgery specialist who is familiar with the process insurance companies require.

Will Breast Reduction Surgery Remove Stretch Marks?

Posted on: September 2, 2013
By: DrDelgado

Vertical Breast Reduction

This is a 32-year-old resident of San Rafael, California who is seen in the Novato office in Marin County. She is 5 feet 4 inches, 130 pounds, and underwent a short scar vertical breast reduction at the Marin Cosmetic Surgery Center. Her size was reduced from a size F to a size C. The photographs are seen approximately nine months after surgery and the incisions are starting to fade quite nicely.

San Francisco, CA-In addition to discomfort, women with large heavy breasts who are seeking breast reduction surgery, also may have unsightly stretch marks. Stretch marks, also called striae, form within the middle layer of the skin, known as the dermis. They are initially red, pink or purple but usually fade with time to white or silver and become much less noticeable. As disturbing as they may be, they do not pose any health issues.

Women who are planning to have breast reduction surgery, many times will ask if the surgery will remove the stretch marks on their breasts. In some cases, it will, but it depends on where the stretch marks are located, only the skin removed with stretch marks will be improved. There will be scars from the surgery, however all will fade with time from red to faint silver, similar to a tummy tuck procedure as far as removing many stretch marks as the skin is tightened and loose skin is excised.

There are not any miracle products to erase stretch marks. There are many creams advertised for stretch mark removal, but for them to work, it would need to penetrate the epidermis and get into the subcutaneous layer, so you may only see some minor improvement. Sometimes, the stretch marks can be improved and lightened with lasers.

Stretch marks can be caused by; pregnancy and some birth control methods that cause hormonal changes, also weight gain, when the skin gets stretched. In addition, corticosteroid creams and lotions may be the cause, even oral or systemic steroids. There are some medical conditions such as adrenal gland disorders, Cushing’s syndrome (a hormonal disorder caused by high levels of cortisol) and some connective tissues disorders are attributed to the formation of stretch marks.

Dehydration and lack of exercise can be a reason for development of stretch marks on the breasts. Anything that causes rapid changes in the size of the breasts can mean the sudden development of stretch marks, not only for women but also noted for some men if they develop gynecomastia (male breasts).

The Mayo Clinic states that stretch marks can be hereditary; if your Mother has them you may get them too. Accelerated growth for teenagers with developing breasts may lead to stretch marks. Also, according to the Mayo Clinic, there is not any way to prevent stretch marks other than maintaining a healthy weight and avoiding excessive weight gain.

Some women report that, after breast augmentation surgery, stretch marks don’t seem to be as bad. Breast implants can make the stretch marks appear less obvious, however, having an implant that is too large may put too much stress on the skin that already has loss of elasticity and may cause sagging.

Inverted T or Anchor

Inverted T or Anchor

Vertical Scar or Short Scar

Vertical Scar or Short Scar

The different types of reduction mammoplasty surgery will remove stretch marks within the area of excised skin. See the pictures to see the differences. During your consultation with Dr. Delgado who is a breast surgery specialist, he will explain what type of breast reduction surgery he recommends for you and the possibility of removal of some stretch marks.

How to Get Insurance to Cover Breast Reduction

Posted on: July 31, 2013
By: DrDelgado

HealthInsurancePapersSan Francisco, CA-Due to all the medical problems that having large breasts, also known as macromastia, can cause (see previous blog), many health insurance policies will cover all or part of breast reduction surgery. However, it is getting more difficult to get approval and with all the changes with health insurance it may become even harder.

In the meantime, if you have a policy that specifically has an exclusion for breast reduction surgery there isn’t much you can do except get a different policy. If you work for a company that offers medical insurance, review all insurance plans offered and switch to one that will cover the cost of breast reduction surgery during the open enrollment period (which is usually in November). The new insurance will probably cost more, but then you can switch back to your previous one at the next open enrollment.

If your insurance does not have an exclusion, that’s a big plus, but you still may have a few hoops to jump through to get approval. Understanding what most insurance companies require and why makes it a little easier to go through the process.

The insurance company will want to know what you have tried to help alleviate your symptoms. For example, have you invested in high quality support bras? For many women, even with top quality bras, they end up with shoulder grooves from the straps whichSupport bra

themselves can be painful. Next, have you tried physical therapy including exercises to strengthen your back muscles to help counteract the additional weight carried on your chest? Have you tried anti-inflammatories to ease back, neck and shoulder pains? It is unlikely that these methods are going to give you any lasting relief, but the insurance company will want to know as they are not anxious to give approval. You can expedite your approval process if you have documentation of all these things ahead of time. Get a letter from the physical therapist, receipts for bras, a letter from your General Practitioner that you have tried anti-inflammatories.

Another requirement some insurance companies have is that you need to be within a certain weight range, and if you are above the limit they may not cover your reduction mammoplasty procedure until you lose weight. This is understandable because for many women when they lose weight they will also lose fat in their breasts, and the back pains may have resolved themselves; therefore, surgery will not be covered. Not only will their breast reduction surgery not be covered, they are left with droopy sagging breasts, and if they desire a breast lift, that won’t be covered either as it is considered cosmetic surgery. Insurance companies will not cover a procedure they consider cosmetic unless it is causing physical pain and/or complications; psychological distress is not considered a reason to cover a procedure, such as gynecomastia, which is male breast reduction.

Losing weight can be very difficult for many women with large breasts as exercising is a challenge. It is important to note that large breasts are not only due to excess fat, for many women it is a combination of fat and tissue and, therefore, losing weight may not make much of a difference.

Having a consultation with a Board Certified Plastic Surgeon who specializes in breast surgery will be your best option. Your surgeon is very familiar with all the ins and outs of the insurance companies and will be able to advise you on the probability of getting coverage.

In addition to all of the requirements mentioned above, one of the main requirements of the insurance company will be how much tissue is needed to be removed. Most say it must be 500 grams per breast or more, otherwise they consider the procedure to be cosmetic in nature, and they will not cover it. Your surgeon will be able to tell you approximately how much tissue you would need to have removed and the probability of your qualifying.

Even after all of these steps have been taken there have been cases where the insurance company has turned down their clients for surgery. While this is extremely frustrating, don’t give up just yet! The next step would be for your surgeon to appeal your case; this can be more successful than you might think. When an appeal is requested, the insurance company brings in an impartial medical doctor to review the case. The doctor will contact your surgeon to discuss your issues. Many times after the surgeon and doctor consult the denial is reversed, and surgery is approved!

Dr. Delgado has had many years of experience with situations such as these, successfully obtaining approval from insurance companies on behalf of his patients.

Macromastia (large breasts) Cause Multiple Problems

Posted on: July 15, 2013
By: DrDelgado

Breast Reduction Before and After

This is a 32-year-old resident of San Rafael, California who was seen in the Novato office in Marin County. She is 5 feet 4 inches, 130 pounds, and underwent a short scar vertical breast reduction at the Marin Cosmetic Surgery Center. Her size was reduced from a size F to a size C. The photographs are seen approximately nine months after surgery and the incisions are starting to fade quite nicely.

San Francisco, CA-Women who have suffered with large breasts will tell you of several conditions that cause them continued misery. Both physical and psychological symptoms of macromastia may affect the quality of life.

Having the extra weight that large pendulous breasts pose, women tend to lean back for support. Leaning back will disrupt the body’s natural support structure around the spine and puts a lot of strain on the lower back muscles which will affect; bending, sports activities and even sleeping. Exercise can be very difficult, jogging with bouncing breasts can be painful and even walking, to the point that many women will avoid exercise all together which will only lead to weight gain and larger breasts.

The resulting poor posture may lead to chronic nerve problems such as numbness and tingling in the arms and hands. Efforts to get extra support from a specialty bra will include large straps may cause grooving into the shoulders, and possible rashes and the extra pressure on the shoulders may result in neck pain.

It is hard to keep the area under large breasts dry which ultimately leads to rashes and yeast infections. In addition, the extra breast weight on the chest may cause breathing difficulties and possible pain in the lungs from the added pressure. However, it is possible that something other than large breasts could be causing breathing problems and needs to be evaluated by your physician.

Unwanted attention from the opposite sex can result in a great deal of mental stress which may lead to low self-esteem and loss of self-confidence resulting in depression and poor quality of life.

Shopping for clothes can be very frustrating and become a chore; it is very difficult to find clothing that fits properly around the chest and then correct for the rest of the body.

Treatment for macromastia without surgery would be with anti-inflammatories, chiropractic adjustments, massage, heat packs, physical therapy, etc. but such treatments rarely will bring lasting permanent relief. Large breasts get progressively heavier with age and gravity.

Fortunately, most insurance companies cover breast reduction surgery for women. Unlike gynecomastia, the condition of breast enlargement for men, where insurance companies will rarely approve male breast reduction surgery.

That is not to say that women won’t have to jump through many hoops to get insurance coverage for their breast reduction surgery, they will, but for a cosmetic plastic surgeon that is used to the ins and outs with the insurance companies, approval can be obtained in most cases. There are exceptions; some insurance companies have a specific exclusion for breast reduction surgery, or they may have a required minimum of breast tissue that needs to be removed. Some insurance companies require documentation of methods tried before approval such as; weight loss, physical therapy, good support bras, analgesics, etc.

In the disappointing event of the insurance company denying coverage, the experienced breast reduction specialist will make an appeal on your behalf. In this case, the insurance companies usually have a medical doctor review the case and speak to the referring physician. I have done this for many patients with the result that approval has been granted on appeal in most instances.

Breast reduction surgery provides one of the highest satisfaction rates with patients experiencing almost immediate relief of symptoms after surgery.

Breast Reduction for Teenage Girls

Posted on: July 1, 2013
By: DrDelgado

Before and After Breast Reduction for Teenage Girl

This is a 19-year-old female resident of San Francisco who presents for a breast reduction. She is 5 feet 2 inches, 130 pounds. At Marin Cosmetic Surgery Center she underwent a vertical short scar breast reduction reducing her size from a DDD to a C cup. She is seen approximately six months after surgery with nicely healing scars.

San Francisco, CA-When young girls start to go through puberty and their bodies start to change, they begin to struggle with self-esteem and body image. They want to be accepted by their friends and can be greatly influenced by the media as to how they think they are “supposed” to look. It is reported that as much as 44% of high school girls are attempting to lose weight. Many girls agonize over breast development worried that their breasts are too small and even try to convince their parents to allow them to have breast augmentation before they have finished developing. Then there is the young woman whose breasts start to grow and seem like they will never stop.

Breast development can start as early as 8 years old or as late as 13. If the breasts continue to grow and become very large, the condition is referred to as juvenile macromastia and even larger breasts juvenile gigantomastia. In the early stage of development, the breast bud will begin to develop. Then the nipple area begins to look a little puffy, but the nipple remains flat. The next stage of development, the breast itself gets a little bigger, and the areola darkens and gets puffier. The hormone estrogen is secreted by the ovaries and is responsible for breast growth. Usually the process for breast development can take 3 to 5 years, but up to 10 years for some. During the time that the breast is developing, girls may experience breast pain and tenderness, and the skin may feel itchy as it stretches.

When the breasts grow too large for a teenage girl, she will most likely suffer physical and psychosocial consequences. The emotional devastation is exacerbated by unwanted attention from classmates leading to destruction of self-esteem and poor body image. Some girls develop such serious psychological problems that it can sometimes even lead to suicide.

Breast size is usually determined by your genes but not always. The amount of body fat versus breast tissue one has can make a difference. If a girl loses weight her and her fat ratio is much higher than the breast tissue, then her breasts may get smaller, although then they may sag as there is not as much fat to fill them out leading to possible breast revision surgery in the future. Teens that are already at a normal weight but want to lose weight in their breasts risk vitamin and mineral deficiency.

Exercise will not make breasts larger or smaller or perkier as there are not any muscles in the breast.

Young girls suffering with large breasts are advised to:

• Stand up straight, hunching over does not hide large breasts but will add to back pain.

• Wear a super supportive bra

• Pick clothing that doesn’t accentuate your breasts, avoid large patterns, horizontal stripes, pencil skirts, and tight jeans

• Avoid necklines that show cleavage

Another option, some girls try to hide their large breasts by using minimizer type bras, while this might help to make the breasts look smaller, the compression can be very uncomfortable and not good for breast health.

The third way some girls seek a reduction of their macromastia is by liposuction, for some this can be a very successful type of breast reduction, but for those with very large breasts, it will only reduce by a small amount. This leaves the most effective way for breast reduction, and that is breast reduction surgery, also known as a reduction mammoplasty. There are risks involved for the younger girl. First, the breast may continue to grow necessitating a second surgery at a future date, there may be loss of nipple sensitivity and the ability to breastfeed may be compromised, and lastly there will be breast reduction scars.

Breast reduction surgery for a teenager is appropriate in some cases, even with the known risks. Almost all women that seek breast reduction surgery state that the removal of the extra weight has freed them of back and neck pain and increased their quality of life, they enjoy having a conversation with people who now look them in the eye.

When parents are aware that their daughter may be facing such a situation, it would be wise to have a consultation with a breast reduction surgeon who is Board Certified in Plastic Surgery to discuss all options and see breast reduction before and after pictures.

Nipple and/or Areola Revision with Breast Reduction

Posted on: June 16, 2013
By: DrDelgado

This is a 52-year-old resident of San Francisco was seen for a breast reduction. She underwent a vertical short scar breast reduction in which her size was reduced from a DD to size C. Notice the reduction in the size of the areola.

What many people think of as the nipple is actually the nipple and the areola. The nipple is the part that projects out and delivers milk via the milk ducts, and the darker pigmented circle of skin from which the nipple projects is the areola. As with the rest of our body, the breasts, nipples and areolas come in all sorts of shapes and sizes. For many people, men included, having large or puffy areolas or protruding or inverted nipples can cause a great deal of embarrassment. This is especially true when the nipple protrudes to the point of being visible through clothing. Corrective surgery can be done for both the nipple and areola or separately.

The size and shape of the nipple areola complex can be genetic, or some changes may have occurred due to weight fluctuations, aging, pregnancy and or breastfeeding. In any case, together the nipple areola complex is one of the most important cosmetic aspects of the breast.

When women elect to have breast reduction surgery, many opt to have the areola reduced and/or the nipple shortened. Men who have male breast reduction surgery, also known as gynecomastia surgery, may also have areola and/or nipple reduction at the same time. In some cases, the breast may not need to be reduced, allowing the areola/nipple revision procedure to be performed as a somewhat minor surgery.

The ideal nipple is shaped like a cylinder with a dome like curved top. There is no standard to the length of the nipple; some people prefer them to be shorter and some like them longer. Inverted nipples can look flat or like a slit or hole in the normal place of the nipple. This happens in different degrees with the severity graded from 1 to 3 with 3 being the most severe. For grade 2 and 3 breast feeding may be a problem. Inverted nipples usually result from a narrow nipple base and or short milk ducts. It can affect one or both nipples.

For the elongated nipple, the tip is often removed and sutured, or the nipple may be shortened by excising skin along the neck of the nipple. If it is the width of the nipple that needs to be reduced, a pie shaped wedge of skin is usually removed from under the nipple.

The goal in surgery is to reshape the nipple and get projection while preserving the sensitivity of the nipple and leaving the milk ducts intact.

To reduce the size of the areola, two concentric incisions are made around the edge of the areola with the inner circle the new radius, leaving the area around the nipple intact, still attached to its blood supply and the milk ducts. Then removing the donut shaped piece of tissue and skin the outer circle is stitched to the inner circle in a purse string fashion creating the new smaller areola.

Whatever your goals are, your first step would be to schedule a consultation with Dr. Delgado and he will be able to explain your options in detail. If you are considering a combination of procedures, be sure to let him know so he can discuss the possibility with you.

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