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Breast Reduction

Before & After Gallery | Patient 3

Patient 03 - Flat Chested with Large Breasts


Patient Details

Case 3 – Breast Reduction with Super Breast Lift and Fat Transfer to Upper Pole

Reason for consulting with OC Breast Surgery Specialist
This 25 year old from the Los Angeles area presented with a difficult breast reduction. She was flat chested but had very large breasts that hung down to her waistline. She reported her current breast size as a 36H and wanted to be a 36D/DD. Upon examination, the surgeon measured the distance from her sternal notch (collar bone) to her nipple areolar complex as 32cm. A general guideline is any measurement over 20 cm, plus or minus a few centimeters, qualifies as a breast lift candidate. In this case she was a full 12cm beyond what is considered a breast lift candidate. The greater the distance, the more the nipple areolar complex has to be lifted which increases the risk of blood supply to the nipples. Her surgeon discussed these risks and the possibility of needing a nipple areolar graft or possibly a Star Flap Nipple Reconstruction. The surgeon also discussed adding a fat transfer to the upper pole to correct its flat appearance.. A small implant could account for more upper pole fullness, but the patient did not want implants. The patient was made aware that fat transfers are unpredictable in how long and how well they last.

Surgical Plan – Breast Reduction with Fat Transfer to Upper Pole

Pre-Op Sizing
The patient provided photos of her ideal breast size along with photos of breasts she thought were too small and too large.

Pre-Op Labs
Blood test
All breast surgery patients are required to have a Mammogram or Ultrasound within 1 year of the surgery date. All patients must have a CBC and Basic Metabolic blood test to be cleared for surgery. Patients over the age of 50 must have had an EKG within 1 year of the surgery date.

Day of Surgery
Breast Reduction surgery is done under General Anesthesia. Surgical time is 5.5 hrs.
Prior to surgery skin marks were placed on the patient in sitting and standing positions. In surgery, the surgeon first reduced the size of her breasts by removing a wedge of tissue along the right breast (375g) and a wedge of tissue from the left breast (335g). Then the internal lifting and tightening techniques of the no drain Super Breast Lift were performed. The nipple areolar complexes had good blood supply and viability throughout the case. To further reduce the size of her breasts, the surgeon applied liposuction and removed an additional 100 ml from each breast. A fat transfer was added to the upper pole. The patient was placed in a surgical bra and skin tape applied to her incisions.

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The next morning at her first post-op appointment, the patient was instructed to compress the lower pole with clean hands and wear a soft bra. She continues to wear the skin tape on incisions for the first 6-8 weeks after surgery, changing tape when needed. The first post-op photo is one month after surgery. The breasts are still high and tight. Patients are instructed to wear a support bra during the day and at night to sleep. Her post-op photos from one year show the gradual effects of gravity and how the breasts settle over time. It is important for breast reduction patients to have realistic expectations and understand that tissues heal differently based on the individual. Though her breasts did drop some, she was very happy with her new size and shape.