David L. Davis, M.D.
I had a left breast mastectomy 11 years ago and had a TRAM Flap done immediately afterwards. I never had to have chemo or radiation and I am wondering if it's possible to have breast implants done now. I would like to increase in size.
It is likely that breast augmentation could be performed to increase the size of your breasts given your history. It is also possible that some other type of operation might be performed on the side of your mastectomy or on the other breast to improve both the the shape of your breasts and their overall symmetry. Since a number of factors are to be considered in the decisions regarding this surgery, I would highly recommend that you return to your original Plastic Surgeon or consult with another Plastic Surgeon certified by the American Board of Plastic Surgery.
I have constant back pain due to my breasts; they are awkwardly sized compared to the rest of my body. I have a narrow waist and torso and being a 34 D cup causes issues. I am 5 foot 2 inches and 140 pounds, are my breasts too small for reduction?
You are not too small for a breast reduction surgery. Physical body size measurements, such as weight and height, in and of themselves, have nothing to do with determining whether you would be a good candidate for this operation. Symptoms such as back, neck or shoulder pain, bra strap grooving and rashes beneath your breasts are factors that are commonly used in this determination. Additionally your own feelings about the size of your breasts and their relationship to the rest of your body, as you described, are also seriously considered. Patients should understand though, that if they are obese and if they lose a significant amount of weight, then it is likely that their breasts will also get smaller. Permanent weight reduction, though difficult, is sometimes recommended as an alternative method of dealing with the above symptoms in some overweight patients.
Since a number of interrelated factors are involved in deciding if you would be a good candidate for breast reduction, I would definitely recommend that you consult with a Plastic Surgeon who is certified by the American Board of Plastic Surgery to assist you in making this decision.
Why do I need to stop smoking in order to have a facelift?
Smoking or the use of any nicotine releasing products, such as patches, vaporizers or gums, has been shown to increase the incidence of serious complications after facelift surgery. For this reason, many plastic surgeons, myself included, refuse to perform facelifts on patients who are smokers or are using nicotine in any form. The safety of our patients is always our primary concern. Therefore at the very least, smoking or the use of any nicotine releasing products should be completely stopped at least several weeks before a facelift, and not restarted for a week or more after such an operation. I strongly recommend that all smokers permanently quit as soon as possible, not just if they are considering plastic surgery, but purely for their own good health and those around them.
I need a breast lift, but I am concerned about the after effects of the surgery. Could cancer be a consequence of breast lift surgery?
Breast surgery of any kind has never been shown to cause cancer nor is such a causal relationship conceivable. Since approximately 11 % of women will develop breast cancer sometime in their lives, it is conceivable that breast cancer may be pre-existing or may develop in women undergoing breast lift surgery. A frank discussion about your concerns with a board-certified plastic surgeon is strongly recommended and a mammorgram prior to such a proceedure may be advised.
D.L. Davis, MD
I am 25 years old. When I was 15, a surgeon approved me for a breast reduction but my mother declined it. Now I am 25 and a mother of three and I have some changes in body size. I have horrible neck and back pain, and cannot go without wearing a bra. I am a size DD pushing whatever would be the next size. Due to the heaviness of my breasts, they hurt when I am not in a bra. Do you think my doctor will advise/approve me to have a breast reduction and will my insurance company approve coverage for the procedure?
From the information you have provided, it is likely that your doctor would recommend that you have breast reduction surgery. It is also possible that he or she may want to rule out or treat other causes of your symptoms such as arthritis or generalized obesity.
Financial coverage for such surgery and the criteria that insurance companies use to determine it, vary widely from company to company. Factors such as the presence of physical signs including bra strap grooving on your shoulders, or rashes beneath your breasts might be considered. An estimate by your surgeon of the weight of the tissue that is to be removed from each breast or the actual weight of the tissue that is removed in an operation is often used in such decisions. I am also aware that some companies or governmental agencies have insisted that patients either achieve, or try to achieve and maintain a normal body weight before authorizing financial coverage for such surgery.
My recommendation to you at this juncture, is to consult with a plastic surgeon, certified by the American Board of Plastic Surgery, and discuss these issues with them.