Robert T. Buchanan, M.D.
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?
Approval and Insurance Coverage for Breast Reduction
Your symptoms and apparent breast size make you what we, as Plastic Surgeons, consider a good candidate for Breast Reduction. Each insurance company has their own requirements before they will approve payment for breast reduction. You could start by asking your company what their requirements are. If this looks promising, see a Plastic Surgeon. He/she will write your company with your specifics, and ask if they will approve your surgery. You will then know if they will pay for the surgery, or what you need to do to become eligible, if anything. If they deny coverage, you can always pay for the procedure yourself.
If a woman's breasts are very large, is it better to have liposuction of the breasts or a complete breast reduction?
Breast Reduction vs Breast Liposuction
Both these procedures will reduce the size of the breasts. Liposuction, however, has its limitations and may not reduce very large breasts enough if you wish a significant reduction in size. Also, Liposuction cannot lift the nipple and restore a "perky" appearance to the breasts. Only a surgical reduction can do that. In fact, you will usually have more breast droop after liposuction, since you are deflating the skin further and there is less breast tissue to hold the nipple up. Therefore, if you wish to have relatively small breasts, you will need a surgical reduction with "very large" breasts. Additionally, if you wish your breasts to have the nipples in their youthful position, no matter how much reduction you desire, you will need a surgical reduction.
I am seven months post op for Breast Augmentation (Mentor Gummy 300cc HP inframammary crease incision) and my implants seem to have never fully "dropped" resulting in breasts that have more upper than lower pole fullness and nipples that seem slightly low which point slightly down. Would moving the nipples up so that they sit at the apex of the breasts adequately address this? I don't want to have a complete re-do to pull the implants down 1/2" or so, or replace them unless absolutely necessary. I think I can live with the fact that my breasts are a bit rounder and higher than I planned if the nipples are centered. I am 5'5" and weigh 125 pounds. Thank you for any thoughts you might share.
Nipple position after Breast Augmentation
In my experience, if the implant is too high after breast augmentation, it is because they were not placed low enough or there was some breast droop before surgery. Leaving the implant high is easy to do while trying not to release the inframammary crease. If there was a mild amount of droop before the augmentation, the implant may lift the nipple occasionally. However, it is just as likely that the surgery accentuates the problem. To solve the problem, you may need a small lift or revision. Discuss this with your surgeon.
Usually how long does it take to recover from a Tummy Tuck or Liposuction?
Recovery from Tummy Tuck or Liposuction
This requires two different answers, as the two procedures are quite different. Abdominoplasty takes the longest. Most people remain stooped over for most of a week and do not return to normal activities for 1-2 weeks. It usually takes 1-2 months, however, until you can do everything you did preoperatively without feeling tired, as your body is using significant energy to heal you during this time. Even if you could return to activities faster, you should not in order to reduce problems. With Liposuction of only one or two areas (such as the abdomen and flanks), recovery is usually quite rapid, within several days. More extensive liposuction extends recovery.
I may need to undergo knee surgery due to torn cartilage and possibly to revise an ACL repair done years ago. I have wanted to have a tummy tuck for a while, but could not justify taking the risk of going under anesthesia for a cosmetic procedure. Would it be possible to combine the two procedures?
Combining Tummy Tuck with other surgery.
Yes, it is possible to combine an abdominoplasty with knee surgery, but they are not a good combination. Both increase the risks of leg vein clots that can break off and go to the lungs. You will need to discuss this at length with your Orthopedist and Plastic Surgeon. I would also very strongly recommend postoperative anticoagulation for at least three weeks because of this combination.