Saul R. Berger, M.D.
I am thinking about getting breast implants. I have gotten keloids from piercings and was wondering if this could be an issue in the scar tissue surrounding the implant or incision. Do you recommend such a procedure for someone who develops excessive scar tissue? What are my options?
A prior history of keloids would likely increase the risk of a thicker scar with any skin surgery, and possibly an actual keloid. Options would include careful consideration of the location of the incision. One could consider an axillary (armpit) approach to keep the scar away from the breast and adjunctive techniques aimed at minimizing hypertrophic scarring, such as steroids and other therapies.
I am considering a breast lift and tummy tuck. I have fibrocystic breasts that cause me quite a bit of discomfort all the time, but even more so around the time of my periods. I was wondering if during the lift and tuck, it would be possible to take out the lumps in the breasts and replace the lost tissue with the fat from my abdomen. I am a 40DD at the moment but would be happy with a full D. I would rather not get implants.
Given a good health profile, it is possible to combine a breast lift with tummy tuck in the properly selected patient. At a 40DD breast size, it is likely that a breast lift without the placement of implants is feasible, and the expected cosmetic result could best be predicted at the time of examination of the breast tissues. In reducing and lifting the breasts, there will be some breast gland removed which may contain fibrocystic tissue and this could have a positive impact on how symptomatic you are. It is important to recognize, though, that there will be fibrocystic tissues that remain behind and consequently you cannot be assured of reduction in the discomfort. It is not possible to remove all of the individual lumps in the course of a routine breast lift. As far as using abdominal fat as a graft to the breasts, it is not recommended.
I am 18 years old. My breasts are size 34DD. They hang and are extremely disproportional with the rest of my body. I have back pain and dents in my shoulders from them. I would like to know about breast reduction surgery and if I could go down to a full C with it. I’m married and plan to have children in the near future. Will this surgery in any way affect my ability to breastfeed?
A breast size of 34DD is often associated with back pain, dents in the shoulders, and the other characteristics you describe. Patients with these symptoms usually are appropriate candidates for breast reduction surgery. A thorough consultation including assessment of your overall health status, body-mass index, psychological profile, and physical findings would offer the plastic surgeon an opportunity to make a more definitive recommendation. It is often possible to go down to a C-cup, though it depends on a number of factors. Though attempts are made to disrupt the breast ductal system as little as possible during surgery, there are certain unavoidable risk factors that any patient must understand before surgery. Impairment of lactation and loss or change in breast sensation, for example, are both well-documented risks.