Breast Gallery

A 6-year follow-up on a woman in her late 50s who was a 36 DD and had problems with grooving and irritation of her shoulders from the bra straps, back pain, rash under the breasts, and difficulty exercising.  She was a size 6 in pants and a size 10-14 in tops and felt that her breasts were out of proportion.  She is an avid runner and wishes to have a smaller C-cup breast. She also had some mild bulging of the fat pads in the armpit area/ upper breast (axillary lipodystrophy) and had liposuction of those areas at the same time. She is 5′ 7 1/2” and 145 lbs.  She is shown just before and again, 6 years after, 381 grams from her right breast and 421 grams from her left breast. (454 grams=one pound)

She is thrilled with her new shape and size, no longer needs to wear special bras to run, and states that “this is the best thing that she has ever done.”

A mother of 2 in her late 40s with bilateral macromastia. She is a 34 DDD and has had problems with neck, back, and shoulder pain, as well as irritation of her shoulders from the bra straps and difficulty with her posture. She would try to wear 2 bras to exercise but still did not have enough support. Frequent massage therapy did not give lasting relief.  She is shown before and gained, 7 ½ months after bilateral breast reduction.  She is thrilled with her new shape and size, and her symptoms have all resolved.

A man in her early 20s with right unilateral gynecomastia which became more noticeable in his 20s. He is a bodybuilder, and although he has not taken anabolic steroids but may have used over-the-counter supplements.

He is bothered by the appearance of fitted shirts and with his shirt off.

He is shown before and again, 7 weeks after power-assisted liposuction of his right chest combined with the direct excision of 24 grams of breast tissue through an incision along the lower areolar border.

Discussion:  Scars are typically at their reddest and thickest at 6 weeks and then will typically fade and improve over the next year or longer.  I now place the lateral liposuction incision along the lateral border of the pectoralis muscle where it is not as noticeable.  We will have him use topical silicone on the scars and avoid sun exposure for 12 months to decrease the risk of darkening the scar in the sun (“Post-inflammatory hyperpigmentation”).  His scars are a little better than we might typically see at 6-7 weeks.

His presentation is typical for bodybuilders with gynecomastia.  Even though his case is mild to moderate, a more even contour is obtained in my hands by using power-assisted liposuction along with excision of the breast tissue.

The “hands on the head” view shows the gynecomastia contour before and 7 weeks after.

A woman in her mid-70s with bilateral macromastia and drooping of her breasts. She had problems with neck pain, back pain, shoulder pain, grooving of her shoulders from the bra straps, Postural difficulties, and difficulty exercising due to the size of her breasts. She described herself as a 34 D cup bra.

She is shown before and again, nearly 4 months after bilateral reduction mastopexy with dermal pedicle plication (internal suturing to give a better shape) and the removal of 330 grams of tissue from each breast.  (454 grams is equal to one pound)

She is thrilled with her new shape and size, and her symptoms have all resolved.  Like most patients, she “wishes she had done this much sooner.” Her scars continue to fade with the topical silicone and should typically improve for another year or longer.

A mother of 2 in her late 40s with breast ptosis (drooping) and macromastia.  She describes herself as a 38J cup.  Despite losing 40 lbs she continues to have back pain, shoulder pain, goring and irritation of her shoulders from the bra straps, neck pain, difficulty exercising due to the size of her breasts, and problems with her posture.

She is shown before and again, just short of 3 months after bilateral reduction mastopexy ( lift and reduction) with the removal of 400 grams of breast tissue from each breast.  She has been using the topical silicone that we suggested and her scars are fading well.  She loves the new shape and size of her breasts, and all of her symptoms have resolved. Scars typically get thicker and redder for 6 weeks and then soften and fade over the next 2 years. Her scars are a little better than the average at 3 months.

A woman in her later 60s is bothered by the drooping of her breasts and difficulty exercising due to the size of her breasts.  She wears 2 bras to exercise,  She also has fatty deposits in the upper armpit area (“axillary lipodystrophy”).  She is 5’6” and 174 lbs. She is shown before and again, 4 ½ months after bilateral breast reduction with the removal of 276 grams of breast tissue from her right breast and 292 grams of tissue from her left breast to reduce her to a “C’ cup.  Liposuction of the axillary lipodystrophy was performed at the same time.  Scars typically will get reader and thicker for 6 weeks and then fade and improve over the next 2 years.  Scars tend to fade faster when patients are older.  She is using her topical silicone and her scars are fading nicely for this time.  Her symptoms have resolved and she is thrilled with the new shape and size of her breasts.

A complicated presentation of a woman in her mid to later 60s with breast ptosis (drooping) after significant weight loss, as well as breast asymmetry after lumpectomy and radiation.

She had a lumpectomy and radiation for breast cancer in her right breast 4 years earlier.  She then had a gastric bypass 2 years later and lost 80 lbs.  In addition to drooping after weight loss, they are also asymmetric after the lumpectomy and radiation.  She describes herself as a D-cup and would like to have her breasts smaller as well.  She had an MRI of her breasts before surgery and the view was free of any evidence of cancer recurrence.  The lumpectomy scar is seen on the right mid breast, and the radiation fields spared the lower breast so an inferior pedicle breast reduction could still be performed.  She is shown before and again, 7 months after surgery with the removal of 360 grams of tissue from her right breast, including the prior lumpectomy site, and 379 grams of tissue from her left.  She is thrilled with her new appearance and has purchased multiple new bathing suits to celebrate.  Her neck and back feel better as well.  Her healing was, thankfully, uneventful, and her scars have faded nicely.  And despite the decreased skin elasticity from significant weight loss and her age, she has maintained a very good breast shape.

A man in his mid-20s who developed bilateral breasts at the age of 11.  They did not resolve after 18 months as is common for idiopathic gynecomastia. He continues to be bothered by the appearance of his chest in fitted shirts and with his shirt off.  He is shown before and again, just 6 weeks after bilateral gynecomastia treatment with a combination of power-assisted liposuction and direct excision of breast tissue through an incision in his lower areolar.  At 6 weeks his scars are typically at their reddest and most noticeable. He is already thrilled with his improvement and will start topical silicone to help with scar maturation, as we expect his scars to continue to fade and improve over the next 1-2 years.  “Hands-on head view” highlights the breast fullness before and improvement after.

A woman in her early 40s who had breast augmentation elsewhere in 2016. She noticed a change in the shape of her left breast a year ago, and  An ultrasound suggested a left implant rupture, which was confirmed on a subsequent MRI.  She originally had Mentor moderate profile plus 350 cc smooth round silicone gel implants placed through an inframammary incision in a partial subpectoral position.  Her left implant fold was 2 cm higher than her right.  She liked the implant size that she had and wished to have it replaced with the same size.   She is shown before and again, 6 weeks after the removal of her left ruptured silicone implants, and replacement with new implants of the same size and manufacture on each side.  Her left fold was lowered to match the right. Because she had her original implant cards and it had been less than 10 years since her original procedure, we were able to open a case with Mentor for a warranty claim which will help to cover some of the costs of surgery.  We also were able to prior approval from her insurance company to cover the removal of her left ruptured silicone breast implant.  At 6 weeks she is healed well and has better symmetry.

An Indian dancer and mother of 2 in her late 40s who is bothered by the small size of her breasts – she describes herself as a 34A cup and would like to fit her dresses better.  She is shown before and again, 6 months after bilateral breast augmentation. She is 5’ 5 ½” and 132 lbs and has Sientra smooth round high profile 385 cohesive gel implants placed through an inframammary incision with a partial sub-pectoral placement.