A woman in her mid 20’s who wears a D cup and is bothered by back pain, shoulder pain, difficulty exercising as well as irritation of her shoulders from her bra straps. She is petite at 4’11” and 114 lbs. She is shown before and again, 2 ½ months after bilateral reduction mastopexy with the removal of just over 220 grams of tissue from each breast. Scars typically are redder a thicker for 6 weeks and then will fade and improve over the next 2 years or longer. She is thrilled with her new shape and size, and all of her symptoms have resolved. Tattoos have been blurred for her privacy, The photos are otherwise unretouched.
A woman in her later 60s shown before and again, 4 months after a bra line back lift performed at the time of a reduction mastopexy (breast lift and reduction) She is 5’5” and 194 lbs and had a little more than 500 grams of breast tissue removed from each side to bring her down to a small C cup as per her request. Scars are typically redder and thicker for 6 weeks and then will fade and improve over the next 2 years or longer She is using topical silicone at our recommendation to help with scar maturation. Her surgery was performed on a cosmetic basis.
A woman in her later 30s with a deflated appearance of her breasts after weight loss. She is 5’ 4 14” and 112 lbs and is shown before and again, 6 weeks after the bilateral partial subpectoral placement of Sientra round smooth moderate profile cohesive silicone gel 355 breast implants. They were placed through an inframammary incision.
A young man in his later teens with gynecomastia since the age of 13. He does not have a history of marijuana or anabolic steroid use so this is most likely idiopathic in origin. Idiopathic is a medical term for “we don’t really know why” and is a common presentation at puberty. He is bothered by fitted shirts and with his shirt off. He is shown before and again, just 6 weeks after surgery with Power Assisted Liposuction using the S.A.F.E. technique ( Separation/Aspiration/Fat Equalization) combined with direct excision of breast tissue from an incision along the lower areola. Scars are typically at their reddest at 6 weeks and we will now have him use topical silicone to help the scars soften and fade faster. He is thrilled with his result and can now resume normal activities and the gym.
A woman in her early 20’s who wears a 34 DD cup bra and has problems with back pain, shoulder pain, difficulty exercising, and grooving and irritation of her shoulders from her bra straps. She was active in high school on volleyball and basketball teams but finds it difficult now to run and jump because of the size of her breasts. She is shown before and again, just 4 ½ months after bilateral breast reduction with the removal of just more than 450 grams from her right breast and just more than 500 grams from her left. Scars are typically at their reddest and thickest at 6 weeks and then fade and improve over the next 2-3 years. She is ahead of schedule with her scars fading, perhaps somewhat from her genetics and somewhat from using the recommended silicone stick twice a day. Her symptoms have resolved and she loves her new shape and size!
A mother of 2 in her later 30s with a 38DDD bra is bothered by back pain, neck pain, shoulder pain, and difficulty exercising due to the size of her breasts. She had gained weight during the quarantine and at 5’9 and 236 lbs was over her ideal body weight. She is shown before and again, just 4 ½ months after a bilateral breast reduction with the removal of more than 500 grams from her right breast and more than 600 grams from her left breast to bring her down to a full C cup in keeping with her frame. Her symptoms have cleared and she feels more comfortable in clothes and bathing suits. Scars typically get redder for 6 weeks and then fade and improve over the next 2-3 years. She is ahead of schedule at 4 ½ months and has been using the topical silicone as recommended to help her scars fade.
A man in his mid 20’s who is bothered by the prominence of his nipples in fitted shirts. He has mild gynecomastia and this calls attention to it. Although he could consider gynecomastia surgery, he preferred to start with bilateral nipple reduction in the office with a free nipple amputation technique. He is shown before and again, 6 weeks after this procedure. He is pleased with his result and now feels comfortable in fitted shirts. He can choose to have the gynecomastia treated at a later time if the female breast development becomes more bothersome to him.
An Asian mother of 2 in her later 40’s who described herself as a 32 A cup and wanted to have a fuller but still natural look. She has some asymmetry with her right breast being higher and slightly more lateral on her chest wall She does not want an “implant” look. She is shown before and again, 4 ½ months after bilateral partial sub-pectoral placement of round smooth highly cohesive silicone gel Sientra 255 High profile implants through an inframammary incision.
Discussion: The Sientra 255 HP implant is 10.8 cm at the base. The measured base width of her breasts was each 10.6 cm and the IMF to nipple distance on the stretch was 7.5 cm. A larger implant would have been significantly wider than her breast and would have been more likely to give her an overly round “implant” look, which she wanted to avoid. She is thrilled with her fuller but still natural appearance.
A woman in her early 50’s described herself as a 40DDD cup and had difficulty exercising as well as grooving and irritation of her shoulders from her bra straps, back pain, and a rash under her breasts in the warmer months. She also has “axillary lipodystrophy”, a fatty prominence in the anterior axilla that shows in an evening dresses and bathing suits. She is shown before and again, 7 months after bilateral breast reduction with the removal of more than 800 grams of tissue from each breast as well as liposuction of the axillary lipodystrophy. She is thrilled with her new appearance, and her symptoms have resolved.