Breast Reduction (Reduction Mammaplasty)
When a woman's breasts are too large, not only do they impede on her activities and lifestyle, but they can be very painful. If you experience bra strap grooving marks on your shoulders, skin irritation in the creases beneath your breasts, or lower back pain, a breast reduction (reduction mammaplasty) procedure will probably be covered by your health insurance plan.
Dr. Trott performs both the traditional “anchor scar” and limited-scar “vertical” reductions. Traditionally, breast lifts (mastopexy) and reductions (reduction mammaplasty) have been done with an anchor scar (around the nipple, vertically down the middle and across the inframammary crease). However, over the past decade, the development of the more modern “lollipop” reduction (just around the nipple and up and down) has evolved. Dr. Trott’s training at the University of California, San Diego Medical Center included performing over one hundred of these lifts and reductions on both reconstructive and cosmetic patients. This training was done under the direction of Dr. Anne Wallace, who has been director of the Breast Center at UCSD since 1995.
Dr. Trott has taken her experience one step further and developed her own technique, “The Dermal Spanning Flap”, which she has incorporated into her vertical lift and reduction surgeries. She feels that this additional procedure improves the contour of the lower rounded portion of the breast and helps to strengthen the lift like an internal bra. She has presented this original technique at the 2006 joint meeting of the California Society of Plastic Surgeons and the Rocky Mountain Association of Plastic Surgeons meeting in Las Vegas. When necessary, Dr. Trott also sculpts the lateral chest wall with Liposculpture (liposuction) to narrow your breasts and give them a smoother, more attractive contour.
Women who undergo breast reduction (reduction mammaplasty) have one of the highest satisfaction rates of all plastic surgery patients. Most of these women go on to lose more weight as they are able to lead more active lifestyles.
Breast Reduction (Reduction Mammaplasty) FAQ’s
Q) Will a breast reduction (reduction mammaplasty) be covered by my insurance?
A) All insurance companies have different stipulations about what they will cover. If you are wearing at least a DD bra and have back pain, bra strap grooving and get rashes underneath your breasts you should check with your insurance company’s requirements. Most insurance companies require that a weight of breast tissue proportional to your body habitus be removed to consider the procedure ‘reconstructive’.” This number is usually calculated using your Body Mass Index and the “Shnur Sliding Scale”, which can usually be found on your Health Insurance website. For most women, the number is about 400 grams, and is approximately half of your breast tissue. If you are a true DD, that is about half your breast size. Less than that is usually considered just a cosmetic lift by an insurance company. Some insurance companies also require that your primary care physician has documented for at least several months that you have been having symptoms from your heavy breasts before they will consider covering your surgery. As unreasonable as this all sounds, it is unfortunately the way it works. If Dr. Trott feels that you are truly a good candidate for the surgery she will do what she can to get you covered but the insurance companies can be very strict and most of it is out of her—and any physician’s—control. Dr. Trott recommends that you contact your insurance company first before scheduling an appointment find out what your benefits are and what their stipulations for coverage are, so you can go through the process as efficiently as possible.
Q) Will I lose nipple sensation after a breast reduction (reduction mammaplasty)?
A) The chances of permanently losing nipple sensation after breast reduction (reduction mammaplasty) surgery are higher than after breast augmentation— approximately fifteen to twenty percent. Sometimes nipple sensation actually increases, because the weight of the breast tissue is no longer stretching the nerves. However, as with breast augmentation surgery, Dr. Trott recommends that if nipple sensation is very important to you, you should never undergo elective breast surgery.
Q) Will I be able to breast feed after a breast reduction (reduction mammaplasty)?
A) The data on this subject is not very accurate because some women just cannot breast feed anyway, and it has nothing to do with their previous breast reduction (reduction mammaplasty). However the chances that you would not be able to breast feed after a breast reduction (reduction mammaplasty) (reduction mammaplasty) are probably about 30%.
Q) What is the down time after a breast reduction (reduction mammaplasty)?
A) Recovery after a breast reduction (reduction mammaplasty) is actually easier than after an augmentation because there is no muscle work involved, and that’s really what causes the soreness. Dr. Trott recommends one week off work and taking it easy after breast reduction (reduction mammaplasty) surgery. You will wear a special surgical support bra during that time and then you can switch to a more attractive support bra of your choice.
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Gynecomastia Correction (Male Breast Reduction)
Enlarged male breasts (gynecomastia) affect nearly 40-60% of men. The most common known causes are marijuana use and the intake of prostate cancer medication. However, most cases of gynecomastia have no known cause. This condition can be highly embarrassing as well as physically uncomfortable.
If gynecomastia presents during a young man’s adolescence, it is usually true fibrous breast tissue and it may resolve on its own, while later in life it can be a more fatty tissue. Either way, it may make you self-conscious since it can even be visible through a t-shirt. Many men and teenage boys would like to take care of this problem but don’t seek help because it is such a sensitive issue.
A general rule is that if the gynecomastia in a teenage boy does not resolve on its own within three years, it should be corrected. In more mature men, it can be corrected at any time. In the past, gynecomastia reduction (male breast reduction) required large incisions for removal of the skin and tissue, which left visible scars. However, very few patients today require excisional surgery. Dr. Trott’s approach for managing gynecomastia combines the latest techniques of power-assisted liposuction (liposculpture) by Microaire™ and VASER™ ultrasound technology to aggressively reduce male breasts through small hidden liposuction (liposculpture) incisions. The ultrasound is thought to tighten and shrink the skin., while the power-assisted suction ensures that all of the unwanted breast tissue is removed. Results are best in younger men because skin is more elastic, however, Dr. Trott’s patients wear a compression vest for six weeks postoperatively and rarely is any sagging skin left remaining after the healing process. If it is, then it is removed as a second stage procedure three months later.
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