Breast Procedures

Breast Reduction

Women experiencing discomfort and health issues from very large breasts may find relief through breast reduction surgery. This condition can lead to back and neck pain, skin irritation, skeletal deformities, and even breathing difficulties. The weight of large breasts can cause bra straps to create indentations in the shoulders, and the physical appearance may lead to self-consciousness for both women and teenagers. Breast reduction, or reduction mammaplasty, aims to alleviate these problems by removing excess fat, glandular tissue, and skin, resulting in smaller, lighter, and firmer breasts. This surgery not only enhances the breast shape and reduces the size of the areola but also aims to achieve a more proportional body silhouette. Typically sought for physical comfort over aesthetic reasons, breast reduction helps women overcome the limitations and discomfort associated with overly large, pendulous breasts.

Pre-Surgery

In your initial consultation, Dr. Weiss will describe in detail the procedure explaining any risks and limitations and scarring that will result.
Discuss your expectations frankly with Dr. Weiss, and to listen to his opinion. Every patient - and every physician, as well - has a different view of what is a desirable size and shape for breasts.
Your insurance company may authorize the surgery if criteria have been met to satisfy a "medical necessity". This practice works with your insurance company to help get necessary approval.
You may be required to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

Reduce neck and back pain

Recovery

After surgery, you'll be wrapped in a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two after which the bandages will be removed. You'll continue to wear a surgical bra around the clock for several weeks.
Stitches removed in one to three weeks.
Most of the swelling and bruising will disappear within the first few weeks.
Most patients can return to social activities in about two weeks.
You should limit exercises to stretching, bending, and swimming until your energy levels return. A good athletic bra is recommended.
Discuss the long-term care of your breast reduction procedure with Dr. Weiss directly. Schedule An Appointment today!

Breast Augmentation

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:

To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small
To correct a reduction in breast volume after pregnancy
To balance a difference in breast size
As a reconstructive technique following breast surgery

Breast augmentation, enhancement, or enlargement is an art, and an experienced Plastic Surgeon, an artist. Choosing the right size and shape implant for each patient is complex and very special. During the initial consultation size, shape, and realistic expectations all come together to create a beautiful body. Breast augmentation can enhance your appearance and your self-confidence. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon Dr. Weiss.

Pre-Surgery

In your initial consultation, Dr. Weiss will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. A breast lift may also be recommended.
Discuss your expectations frankly with Dr. Weiss. He will describe your alternatives and the risks and limitations of each.
Dr. Weiss will also explain the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.
Most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure.
You may be required to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

Surgery

Implant insertion and positioning will depend on your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola, or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Implants are centered beneath your nipples behind the breast tissue or underneath the chest wall muscle (pectoral).
Surgery completion usually takes two hours. Stitches are used to close the incisions and tape may be used for greater support.
Discuss your breast augmentation procedure more in depth with Dr. Weiss today - Schedule An Appointment

Recovery

Read about Dr. Weiss' technique below that promotes faster and earlier recovery!
A gauze bandage may be applied over your breasts to help healing for a few days - at which point a surgical bra should be worn as directed.
Tiredness and Soreness for the first 24 to 48 hours
Stitches removed in seven to fourteen days. Swelling may take three to five weeks to disappear.
Return to work within a few days, depending on the level of activity required.
Scars will be firm and pink for at least six weeks and will remain the same size for several months. After several months they will begin to fade but will never disappear completely.
Regular examination by your plastic surgeon and routine mammograms for those in the appropriate age groups at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.

Tumescent Breast Augmentation

I believe this delivery method of the tumescent solution has proven its usefulness by minimizing patient discomfort postoperatively, saving operating room time, as well as reducing incidence of hematomas.

Revised from the Plastic and Reconstructive Surgery Journal December 2002 Alan Weiss, M.D.

Technique Summary

A technique that promotes earlier recovery after an augmentation mammoplasty. This technique addresses the issue that patients awaken from general anesthesia with significant discomfort after breast augmentation surgery.

Dr. Weiss has been using the Tumescent solution (containing marcaine with epinephrine) for a number of years to reduce recovery time in patients post-surgery. The patient awakens virtually pain free. The slow onset of pain is better managed in a conscious, and oriented patient. Subsequent discomfort can be managed with oral analgesics.

This solution also helps secure hemostasis and saves time in the operating room. After the first subpectoral pocket is dissected in a manner similar to that described by Tebbetts(1), it is packed with lap sponges moistened with tumescent solution. These are left in place while the other side is operated upon. The surgeon then returns to the first side, removes the sponges, and places the implant. This allows adequate time for distribution of the tumescent solution, without prolonging the procedure. The subpectoral pocket is now dry and anesthetized. The sponges also tamponade small vessels and help define the pocket.

REFERENCES
1. Tebbetts, John B. Achieving a Predictable 24-Hour Return to Normal Activities after Breast Augmentation: Part 1. Refining practices by Using Molion and Time Study Principles. Plastic and Reconstructive Surgery 129: 273, 2002.