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Breast Procedures

Washington DC Plastic Surgery Breast procedures

Breast Reduction

Breast Lift (Mastopexy)

Breast Augmentation


Breast Reduction

What is Breast Reduction?

Women with large breasts, or “macromastia”, may often suffer from associated back, neck, and shoulder pain, as well as skin irritation under the breasts. Non-surgical treatment options include weight loss, physical therapy, and supportive bras. When this is not enough, breast reduction surgery can be performed to remove excess breast tissue and reshape the breasts. Our surgeons perform a variety of techniques, including vertical and “short scar” breast reduction. Based on your particular anatomy and wishes, we will help you decide what option would be ideal for you. This is done as an outpatient surgery and often results in quick symptom relief. Some insurance plans may provide coverage for breast reduction.

Am I a Good Candidate for Breast Reduction?

You may be a candidate for breast reduction if you suffer from symptoms such as chronic back, neck, and shoulder pain, or skin irritation under the breasts that are caused by the weight of the breasts. Some patients seek breast reduction because they are bothered by the feeling that their breasts are too large. The ideal candidate will also be near her ideal body weight. Often, patients referred for breast reduction will have had other sources of discomfort ruled out by a primary physician prior to referral.

What Are the Risks of Breast Reduction?

Some possible risks include bleeding, infection, asymmetry, poor scarring,w ound separation, changes in nipple sensation, nlood clots, contour irregularities, seroma (fluid accumulation), fat necrosis (firm areas in the breast), partial or complete loss of breast skin or the nipple and areola, pain, possible inability to breastfeed, and need for revision surgery. You will be asked to sign a consent form to express understanding of potential outcomes.

How is Breast Reduction Surgery Done?

Breast reduction is performed under general anesthesia as an outpatient surgery. Our surgeons offer multiple techniques for reducing the breasts, and will help you decide what will is best for your individual body. The most common of these are the inverted T (“anchor” pattern) and vertical (“keyhole”, “short scar”) breast reduction. The primary difference in these is the scar pattern from the surgery. During the surgery, excess skin and breast tissue will be removed, and the breasts will be reshaped. The nipple and areola will be re-positioned. The incisions will be repaired using absorbable sutures, and you may have a drain placed after surgery to reduce the possibility of complications related to fluid accumulation.

What Will My Recovery Be Like After Breast Reduction?

You will be instructed on avoiding bras with underwires (a surgical bra will be placed immediately after surgery) for a period of time. Many women return to work after 1 week, and most fully recover by 4-6 weeks. Your surgeon will instruct you further on taking care of the scars after surgery, and these will typically fade and improve over time.

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Breast Lift (Mastopexy)


What is a Mastopexy (Breast Lift)?
Breast sagging, or “ptosis”, can happen after weight loss, pregnancy, breast feeding, or with aging. Mastopexy (breast lift) is a procedure performed to lift and reposition the breasts by removing excess skin, reshaping the breast tissue, and restoring a youthful breast shape. Mastopexy alone does not increase the overall volume of the breasts, but sometimes is done with breast augmentation. This is done as an outpatient surgery.

Am I a Good Candidate for Mastopexy (Breast Lift)?
You may be a candidate for mastopexy (breast lift) if you are unhappy with breast sagging, flatness, nipple position, or loss of shape.

At your visit, your doctor will assess:

  • Your overall physical health and medical history
  • Your expectations and motivations for surgery
  • Perform a detailed physical exam of the breasts
  • Take photographs for your medical record
  • Discuss whether you are a good candidate for surgery and expected outcome

What Are The Risks of Mastopexy (Breast Lift)?
Some possible risks include bleeding, infection, asymmetry, poor scarring, wound separation, changes in nipple sensation, blood clots, contour irregularities, seroma (fluid accumulation), fat necrosis (firm areas in the breast), partial or complete loss of breast skin or the nipple and areola, pain, possible inability to breastfeed, and need for revision surgery. You will be asked to sign a consent form to express understanding of potential outcomes.

How is Mastopexy (Breast Lift) done?
Mastopexy (breast lift) is performed as an outpatient surgery. Our surgeons offer multiple techniques for lifting the breasts, and will help you decide what will is best for your individual body. The most common of these are the periareolar, inverted T (“anchor” pattern) and vertical (“keyhole”, “short scar”) mastopexy. The primary difference in these is the scar pattern from the surgery and the amount of lifting achievable. During the surgery, excess skin (and possibly some breast tissue) will be removed, and the breasts will be reshaped. The nipple and areola will be re-positioned. The incisions will be repaired using absorbable sutures, and you may have a drain placed after surgery to reduce the possibility of complications related to fluid accumulation.

What Will My Recovery Be Like After Mastopexy (Breast Lift)?
You will be instructed on avoiding bras with underwires (a surgical bra will be placed immediately after surgery) for a period of time. Many women return to work after 1 week, and most fully recover by 4-6 weeks. Your surgeon will instruct you further on taking care of the scars after surgery, and these will typically fade and improve over time.

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Breast Augmentation

What is Breast Augmentation?
Breast augmentation is performed to increase the size and fullness of the breasts, and is most commonly performed with implants, which are filled with either saline or silicone gel. Breast augmentation is also colloquially referred to as a “boob job”. This procedure can achieve a fuller breast shape, restore volume lost after pregnancy or weight loss, and correct congenital asymmetries. You will see immediate results after your surgery. Sometimes breast augmentation is performed in concert or staged with breast lift for severely sagging breasts. The surgery takes approximately 1-2 hours and is performed under general anesthesia.

Am I A Good Candidate For A Breast Augmentation?
You may be a candidate for a breast augmentation if you are unhappy with your breast size, fullness, or shape. Breast augmentation can also correct minor amounts of breast sagging while also increasing breast volume.

At your visit, your doctor will assess:

  • Your overall physical health and medical history
  • Your expectations and motivations for surgery
  • Perform a detailed physical exam of the breasts
  • Take photographs for your medical record
  • Discuss whether you are a good candidate for surgery and expected outcome

At your consultation, you will discuss with your surgeon the pros and cons of decisions such as breast implant type (silicone versus saline), implant position (above or below the pectoralis muscle), and incision location.

What Are The Risks of Breast Augmentation?
Some possible risks include bleeding, infection, asymmetry, poor scarring, wound separation, changes in nipple sensation, blood clots, contour irregularities, seroma (fluid accumulation), implant visibility, implant malposition, pain, capsular contracture (formation of tight scar tissue around the breast implant), skin laxity after breast implant removal, and need for revision surgery. Breast implants are man-made devices and have a limited life-span – there is a possibility that you will need surgery to remove or replace the implants if they develop a rupture.

Breast implants have been extensively studied and no definitive link between silicone breast implants and systemic diseases has been identified. There has been a link between textured breast implants and BIA-ALCL (breast implant associated anaplastic large cell lymphoma), a rare type of lymphoma that can develop around breast implants. You will be asked to sign a consent form to express understanding of potential outcomes.

Click here for more information on BIA-ALCL

How is Breast Augmentation Done?
Breast augmentation is performed as an outpatient surgery. The length of the incision will depend on the size and type of implant that is being placed. Your surgeon will create a space either above or below the pectoralis major muscle and insert the breast implant. After appropriate symmetry is confirmed and adjusted, the incisions will be repaired using absorbable sutures. You typically will not need a drain after breast augmentation.

What Will My Recovery Be Like After Breast Augmentation?
You will see the increased breast fullness immediately after surgery. You will be instructed on avoiding bras with underwires (a surgical bra will be placed immediately after surgery) for a period of time. Many women return to work after 1 week, and most fully recover by 4 weeks. It will take several months for your implants to “settle” into their natural position and in the meantime your surgeon may instruct you on massaging the implant. Your surgeon will instruct you further on taking care of the scars after surgery, and these will typically fade and improve over time. It is important to have regular follow up with your surgeon even after the initial healing period to make sure there are no long-term problems related to the implant.

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