Before you undergo a breast reduction surgery, Dr. Pautler will ask you to do the following:
Have a mammogram: If you are 30 or older, Dr. Pautler will send you for a mammogram. A mammogram is a special way to take a digital image of your breasts. Having a mammogram is purely a precaution to make sure that there are no suspicious areas in your breast. If there is a positive finding on the mammogram, Dr. Pautler will consult with you and refer you to a general surgeon before proceeding with breast lift surgery. If you have a very strong family history of breast cancer, Dr. Pautler may send you for a mammogram even if you are younger than 30.
Stop Smoking: Cigarettes contain nicotine, a powerful substance that decreases blood circulation especially in the areas that need it most: your plastic surgery wounds. Smoking after your breast lift, your plastic surgery wounds heal slowly, infection risk increases, and recovery from breast lift surgery may be prolonged. You need to stop smoking at least four weeks before and six weeks after your planned breast lift surgery. In many cases, Dr. Pautler prescribes a smoking cessation medication called Zyban, however, it is not always covered by insurance drug plans. Nicotine-containing chewing gums and patches are as harmful as cigarettes, so do not use them. If you absolutely cannot curb your smoking, Dr. Pautler asks that you be honest about it and let her know because she may need to alter her breast lift surgical plan for you.
Take Vitamin C: This vitamin helps boost plastic surgery wound healing. It is available over-the-counter and is helpful to take two weeks before and two weeks after breast lift surgery.
Stop taking aspirin, ibuprofen or other non-steriod, anti-inflammatory medications including herbals and supplements that cause blood-thinning such as Ginko Biloba: These types of medications and supplements can increase your risk of a bleeding complication during and after breast lift surgery, so avoid them. Aleve, Advil, Motrin, Naprosyn, Bufferin, Anacin, Toradol and Alka Seltzer and similar products are examples of products to avoid before and after breast lift surgery. Inform Dr. Pautler of all medications and supplements that you take to see what you need to avoid. Tylenol is permitted, as are the pain medications that Dr. Pautler prescribes after breast lift surgery. Examples of blood thinning medications include Plavix, Lovenox, or Coumadine and their generic alternatives. Inform Dr. Pautler if you are taking this type of medication, as these will need to be stopped as well for breast lift surgery.
Discontinue birth control pills three weeks before breast lift surgery if you are a current smoker or if you have a history of blood clots, high blood pressure, or heart disease. Resume the birth control pills three days after breast lift surgery.
Bring button-down top to wear home from breast lift surgery: Pullovers are cumbersome and can cause discomfort or damage at your plastic surgery wound sites as you raise your arms to get the top on and off. Wear button-down tops during your recovery from breast lift surgery because they will be easier to put on and take off without risking injury to your breast lift.
After your Breast Reduction Surgery
After your breast reduction surgery, there are several items to do and consider for your own health and plastic surgery wound healing. They are:
other non-steroid anti-inflammatory medications, blood thinners and other herbals and supplements for at least two weeks after your breast reduction surgery.
Diet: No restrictions. You can eat what you like provided you don't have an upset stomach from the anesthesia you received during your breast reduction surgery.
Limit activity: Refrain from any exercise or strenuous activity for the first two to three weeks after breast reduction surgery including: housecleaning, vacuuming, anything with requiring arm movement, and brisk walking. The day after breast reduction surgery, it is permissible to go out or run errands but do not carry any heavy bags. Limit your lifting to no greater than 12 pounds. Do not lift or carry small children. Instead, have someone else put them on your lap and you can hold them. Two weeks after your breast reduction surgery, Dr. Pautler will remove your sutures, assess your level of plastic surgery wound healing and determine whether or not you can increase your activity level. Typically six weeks after breast reduction surgery, restrictions are halted and exercise can be resumed. For less extensive breast reduction surgeries, this should occur before six weeks.
Wear compressive bras: If you go home from breast reduction surgery in a support bra, you should wear it day and night for the first two weeks. If you have a compressive type of sports bra that fastens in the front and is seamless, you can switch after the first two weeks. Bring this bra to your two-week check-up after breast reduction surgery so that Dr. Pautler can verify that its support is adequate. You should continue to wear your bra day and night until Dr. Pautler informs you otherwise (usually after two weeks or so the bra does not need to be worn at night). In general, a compressive bra should be worn for six weeks after the surgery, and thereafter for exercise and other strenuous activity. Going without a bra after six weeks is strongly discouraged. The amount of time you do not wear a bra should be very brief, especially for extensive breast reduction surgeries. If your breast reduction is minimal, compressive bras are not necessary for as long a time. In some cases, especially if you have a large cup size, you should even wear a light compressive bra while you sleep.
Stop smoking: NO SMOKING FOR AT LEAST 6 WEEKS AFTER BREAST REDUCTION SURGERY! Dr. Pautler strongly advises that you stop smoking altogether for your overall health as well.
Bathing: It is permissible to shower two to three days after your surgery. NO BATHS OR SWIMMING until your plastic surgery wounds are healed and it is approved with Dr. Pautler.
Scar maintenance: You should massage your plastic surgery scars a few times a day with a product such as vitamin E oil, cocoa butter or Mederma applying pressure while massaging the scars. The pressure during the massage is more important than the type of cream product used. Combined with massage, these emollients can help accelerate softening, fading, and maturation of scars from breast reduction surgery. Silicone preparations are also available, but costly, and more suitable for patients that have a known tendency to form poor scars. Every individual is unique. Some women heal quickly and some heal slowly. In general, skin type determines the quality of the scar. Despite the most meticulous technique, some individuals heal poorly, while others heal beautifully. Age can also play a factor in healing time after breast reduction surgery. The older you are the less red and tender your breast reduction scars may appear while younger women may have pink or reddish scars that will be tender for several months and may take up to a year to fade.
Risks with Breast Reduction Surgery
The following lists the possible complications that could occur following a breast reduction surgery:
Numbness of the breasts:There will be some numb areas on your breast, including the nipple. This may or may not be permanent, but sensation can return in most breast areas even up to 2-3 years after the breast reduction surgery. As sensation returns it is not unusual to experience shooting pains, or “pins and needles.”
Infection: Unusual in breast reduction surgery, however, in the unlikely occurrence, it is treated with antibiotics.
Asymmetry of the breasts: Some asymmetries may appear as the breasts settle. With time, evening-out of the breasts can occur. If not, a touch-up or additional plastic surgery may be necessary if the asymmetry does not correct itself.
Tissue loss: Rarely, due to some compromise of circulation to the breast tissue (such as smoking, diabetes, steroid use, or from a very large resection), there can be some tissue loss from breast reduction surgery. Even more rarely, this breast reduction complication could involve nipple or areola. Some of the dead skin or tissue may need to be removed in the office and, with plastic surgery wound care, healing should proceed quickly. The shape and appearance of the breast is usually not affected, but the breast reduction scar in one area may be a little wide or pinker. In the worst-case scenario, should a nipple be lost (VERY rare), a nipple reconstruction can be done.
Dog-ears: Little cones of excess skin can form at the end of the breast reduction surgery scar that goes under the breast. These cones usually show up after the settling and healing of the breasts is concluded. If bothersome to the breast reduction patient, they can be removed in the office.
Delayed plastic surgery wound healing: In some cases, plastic surgery healing from breast reduction surgery takes longer than two weeks and usually involves the upside down 'T' part of the breast reduction surgery scar under the breast. This breast reduction complication can occur in the shape of a small triangle under the breast causing some separation of the breast reduction surgery incision. The area can seep and even bleed a small amount. This breast reduction complication is very common and should not affect the overall result of breast appearance. This breast reduction complication simply requires dressings and ointment applied for a few weeks. If the area of delayed plastic surgery wound healing is very large, Dr. Pautler may perform a breast reduction surgery scar revision anywhere from 6-12 months after plastic surgery healing.
Changes on mammogram: With some breast reduction surgeries, the breast tissue may get rearranged internally causing scar tissue to appear on a mammogram that was not there before the breast reduction surgery. When you go for your first mammogram after your breast reduction surgery (usually 6-12 months after breast reduction surgery) tell your radiologist about the breast reduction surgery. This new mammogram will now serve as your new baseline for comparison against all subsequent mammograms.
Hematoma or seroma within the breasts: Rarely does a collection of blood or body fluid become large enough to necessitate aspiration or removal with plastic surgery. If so, it needs to be done to prevent infection or plastic surgery wound healing problems. Small collections of blood or body fluid are normal but watched carefully until they absorb on their own.
Bottoming out of the breasts: If this breast reduction complication occurs, it does so months after the breast reduction surgery, and the nipple and areola may appear higher on the breast mound. This breast reduction complication can happen in individuals who have very stretchy skin or heavy breast tissue. If necessary, the breast appearance can be corrected by removing a wedge of skin under the breast through plastic surgery techniques.
Fat necrosis of the breasts: In some breast reduction cases, fat in the breast may scar internally and form a lump. Typically, these lumps soften in time, but in rare instances, they can persist. Dr. Pautler can remove the lump through a plastic surgery technique using the same incision as the breast reduction. The lumps are then sent off and analyzed by a pathologist to make sure that all they are, indeed, are fat.
Breast size unpredictability: During breast reduction surgery, Dr. Pautler will try her best to get you the breast size that you desire, but it is always possible to be either slightly larger or smaller breast size than anticipated. Pre-operative communication and looking at pictures before the breast reduction surgery is the best way to avoid disappointment with breast size.
Breast cancer: Studies show that a breast reduction can reduce cancer risk by 40% but it cannot eliminate the risk. It has been documented in the literature that on RARE occasions, a cancer has been detected in the breast during breast reduction surgery. A mammogram is obtained prior to the breast reduction surgery to see if there are any breast areas that should be studied prior to breast reduction surgery, but an occasional lump can be missed. Should this unusual circumstance arise during breast reduction surgery, it is possible that breast conservation surgery may not be possible and that eventually a mastectomy may need to be performed.
Shape change of the breasts: The breasts will be quite snug after breast reduction surgery and need to be supported to maintain shape. However, gravity cannot be eliminated, and despite best efforts to compress with bras and tape, the skin may stretch with time. Usually a flatter, upper-portion of the breast appears. For breast reduction surgery patients who have very stretchy skin, Dr. Pautler may perform the breast reduction surgery in such a manner to account for eventual shape change of the breasts. Consequently, the breasts may initially have an unusually full, upper-portion of the breast after breast reduction surgery. By anticipating the settling and stretching of skin during breast reduction surgery, the fullness dissipates and the desired breast shape eventually evolves.
Breastfeeding after breast reduction surgery: Many women are able to nurse successfully after breast reduction surgery; however, it cannot be guaranteed. If breastfeeding is something you absolutely wish to do, you may want to consider holding off on the breast reduction surgery until finished with childbearing.
Volume change: Weight loss or gain, or the use of oral contraceptives can alter your breast size after breast reduction surgery. Also, it is possible to have re-growth of breast tissue, which can occur with hormone changes. In the case of this unlikely breast reduction complication, it may necessitate further plastic surgery.
View our Glossary of Breast Surgery key terms Here.
Breast Augmentation Testimonial
Dr. Pautler and Staff...
Words cannot begin to express how happy I am with the results of my
surgery and what a wonderful surgeon you are. What you were able to do is
simply amazing! I never dreamed that the difference would be this
dramatic!
My entire experience with you and your staff was also terrific. I also
want to thank you for spending so much time with me during my
consultations and before and after the surgery.
It is obvious how much you care about your patients and what you do.
You have changed my life in such a positive way. I simply cannot thank
you enough for the wonderful job you've done.
Breast Reduction Testimonial
Dr. Pautler and Staff...
I am writing this only five days postop and I wanted to thank you already.
You have a wonderful staff and a wonderful heart. It is so nice to have
such a supportive doctor! You really prepared me for what I should expect
and left me feeling very confident before and after surgery. The breast
reduction alone has made me so much happier already and the tummy tuck and
liposuction will only ensure a much easier life (physically and
emotionally). If I could only explain the emotional relief I feel: the burden gone, the list of things I can do and wear. Thinking about what
life will be like without the 'DDD' ball and chain I used to have, brings
tears to my eyes. Tears of relief and joy! Thank you so much for making me feel important and special!
Plastic Surgery Testimonial Dr. Pautler and Staff...
I want to thank you so much for the wonderful care I received in your office before, during and after my surgery. I was so impressed with your office and how I was treated each time I was in. I am so happy with my results so far. Dr. Pautler's surgical skills are fabulous! Thank you so much & happy holidays to all!
Liposuction
Testimonial
Dr. Pautler and Staff...
From the very first time I entered your office, I felt special. You all are the most kind and lovely people. You’ve been with me through it all and I love you all for that. I am so happy for having my tummy tuck. That was the best decision I ever made. I feel so good about myself now. May God’s blessings continue to be upon you and your staff.
Facelift Surgery Testimonial
Dr. Pautler and Staff...
Thank you for making me look as good as I feel. It is so nice to look into the mirror and not see a tired looking stranger!
Thank you also for being so patient with me and my anxieties!
Lower Body Lift Testimonial
Dr. Pautler and Staff...
I hope you realize what a blessing I consider you to be. You truly understood everything I was going through after such a weight loss, and offered me ways to become beautiful again! After two years of hard work, I finally have my body back and it wouldn't be so without you. Not only am I thrilled but my husband can't believe the difference in my body and my self-esteem. It is through the roof!!! I finally feel "sexy!" Thank you. You are the best!!!
“I believe [Dr. Pautler] is a superior surgeon and is a wonderful choice if you're interested in a breast lift.” - Linda B., Pennsylvania.
