Bermant Breast Reduction Surgery
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Breast Reduction (Reduction Mammoplasty)

Explore what others have to say about breast reduction (reduction mammoplasty) with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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  • Did it have any effect on your life
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  • How did others react to your surgery?
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  • What would you advise others?

Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Subj: Re: Time to become natural breast

I had breast reduction surgery one week ago. Everything is going well. I am wondering, however, how long I should expect to wait until the breasts are more "natural", in that the shape is what I will eventually end up with. Right now, the skin is tight, the nipples high (compared to what they were) and the shape isn't the same between the two breasts.

Any insight you can give me is greatly appreciated.

M

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

These questions are ideal for your doctor. Each surgeon uses different methods to achieve results. Swelling is a fact after surgery. For my patients I use a variety of breast reduction techniques and each has its own swelling reduction course. The more tissue is undermined or injured, the more it will swell. Blood supply, lymphatic drainage, prior scars, wound healing / closure all affect how long swelling lasts.

Initial swelling improves over time with an initial rapid decrease after wound closure. Over the next several months further improvement occurs during the basic scar softening.

Nipple position and symmetry also are affected by the healing process.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: free nipple graft breast reduction

I saw a plastic surgeon for breast reduction and she said that in my case a free nipple graft procedure was essential. I am 25 years old and 5 feet tall. I measure 34" around my chest and my breasts are 13 inches from chest wall to the nipple. Can you tell me what are the risks with this particular procedure... I know I can't breast feed..But if I get pregnant I presume I shall still lactate... what happens to this milk? will it cause cysts/clots and require further surgery? I plan to have a couple in the next five years... How do I preserve the benefits of this surgery? Also I am told that dark skinned people scar more(keloid scars) How can I prevent exceesive scarring?

Dr. Bermant responds:

Dr. Bermant responds:

Breast reduction surgery for very large breast sometimes needs free nipple areolar grafting. To transpose these tissues from their displaced position to their new site and maintain a blood supply can be an impossible task. The pedicle to maintain the nipple areola can be so big that there is just not enough breast reduction. Instead we remove the tissue from the underlying connections and move them to the new position as grafts. They get a new blood supply from the new site. However the connections to the underlying glands are thus cut when moved as grafts. Milk production is not usually possible in such patients. The glands are still stimulated by the pregnancies hormones which can lead to some pain / discomfort. The breasts also swell during pregnancy. This can stretch the breasts whether they have been reduced or not. Explore more issues about breast feeding after breast reduction.

I generally recommend to wait for the breast reduction until after pregnancies. I prefer my patients to wait especially for free nipple graft cases. You should discuss this with your surgeon to explore the options before the pregnancy. Support bras are sometimes a temporary option.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: breast wound

Hi,

I'm searching for information on the web for a friend of mine. She had breast reduction surgery in late June, 10 weeks ago, and then she had a serious staph infection where she ran a high fever for several weeks and had to visit a doctor every day to have it cleaned, drained and packed, and her white blood count was very high and she had to have IV's to help get rid of the infection. A different doctor did the cleaning and maintenance during this time, and when she went back to the first one, he didn't even physically examine her! It took him awhile to even read her paperwork, and then he assured her that she would be fine, it would just take time. The last time she went back to the doctor and he finally took off the bandages to look, it was bleeding so heavily, fresh blood, that he couldn't see anything, so he had the nurse bandage her up right away and said that she was probably fine, just to give it time.

In the meantime it is still bleeding, not even scabbed over yet, she has had to change the bandages 3 times a day - at 10 weeks! - and there is so much swelling and pain that she can't sleep at night or do anything physically demanding.

Her doctor is an idiot, and she has an appointment with a new specialist in September. But, she is looking for information in the meantime, and I wondered if you could direct me to anyplace that might help.

Thank you

J>

Dr. Bermant responds:

Infection after breast surgery happens. If a surgeon says he/she has never seen a case, it is probably because they have not done very many breast surgeries. After breast reduction the blood supply to some of the breast tissue is compromised (not great). Some deep fat is particularly at risk. Infection and this risk at less blood supply can result in death of some tissue. Getting deeper wounds of the breast to heal can be a frustrating process for the patient and the surgeon. Sometimes one or more operations are needed to close the wound. Sometimes healing is best on its own (secondary healing), although this may take quite a lot of time. The problem is that deep wounds try to close at the top before the deep portions have healed. This leads to a closed sac that would otherwise would still be draining. These sacs frequently get inflamed and open back up.

To keep the top from closing too early, I generally pack the wound. The wound is filled with a dressing material that needs to be changed by the patient or family. Material and frequency are dictated by the wound itself. As packing is removed, some bleeding can occur. There can be some discomfort with the packing process or the removal of packing. Surrounding breast tissue can remain swollen and tender until near by open wounds are closed.

If secondary healing is used, I like to carefully monitor how the wound AND patient are doing. I schedule my visits with the patient based on how the wound is doing, how the patient is coping with the care, and my best prediction on when the next surgical decision needs to be made. I prefer to err on the side of seeing the patient too often, there is an emotional component to this process! Close monitoring is part of the process of healing and I suggest following the advice of a doctor who has been able to evaluate the situation. I cannot make a clinical recommendation without an evaluation or examination.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: After breast surgery

My wife is concerned about the hardness in her breast after surgery (Breast reduction) 10 months ago. The doctor mentioned calcification of the tissue. What is this. Is it a problem? Will it eventually go away? She had fat necrosis and packed the wound for 4ish weeks.

Thanks

M

Dr. Bermant responds:

Calcification of breast tissue can occur with healing after surgery. Such calcifications are important with breast surgery as they can show up on breast xrays (mammograms). For this reason many surgeons have mammograms after breast surgery to reestablish a baseline. Other patient may require biopsies for some calcifications that are suspicious (I warn my patients of this possibility before surgery).

Breasts that heal after packing the wound (secondary healing) frequently have thicker scars and lumps than those patients who heal directly (primarily). An examination by her doctor may be appropriate. Ask your doctor. I would want my patients to ask me.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Breast Reduction

Dr. Bermant,

I am waiting for a reply from my insurance on wheteher or not I am approved for surgery, bu tmy question is this; What do you think about the Mckissoc technique? ( I measured 35 cm, if that helps you )

w

Dr. Bermant responds:

Different surgeons use different methods of breast reduction. Different breasts benefit from different techniques. I prefer to examine the problem before suggesting a method of reduction. There is much more than just a measurement that goes into my decision. The McKissock pattern is one of the standard methods and can produce a fine result for the right breast in the right hands. I usually prefer one of the dynamic methods, that although harder to master, can usually produce what I think are superior results in my hands.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: breast reduction

Hi,

I am 18 years old and I am VERY unhappy with my breasts. One of them is noticably larger then the other. I wanna have it fixed as soon as possable, but I don't know when I should. I mean, am I still growing at 18??? Should I wait untill I'm 21...or older??? Will they grow to the same size by themselves??? I would be SOOO greatful if you could give me info on this subject.

THANK YOU,

j.

Dr. Bermant responds:

These are best questions answered in an office after a better evaluation and examination. Breast growth stops at different ages for different patients. Asymmetrical breast will usually remain asymmetrical during the remaining growth. There are options until size starts stabilizing. There are medical reasons sometimes that need to be evaluated in some cases as the cause for breast size discrepancy. In some cases, like a severe scar of one side of the chest, early surgery is indicated.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: breast reduction

A friend of mine is 18 years old,5'5, 165 lbs.,with a 38DD chest, who is planning to have breast reduction during the winter break of December. Could you recommend any surgeons or hospitals in the South Florida area that you would want your daughter to go to if she was to have breast reduction? Are there any particular risks for females in her age group? If you could give suggestions as to other resources for information on breast reduction surgery I'd be immensely grateful.Thank you for your time and input.

Dr. Bermant responds:

I am sorry the plasticsurgery4u website is an example of my commitment to patient education. We see patients from all over. My office staff and I must use our time to help our own patients and cannot provide a general referral service.

Breast reduction discussions of risk, benefits, and alternative methods of care are part of a standard consultation and are too extensive for web communications. Since each patient presents with different problems, the discussion must be adapted to that patient. Without an examination, the potential variations become extensive enough for a textbook.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: looking for a brilliant P.S

Dear Dr. Bermant:

My sister had breast reduction surgery about 10 months ago and since then she has been in such great pain that she is considering having both breasts removed for good!!

1) The left breast is cut 2 cm lower than the right and all together so low that she feels her breasts are in her stomach.

2) The cut under the left breast is crooked making the breast lean outward and feels like all the weight of the breast tissues are on one point. She has horrible neck, arm and chest pains.

3) She was 10 ilb. overweight at the time of surgery and was never told should lose the weight so now if she loses it the breast are going to sag down even more creating more pain and never mind the appearance.

Is a secong srugery possible or since the folds under her breasts are low and crooked there is no fixing it?

Please write back to me if you feel that this is withing your expertise.

Thank you.

Dr. Bermant responds:

Something does not sound right here. Most breast reduction patients (for very large breasts) have such relief from the weight, that they are among the happiest after surgery patients. The satisfaction ratio on this type of surgery is usually very high. Back, neck, or shoulder pain that is unrelated to the breast weight is not improved by this type of surgery. Incision pain does occur with large breast reduction. There are nerves that must be cut in the process of removing the redundant tissue. As these nerves try to regenerate, hypersensitivity (greater than normal sensitivity) occurs. Such regeneration of nerves can be uncomfortable. Asymmetry after surgery is normal, the degree does not sound appropriate but any comments should be reserved for the doctor performing an examination and evaluation. Breast and scar revision can in some situations improve the results. The first best step is going back to her doctor to ask these questions. Otherwise she needs someone to evaluate and examine her before discussing options.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Re: breast reduction revision

Dear Dr. Bermant:

Thank you for your speedy reply. We have lost all confidence in the surgeon who originally did the procedure that't why I am turning to you. He has not made any attempt to understand the problem.

My sister never had this kind pain in her neck and shoulder before. it is all post surgery. While I understand that your definite opinion is subject to examination and evaluation of my sister, what I am trying to find out before I set up time with your office is

1) Eventhough the first Dr. made the cuts so low that they fold on her stomach!, could a second procedure lift the breasts up?

2) If not, can she have both breasts removed( you don't know how uncomfortable she is)

3) She was cut crooked. Does this eliminate the chance of a "repositioning" procedure?

Thank you so much for your time.

Dr. Bermant responds:

Breast pain can come from nerve sensitivity such as a neuroma. Other sources are breast pain itself (mastodynia) a very uncomfortable condition. Breast removal for mastodynia is a controversial subject and needs a more complete evaluation.

Your very specific questions cannot be answered without an examination and evaluation. Sever post surgical breast pain problems are usually better managed close to home where reevaluations and doctor support can be more effective. Breast reconstruction may or may not be possible depending on what the clinical evaluation shows. The most important part of the equation is trust in the team you are working with. If you cannot reestablish that trust, it is time to start with a new team.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: New Breast Reduction Procudure

I recently heard there is a new reduction procedure developed in Belgium that eliminates a lot of the scaring from the "T" scar. There are only few doctors to date in the US and I am very interested in knowing what you think about this new procedure and have you seen the results in pictures, is there less scaring and would you be interested in learing this new method?

I have seen pictures of the regular process and the radical scaring really bothers me so much so that I will wait until something else comes along with less scaring.

Waiting patiently!

Dr. Bermant responds:

Different breasts need different methods of breast reduction. Many techniques have evolved to take a moderately or slightly enlarged breast and reduce the length of the scar. The inverted T method is very well suited for the larger breasts. We can often limit the extent of the scars, but that really depends on the geometry of the larger breasts. Scars in the center of the chest tend to be worse than most other parts of the body, and we design the incisions to avoid this region as much as possible. The "new" vertical technique is just one more method that is not really suitable for all breasts. The better surgeon has several options available depending on the patient's problem.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Dr. Bermant responds:

Large breasts can be very uncomfortable. Thank you for your post.

Michael Bermant, MD

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