Patient - Breast Reduction

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Patients should always be wary of plastic surgeons who claim they always get perfect results or who only show their very best work. Surgeons are not perfect, patients are not perfect, and no operation is perfect either. There are just too many variables in surgery. You can do everything right and still have an outcome that is less than ideal. I would point to this patient as an example.


She presented with complaints related to her 36 DD cup breasts. She had chronic pain in her back, neck, and shoulders. Everything about her confirmed that she would benefit greatly from a breast reduction. Her insurance company required that I remove 460 grams ( just over 1 lb) from each breast, however, and I did not believe I could do this without making her much too small. She elected to proceed on her own.


She was young and healthy and I had every reason to believe she would obtain the usual great cosmetic result in addition to feeling much better.


I did the surgery with my usual care and removed 296 grams from the left breast and 330 grams from the right, which I felt was the larger of the two. In addition, she had asymmetrical nipple/areola complexes and I tried to correct this as well. I felt that she looked very good at the end of surgery and anticipated an uneventful recovery.


After surgery, she had some unusual breakdown along her left incision, something I rarely see. This took a while to heal. In addition, I did not like the contour and persistent asymmetry, and both breasts developed wide, thin scars that I did not like either. I offered her a cosmetic revision, which she accepted.

Breast Reduction - Dr. Richard Bosshardt
Breast Reduction - Dr. Richard Bosshardt


She is shown after the revision surgery. She still looks to me to be a bit more full on the left. Her shape is improved and the nipple/areola complexes are better proportioned and more symmetrically positioned. Her scars are better. The result is not, in my view, ideal but she and I discussed whether any further revisional surgery should be considered. We were in agreement that the result was acceptable and much better than what she started with. It is important to mention that she obtained near complete relief of her presenting back, neck, and shoulder pain. Breast reductions remain, in my experience the single most successful operation in producing satisfaied patients, even when things do not go exactly as hoped. 

Breast Reduction - Dr. Richard Bosshardt
Breast Reduction - Dr. Richard Bosshardt

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