Announcer: [00:00:00] You're listening to Behind the Double Doors, bringing you behind the scenes to learn about cosmetic surgery procedures and the latest non-surgical aesthetic treatments with Houston board certified plastic and reconstructive surgeon Dr. Bob Basu.  


Dr. Bob Basu: [00:00:17] Today, we're talking about breast reduction and lift. This is a cosmetic breast reduction for women of any age who are just tired of having heavy sagging breasts.


So the common concern that I hear from patients seeking a cosmetic breast reduction or lift, are they're just tired of the heaviness, it's causing discomfort in their neck, it's difficult to find clothing. They feel like their breasts are spilling out of their dresses and outfits and sports bras, just overall discomfort, and even more severe cases.


They're complaining of rashes underneath the skin and they feel that large, heavy breasts make them look heavier. We see patients of all ages, whether they be 17 to 80, who are seeking a relief from a breast reduction and lift. I'm going to be utilizing the terms, breast reduction and lift interchangeably. I use the same technique to perform a breast reduction as I use for breast lift.


The only difference is in a breast lift, I'm not necessarily reducing the size of the breast. We're reshaping the breast we're improving symmetry and we're raising the position of the breast. However, in a breast reduction, we are also lifting the breast, but we are actually reducing the volume of the breast.


So I call my technique, uh, a breast lift with "auto augmentation of cleavage" technique. Now the standard of care for a breast reduction lift is to tighten up the skin envelope that raises up the breast position. And that's part of what I do. I want patients to think about their breast tissue into two categories.


There's good breast volume and there's not so good breast volume. I'm not going to call it bad volume, but we're going to call it not-so-good volume. So the good volume is the volume that's sagging down, medially, meaning close to the cleavage area, but it's in the wrong spot. We can often take that tissue and reshape the breast and reposition that good tissue back up into the cleavage, giving it almost an augmented result or look using the patient's own tissue, no foreign body implant. 


The not so good volume is the volume that all women seeking breast reduction understand, which is the volume that's spilling out of their bras that are causing the heaviness, the pendulum effect that's pulling at their neck causing bras trap grooving, causing a lot of discomfort.


That's the volume that we try to get rid of the volume that's in the lower outer quadrant of each breast. And we do a reduction take that lateral heaviness away. So when I do a breast lift, Um, essentially utilizing my auto augmentation with cleavage technique. In other words, I'm taking the good volume and reshaping the breast and getting it back up into the cleavage to volumize the cleavage and a reduction on removing the not so good volume that's causing the heaviness and discomfort that's falling out of patient's outfits. And that's what we're removing. 


There are a lot of different techniques out there when we perform breast lifts and reduction to every surgeon has their preferred technique. My preferred technique is to preserve good volume. Take that good volume and reshape the breast and place that good volume up into the cleavage and take away the not so good volume. The not so good volume is what's contributing to the heaviness of the breast. That's precipitating the sagging and causing discomfort. And that's what we remove in a reduction.


I generally guide my patients to the before after galleries, because they can see different befores and afters and see the transformations that we can achieve for them.


One of the concepts that I go over with patients is that in a breast lift or reduction, the basic principle that applies with any of these procedures, quite frankly, any procedures that we do in plastic surgery is we have to accept some degree of scar to achieve that much, much better form. So scar for better form is the guiding principle of many of the procedures that we do. Now, we, of course, we tried to do limited scar techniques whenever or wherever possible. And of course we do a cosmetic closure of all of our incisions to optimize good healing so that the scars fade with time. So the scars vary depending on the severity of sagging and depending on the degree of reduction that needs to be done.


But typically there's an incision that's around the areola. Meaning there's a little scar line that's hidden at the aerial or border. There's also a line that goes from the six o'clock position of the areola down to the underside of the breast. We'll call that the lollipop scar. And sometimes there's an incision hidden underneath the breast along what's called the inframammary fold crease. Now I know a lot of patients are concerned about that up and down vertical scar. Nobody wants to be riddled with scars. But what I share with my patients based on my 17 years of experience doing these procedures is that the vertical up and down scar is a scar that fades away the fastest it's actually the periareolar scar that takes longer to heal.


And I explain to patients that in the vertical scar, the tension to the pulling is only to the right and to the left. Whereas with the periareolar or scar, the tension is all the way around. So in most of my cases, the vertical scar up and down scar is barely noticeable a matter of weeks right after surgery.


It's quite common when patients have very large breasts or with sagging the areola has stretched out. So an areolar reduction is part of the breast lift or reduction procedure. Typically a breast lift and or reduction can take anywhere from two to up to four hours, sometimes a little bit longer for doing additional lipo sculpting of the lateral chest wall or other areas.


All breast reduction, breast lift surgery. Even if we add additional liposuction is done as outpatient surgery, which means if you have the surgery in the morning, you'll be yeah home in time for a late lunch and you can eat whatever you like. The recovery is fairly quick and benign. In fact, because we're taking heaviness away in a breast reduction, patients experience immediate relief from their discomfort they that they were experiencing from their heavy breasts. The results are immediate. They see the results right away. Of course there'll be some swelling and bruising that takes time to resolve the next four to six weeks. But. The relief is right away. The good news is that in terms of discomfort, patients, maybe take pain pills for three to five days at most quickly, transition to Tylenol or nothing at all.


When the heaviness has gone, they're fitting better under clothing. They're just amazed in how far we lifted the breast. And I love showing them their before pictures when they come back. And one of the things that I enjoy doing in the operating room is I love completing one breast with a breast lift reduction.


And I like to sit the patient upright on the operating table and we take an interoperative photo with one breast done the other breast not done. And it's obvious that we're raising the breast position of several inches in many cases. And the transformation is quite striking. Patients love seeing that on table result after surgery.


Many, many years ago, we would sometimes get breast reductions covered by insurance, but unfortunately, It's gotten so difficult to work with insurance. Although on one hand they say, oh, breast reduction is a covered benefit. What patients often don't see is a small print for the requirements to get breast reduction covered are often quite onerous. In fact, they set these requirements that you have to remove so much tissue in order to get a reduction covered.


Well, in many cases, when you remove that much tissue, the patients are left with nothing. Typically we find that insurance does not cover breast reduction because they made it too difficult for coverage. Add that to the list of complaints against insurance companies. Right? So 99% of our breast reductions are done as self pay cosmetic surgery.


And oftentimes that's more cost-effective for patients. We also have some very competitive financing programs that allow patients to break down the costs into small, manageable, monthly payments. Which had been very popular with patients. The cost really varies depending on what is exactly being done because no two breast reductions and lifts are exactly the same.


The cost depends on the length of surgery, how long it takes. It also includes the operating room fees, the anesthesiologist fees, any supplies and garment costs, and our friendly patient consultants will go over what all the inclusive costs are. The cost, I would say varies between 9,500 to up to 16,000. It just really depends on what's being done. 


A lot of mommy makeovers, you know, people hear the term, mommy makeover, mommy makeovers as simply combined procedures to restore a mom's body to what it was before having kids. And oftentimes even better than what it was before having kids and many mommy makeovers do not involve implants.


I think a lot of patients think that when they think about breast surgery has to include an implant that is far from the truth. A lot of my mommy makeovers are simply a breast lift or a breast lift with reduction and a tummy tuck, or sometimes it's a breast lift or breast reduction with liposuctioning.


Of course it's not a one size fits all, but it's very common for us to perform a breast reduction, lift with another procedure. The recovery from a breast lift or a breast reduction it's fairly quick and benign patients feel great. In a matter of days, they're feeling at their baseline in about three to five days after surgery.


Most women go back to a desk job, I would say in about three to five days after surgery in a desk job where they're not doing any heavy lifting. Now, there are some restrictions after breast reduction or lift surgery. We recommend patients do no heavy lifting. Were strenuous activity for about four to five weeks.


We've got to give time for the incisions to heal. Just like with any surgery, we don't want our patient's heart rate or blood pressure elevated for prolonged periods of time, because that can increase the risk for bruising or bleeding. We don't want to have any problems with incisions busting open or a blood collection such as hematomas.


So a great starting point would be our website and we have an extensive photo gallery of all types of breast procedures, including breast lift and breast reduction surgery, where you can find us on Instagram at @basuplasticsurgery, where we post before or after pictures frequently about breast lift and breast reduction procedures.


Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basuplasticsurgery.com forward slash podcast. On Instagram follow Dr. Basu and the team at @basuplasticsurgery.


That's B A S U plastic surgery. behind the double doors is a production of The Axis, theaxis.io.