Plastic Surgery at VA Boston healthcare

Breast Reduction

What is a breast reduction?

A breast reduction is a procedure that involves removal of tissue from the breasts to reduce their size. For patients that experience significant discomfort because of large breasts (e.g., shoulder grooving from bra straps, persistent skin irritation in skin folds, neck pain), the surgery may potentially improve symptoms.

 

What to Expect

The breast reduction procedure is done in the operating room under general anesthesia on the West Roxbury campus. The surgery itself typically takes 3-4 hours.

 

During the procedure:

• Your surgeon will make incisions around the perimeter of the nipple, vertically down the center of each breast, and horizontally along the base of each breast. The incisions often resemble an anchor shape.
• Tissue is removed from the breasts and weighed. This helps to achieve as much consistency between sides as possible, though there will always be some variation in breast size and shape.
• Depending on the size of the breasts, the nipple and areola may be removed and replaced as a skin graft.
• The incisions are closed with sutures, and two drains are placed (one on either side of your chest) to reduce the risk of fluid collection at the surgical site.
• A compressive dressing and sports bra are secured over the breasts.

 

Recovery

Most patients remain in the hospital for one night after a breast reduction. Depending on the fluid output, we may remove the drains before patients return home. All patients receive individualized instructions for postoperative care prior to leaving the hospital. In general, it is important that patients continue to wear a sports bra over the surgical dressing, as this helps to reduce swelling and minimize the risk of fluid collection at the surgical site. Walking is typically fine to do soon after surgery, but patients are advised to avoid strenuous physical activity until ~6 weeks after surgery.

We will see patients in clinic 1-2 weeks after surgery for suture removal and to assess wound healing.

 

Panniculectomy

What is a panniculectomy?

A panniculectomy is a procedure that involves excision of excess skin and subcutaneous tissue from the lower abdomen. Some individuals may develop loose skin in this area after losing a significant amount of weight, as is often seen following bariatric surgery. The excess skin, also known as a pannus, may cause irritation due to retained moisture in the skin folds, which a panniculectomy may help to address. This procedure is different from an abdominoplasty, as it does not address excess tissue in the upper abdomen or flanks, and does not tighten the abdominal muscles.

In most cases, patients who are good candidates for a panniculectomy have lost a significant amount of weight, often around 100lbs or more. Patients should maintain a stable weight, ideally at a BMI of < 35, for 6-12 months prior to considering a panniculectomy procedure, and they should not be seeking further weight loss in the future.

 

What to Expect

The panniculectomy procedure is done in the operating room under general anesthesia on the West Roxbury campus. The surgery itself typically takes 2-3 hours.

 

During the procedure:

• Your surgeon will make a horizontal incision in your lower abdomen.
• The excess skin and subcutaneous tissue is removed.
• The incision is closed with sutures, and two drains are placed (one on either side of your abdomen) to reduce the risk of fluid collection at the surgical site.
• An abdominal binder is secured over the surgical dressing.

 

Recovery

Most patients remain in the hospital for two nights after the panniculectomy procedure. Depending on the fluid output in the surgical drains, we may remove these before patients return home. All patients receive individualized instructions for postoperative care prior to leaving the hospital. In general, it is important that patients continue to wear an abdominal binder at all times, as this helps to reduce the risk of fluid collection at the surgical site. Walking is typically fine to do soon after surgery, but patients are advised to avoid strenuous physical activity until ~6 weeks after surgery.

We will see patients in clinic 1-2 weeks after surgery for suture removal and to assess wound healing.

 

How to Make an Appointment

If you aren't currently being seen by Plastic surgery, you can be referred by your Primary Care Provider for an initial consultation. If you are already being followed by Plastic Surgery, please call the clinic directly at .

Learn more about your Plastic Surgeon at VA Boston health care