Saturday, December 31, 2011

Risks With Breast Reduction Surgery

Breast reduction surgery is also called by its more formal name of reduction mammaplasty. Women who choose to have this type of operation are usually quite relieved and happy with the results. Extremely large breasts can be cumbersome, painful and the subject of ridicule and embarrassment. After achieving a more proportionate shape, post-op patients often feel a great sense of freedom. There are risks, however, that females who are considering this type of operation should be aware of. Here are some things to think about:

-Cumbersome: Excessively large bosoms make buying clothes a difficult process. It's hard to achieve a proper fit when one's chest is out of proportion. Participating in certain sports, especially those that entail running and jumping, can be out of the question. The pain experienced by toting this extra poundage cannot even be alleviated with a sturdy sports bra.

-Painful: Huge breasts rub against the skin on the midsection below them as well as against the lower portion of a bra. This can cause skin irritation and rashes which can be very uncomfortable. Bra straps often dig into the shoulders' flesh due to the weight of the bosoms. Posture problems, shoulder and neck aches, and backaches may occur, as well.

-Embarrassment: Many females develop these immense chests at young ages such as twelve years old. They may still be children, but they are often already the subject of men gawking, ogling, staring and making cat calls. This can be highly embarrassing for these pre-teens and something that they will likely experience into adulthood.

A reduction mammaplasty is a surgical procedure performed by a plastic surgeon in a hospital or clinical setting. The operation takes two or three hours and is performed under general anesthesia. An overnight stay is usually required before a patient is ready to be released. There will be pain and swelling initially which will recede over time. Pain medication is given at first in order to make the patient more comfortable. During surgery, the nipple and areola will be removed and reattached after a portion of the breast skin and tissue is removed. Liposuction may be done to remove excess fatty deposits. There will be scarring but it will fade over time.

Some risks that patients should be aware of before the procedure include:

-Unexpected scarring: No one knows ahead of time exactly how the scars will look. Some individuals' scars end up fairly light and barely noticeable while others have much more pronounced results.

-Infection: All surgical procedures carry some risk of infection. This is usually easily controlled with antibiotics.

-Breastfeeding may be impossible: A woman who is planning to have future children should realize that her ability to breastfeed may be limited or nonexistent.

-Loss of sensitivity: Nipple sensitivity may be lessened after the procedure.

Breast reduction surgery can lighten a woman's load both physically and emotionally. It can be a great change in her life but she needs to be aware of the risks of complications before going under the scalpel.

Thursday, December 22, 2011

Breast Cancer Stages

Breast cancer is divided into five stages. Stages 0-2 are considered "early", stage 3 considered "advanced", and stage 4 "late". Staging categories are important for predicting future prognosis, and determine optimal treatment recommendations.


Stage 0 is DCIS, or ductal carcinoma in situ. Breast cancer arises from the cells that line the milk ducts. When the cancerous cells are still contained inside the duct, it is diagnosed as DCIS. This can only be determined by a pathologist doctor looking at the tissue under a microscope. In general, when the DCIS lesion is small, there is no need to suspect cancer spread outside the breast.


Stage 1 is invasive or infiltrating cancer. Here, the cancer cells have broken through the duct wall and are found outside the ducts as well. In this case, doctors need to determine whether the cancer has spread to the lymph nodes.

Stage 1 breast cancer must be equal or smaller than 2 cm in its invasive component, AND have no spread to lymph nodes. Often, the tissue removed at surgery contain DCIS in addition to the invasive cancer. However, only the dimensions of the invasive cancer count. If the patient needs to have multiple surgeries and the invasive cancer is found at more than one operation, usually the dimensions are added together to arrive at the final size.

Stage 2 has two subcategories. In stage 2A, the invasive cancer can be 2 cm or less and has spread to axillary (armpit) lymph node(s), i.e. positive node(s). Also, the invasive cancer can be as large as 5 cm, but has not spread to lymph nodes, i.e. negative nodes. In stage 2B, the invasive cancer is between 2cm and up to 5 cm and has spread to nodes. Here, cancer may measure even larger than 5 cm if it has not spread to nodes.


Stage 3 includes invasive cancer larger than 5 cm that has spread to lymph nodes.

Also, cancer of any size that heavily involves the axillary lymph nodes to the point that these nodes are bulky and stuck together or stuck to other structures in the axilla (armpit) are in this stage. Tumor spread to lymph nodes either above or below the clavicle bone, or to nodes underneath the sternum (breast bone), also falls into this category. Furthermore, if the cancer of any size is attached to the chest wall (pectoralis muscle and/or ribs), it qualifies as stage 3. Inflammatory cancer, where the skin of the breast is red and swollen, is classified in this stage, regardless of size.

Stage 4 is invasive cancer found outside the breast and axillary lymph nodes, or "metastatic" to distant sites. At this stage, it does not matter how large the primary cancer in the breast is. Nor does it matter whether axillary/clavicle/breast bone lymph nodes have cancer or not. The most common sites for metastasis for breast cancer are bone and liver, followed by lungs and brain. Standard testing include bone scan and CT scan of the chest, abdomen and pelvis. More recently, PET scan is often done to look for cancer spread. Sometimes, a brain MRI or CT is also useful.

Friday, December 16, 2011

Breast Reduction Covered By Insurance?

For some women, having large breasts means experiencing pain every single day. This condition, also known as macromastia, often causes physical pain and brings about emotional distress. While some women may learn to live with the physical and emotional hardships that come with having large breasts, others want to address this condition with reduction mammaplasty (breast reduction). For my patients in Los Angeles, a breast reduction can enhance self-confidence in addition to providing physical relief.

Breast Reduction Methods

Before discussing insurance coverage for breast reduction, it is important to understand the surgical methods available to achieve more proportionate breasts. The goal of any reduction procedure is to remove excess fat, breast tissue and skin. There are different types of incision methods, largely dependent on how much breast tissue or fat needs to be removed.

Anchor-Shaped Incision: This method uses an incision circling around the areola, descending down vertically toward the bottom of the breast, and running horizontally along the crease of the breast. The nipple (still attached) is then moved to a higher position on the breast, and the excess tissue, fat or skin is removed. The breast is then lifted and tightened.

Lollipop Incision: This technique is typically utilized when less skin or tissue needs to be removed. Also known as the short-scar method, the incision encircles the areola and descends vertically down the breast. Excess skin and tissue is removed at this time.

Liposuction: Liposuction may be performed along with a breast reduction to help reshape the breast. While not always used with breast reduction, liposuction can help remove fat from under the arms and around the bottom of the breast crease. It can also be performed on its own as a way to reduce the size of the breast, but this is not very common.

Insurance Considerations

Because this procedure is far more than cosmetic, many insurance carriers will offer full or partial coverage for breast reduction surgery. However, many women remain unaware of what their insurance will cover. In almost all cases, an insurer will require that the procedure is being performed for medical reasons in order to extend coverage.

Often, the physical discomfort of large breasts is one of the factors in determining insurance coverage. Some of the physical difficulties associated with having large breasts include stretched skin, back and neck pain, headaches, poor posture, grooves in the shoulders from bra straps, and the inability to exercise.

Before insurance companies cover the cost of a breast reduction procedure, they first need to make sure that oversized breasts are not the result of being overweight. For heavier patients, Insurance companies require a larger amount of breast tissue to be removed for the surgery to be covered.

Your Individual Case

Some patients' insurance companies cover the entire cost of the procedure, while others cover only a portion of the cost. Not all insurance companies provide the same coverage. After meeting with a surgeon and determining if you are a good candidate for breast reduction surgery, submitting necessary documents to insurance companies is important as pre-certification is required for reimbursement or coverage. As a final note, for those who have had a mastectomy and require a breast reduction on their normal breast to achieve symmetry, under federal law, insurance companies are required to pay for the cost of this procedure.

Wednesday, December 7, 2011

Los Angeles Breast Reduction-Why And How

If you are considering a Los Angeles breast reduction procedure in order to achieve that perfect breast size, the decision needs to be a well-contemplated one. You need to weigh your options carefully before deciding to go under the knife. Breast reduction is a surgical process performed to remove excess fat, skin, and glandular tissue from the oversized breasts. Yes, if the size of your breast embarrasses you and causes immense social depression, a Los Angeles breast reduction procedure could be one of the ways out. In addition, you should also look out for certain added signs and problems before deciding to spend on one.


When Should You Consider A Breast Reduction?


Breast Reduction Surgery Should Be Performed When:


* You have oversized sagging breasts that make you look overtly busty and highly inappropriate.


* There are rashes under your breasts.


* You need to resort to poor posture.


* You are suffering from poor self-image and low self-esteem.


* You daily activities are restricted as a result of heavy breasts.


* You have deep grooves in your shoulder as a result of excessive pressure on your bra.


* You cannot find a size for your bra which is large enough.


* When you are suffering from chronic shoulder, back, and neck pain.


If all or some of these conditions are wreaking havoc in your life, breast reduction surgery is definitely an option.


Los Angeles Breast Reduction-The Process


A Los Angeles breast reduction procedure should follow some pre-established guidelines.

For example, when you meet your doctor for the first time, the following actions would be typically executed to kick-start the process:

* He would perform a detailed evaluation of your overall medical history.


* He would have a detailed discussion with you regarding your expectations from the process.


* The surgeon will explain the entire process to you inclusive of the benefits and risks.


* Once the explanations have been completed, he would take measurements of your breasts and record the size in photographs.


* He would also explain the anesthesia which would take place during surgery.


* Insurance and other cost-related aspects would also be discussed.


Besides, you will also be asked to go through several laboratory tests, complete a baseline mammogram, as well as quit smoking for a given period of time.

You would also need to refrain from taking NSAIDS like aspirin and also refrain from consuming herbal supplements.

Once these prerequisites are taken care of, the actual surgery would be scheduled. The process incorporated would vary as per the requirement, from person to person. Post-surgery, both breasts would be bandaged or covered with gauge. Pipes may also be fitted which would pass through your underarm. This will allow the excess fluid and the blood to flow out. Subsequently, your breasts would remain sore and painful for some time. The scars would be visible initially, but will fade over time. Medications will be prescribed by a Los Angeles breast reduction surgeon, primarily for nausea and pain.