From G cup to D cup?! Breast reduction EXPLAINED [Dan Zegzula, MD, Portland]

Eva Sheie (00:00):
You're listening to Where Before Meets After?

Dr. Zegzula (00:03):
Yes. This patient definitely had a breast reduction and it looks like also some lateral breast liposuction. And I would say before she had very ptotic, very low breasts volume, probably close to a G cup that is like G as in golly. And when she's done probably a full C a small D cup in volume. And we were able to first of all, eliminate so much weight on her shoulders. Second of all, eliminate the ptosis, that is all of the droop. She has little to no skin on skin contact from her breasts to her tummy in the after pictures, where before her breasts were kind of resting on her upper tummy. And a lot of skin on skin, which leads to chafing when you're exercising and definitely sweat accumulation in those skin folds. So smaller breasts, higher breasts, much more youthful and perky shape. And on the lateral aspect, below her armpit area, we did some liposuction, which was in combination, we approached it from the front and also from the back. So when we were doing liposuction in the back, we can do a little work there. And then when we work on her breasts on the lateral side, we do some liposuction there too, to give a nice contour like you see there with no extra fat roll under the armpit.

Eva Sheie (01:18):
She does not have breast implants, correct?

Dr. Zegzula (01:20):
No breast implants in this procedure. Nope. All her.

Eva Sheie (01:23):
And I think what's most remarkable about that lateral after photo of the one in the right is how much younger she looks. She looks great, but she looks so much younger.

Dr. Zegzula (01:33):
Heavy breasts that are very ptotic, that is very droopy, gives a matronly look. That reverses when you do a breast reduction. Not only does it make you look like you have lost weight, which you have surgically, but it makes you really look like you've lost weight and more youthful, younger, more athletic.

Eva Sheie (01:52):
All right, let's move through this one too.

Dr. Zegzula (01:54):
So this patient also had a mommy makeover. She had breast and abdominal surgery. One thing I wanted to point out about this is her belly button. Her belly button has a funny shape in the before it pictures because she has a belly button hernia or an umbilical hernia. The nature of that when you have a belly button hernia is that when you're doing a tummy tuck, you have to deal with that belly button and you try and fix it. But when you're fixing a belly button hernia, you also are interfering with the blood supply to the skin of the belly button. So in this case, because her hernia was so big and it was important to fix that hernia, we weren't able to save the skin of her belly button. So if you notice in her after pictures, she has no belly button, she's got improved contour, she has a much more defined waistline, she has tighter skin, but she doesn't have a belly button.

(02:54):
In these situations, we go back and we perform a neoumbilicoplasty or a new belly button. And we will form a new belly button for her usually two or three months after her tummy tuck is done. And it's done under local anesthesia. And it's a very quick operation with virtually minimal downtime. I do prevent my patients from exercising aggressively while the belly button is healing. But you can be up walking, you can be cycling, spinning, I should say almost immediately. The new belly button will be in the right place and it'll have a pretty innie appearance, but it is done separately about two or three months after the tummy tuck.

Eva Sheie (03:34):
Some of us might wonder why she had a tummy tuck in the first place because she looks really flat in the before. So was it just the umbilical hernia or was there something else?

Dr. Zegzula (03:45):
If you look down towards the lower part of her abdomen where the abdominal skin meets the mons, she has that bunching of skin. So the skin has drooped down, it has fallen, and she had a contour that she didn't like when she was wearing a swimsuit or a sundress. And in the after picture, she's flat also in the middle of the abdomen where her waistband of her pants would be sitting. She's more cinched and so she has a flatter tummy and less skin.

Eva Sheie (04:11):
And then she also had a breast lift?

Dr. Zegzula (04:14):
Yeah, I think this was a breast lift. Maybe she's about a cup size smaller. So this might've been actually a reduction. And I think again, the lateral pictures show the best change. And that's a good view there because it shows the breast that's farther away from us. You can see how much skin on skin contact she has, how much her breast is resting on her upper abdomen. The after pictures show that her breasts are higher, nipple position is better, and she has no skin on skin contact in the lower aspect of her breasts. So a more youthful appearance. No more skin on skin contact causing chafing and sweating in the under boob area. Good symmetry and improved nipple position.

Eva Sheie (04:57):
Thank you for explaining.

Dr. Zegzula (04:59):
You're welcome. These are good cases.

Eva Sheie (05:00):
It feels like a treat to have the doctor tell you the story. It just is like it's so much richer than just looking at the pictures.

Dr. Zegzula (05:08):
It is. And then I think it also just gives a little bit of a hint on how happy these patients are afterwards. These are the issues that they come and sometimes they don't have the words to describe why they don't like the shape of their abdomen. I don't like the skin down here. I don't like this bulge here. And you go through this and you plan it, and then you execute these surgeries and patients are so happy afterwards. They have so much more confidence in how they're wearing their clothes, how active they can be, not having chafing and sweating under their breasts when they're exercising. It's just so enriching to be able to do this for patients. I think we're really lucky to be able to do this.

Eva Sheie (05:46):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wherebeforemeetsafter.com. Where Before Meets After is a production of The Axis.