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Comparison of Breast Size with Respect to Skin Vs. Volume Discrepancy

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On initial examination of women who have enormous size breasts, it is absolutely essential that the Board Certified Plastic and Reconstructive Surgeon be able to differentiate between the bilateral breast hypertrophy or gigantomastic breasts with either a skin discrepancy of increased volume of skin causing severe sagginess, a volume discrepancy with significant amounts of glandular and/or fatty tissue or a combination of both.

This is very, very important with respect to the actual surgery itself. Although an anchor scar is usually performed using the Wise-pattern technique in both bilateral reduction mammoplasty and the inferior pedicle technique as well as a Wise-pattern for a formal breast lift, it is essential that the patientís amount of skin laxity be completely addressed. Some patients we see here in our Beverly Hills plastic surgery practice actually significantly have increased amounts of skin and grade III ptosis, meaning that the nipple is well below the fold and there is so much skin that just removing the skin will bring the breast to what appears to be for example, a very large breast, maybe a Double-E, to actually only a full D. If tissue was removed, glandular and/or fatty tissue, concurrently with the skin, the patient could actually be made too small for her body.

Addressing skin volume relationships is essential in order to prevent making the patient too small and disproportionately small for her stature. Whenever I see a patient in consultation for bilateral breast reduction surgery, the first thing I do is mark the patient in the standing position in front of a mirror, tighten with my hands and fingers the skin areas that will be removed and ask the patient if this size is appropriate for her. Often they are very happy with simply skin removal, which will actually reduce the size of the breast at least one to one and a half cup sizes. If tissue was removed as well, the patient again would end up too small and be very unhappy with the final appearance.

Please review hundreds of before and after photographs of the plastic surgeonís which you are hoping to have the breast reduction surgery with and make sure that you and your surgeon have the same idea as to your final outcome. Remember, volume is not only breast tissue removed, but is also associated with skin and the more skin laxity, the less volume of tissue that needs to be removed in order to end up with the perfect result.

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Dr. Linder is a
Breast Reduction Specialist

Dr. Stuart Linder

Stuart A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.

Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery.

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PSP Magazine

PSP Magazine

The Evolving Breast-Reduction Procedure

By Stuart A. Linder, Md, FACS
Issue Date: December 2011

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