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Breast Reduction Revision





John Q. Cook, M.D.

Chicago 312-751-2112
Winnetka 847-446-7562

Bottoming Out After Surgery Is Probably The Most Frequent Reason Breast Reduction Revision Patients Come See Me

Over time, the weight of the remaining breast tissue after breast reduction may stretch the skin of the lower part of the breast. This allows the breast tissue to droop downward usually with a hollowing out of the upper part of the breast. The nipple and areola take on an upward tilt and sometimes rise to a level that can be embarrassing in clothes and swimsuits.

I analyze each patient on an individual basis in order to come up with the best treatment plan for bottoming out. For some patients a nice improvement can be obtained if I remove skin according to the original pattern. Sometimes the fold under the breast needs to be stabilized. Sometimes the lower part of the breast needs to be stabilized with acellular dermal matrix or mesh. The breast is a structure that responds to the hormonal environment of the body as well as weight gain and weight loss. Some breasts may be an ideal size after breast reduction surgery, but then over the years they may become larger. For some patients the breasts may reach a size where they will require further reduction.

There are many different ways to sculpt breast tissue in breast reduction surgery. The precise method of sculpting may not be predictable from the scars on the surface of the breasts. The way the tissue was sculpted by the original surgeon may have significant implications for blood supply to the nipple if further sculpting is carried out in a revisional procedure. For this reason, it is very important for you to provide me with a copy of the original operative report if you desire further reduction of breast tissue. Some patients have too little breast tissue after breast reduction surgery, either as a result of the original operation or as a result of changes in the breast over time.

It is very common for patients to lose significant weight after breast reduction, since the operation improves body mechanics and makes exercise more pleasurable. Often a virtuous cycle is created where there is a self-reinforcing desire for increasing levels of exercise. This, of course, is wonderful for the patient but may have negative consequences for the shape of the breast. This is particularly true for fatty breasts, which tend to respond more to overall weight loss and weight gain than glandular breasts.

Revision of breasts that are deficient in volume after breast reduction surgery usually involves the placement of breast implants. The size, type, and position of the implant are determined as part of a detailed discussion of the patient’s goals as well. The previous pattern of sculpting breast tissue may also affect my choice of implant placement. As part of an overall artistic assessment of the breast, I may also adjust the balance of the breast skin and the position of the areola.

Most patients heal beautifully after breast reduction surgery, but as with any surgical procedure, the scars from the surgery may be less than ideal. The most frequent area of revision is the scar that runs around the areola. Sometimes this spreads or can have a zone of whiteness that is embarrassing to the patient. There may also be spreading of other scars from the breast reduction surgery. In some patients the lower pole of the breast slips below the original scar from the surgery, in which case it may be desirable to reset and anchor the scar in the proper position. If the patient simply needs a revision of the scars without any other modification of the breast structure, this can often be done under local anesthesia in the office.

Contact Dr. John Q. Cook

As an experienced breast surgeon in Chicago, Dr. Cook has performed many breast reduction revision procedures. If you would like to learn more about revision breast surgery with Dr. Cook, contact his practice today at 312-751-2112 or 847-446-7562.