Case #1311
Breast Reduction
A woman in her 70s with large breasts causing significant back pain underwent a breast reduction.
This patient, in her 70s, had large breasts that caused significant back pain and day-to-day discomfort. Dr. Azadgoli performed a bilateral breast reduction, removing 333 grams of tissue from the right breast and 381 grams from the left. She is shown six months after surgery.
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Why this approach
The decisions that shaped this surgical plan.
- Bilateral breast reduction performed in one operative session so symmetry, tissue handling, and final shape track between both sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Aspirin, ibuprofen, vitamin E, and fish oil discontinued 14 days pre-op to reduce bruising risk. Acetaminophen is allowed.
- No nicotine for 6 weeks before through 6 weeks after surgery. The vascular impact directly affects skin healing.
- Arrange button-front or zip-front tops for the first three weeks — overhead reaching is restricted. A drain holder or apron is provided.
- Day-of transport and an overnight companion (24 hours minimum) are required for discharge.
- Internal medicine sign-off — and cardiac workup when indicated — completes a few weeks before the surgical date.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week is the strictest activity window. Bilateral cases benefit most from staying ahead of swelling with consistent icing and rest.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Activity ramps slower than average. PT check-in at week 4 anchors the next phase.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Tissue softens, scars begin to fade, and overall shape settles toward final. Scar maturation continues for another 6 months.
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Reduction.
- Surgical bra continuously for 6 weeks
- Sleep elevated on your back; no side or stomach sleeping for 4 weeks
- Drains typically removed at days 5–7
- Scar management protocol at 3 weeks
- Medical-grade silicone sheeting on the anchor or lollipop incisions
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- Hydrating body protocol while skin retracts
- Fractional laser for scar refinement after 3 months
- LED light therapy weekly for the first 8 weeks
- Lymphatic drainage starting week 2
- Aftercare
Hyperbaric oxygen series extended to 10–15 sessions for bilateral tissue support.
Bilateral procedures heal more reliably with sustained HBOT.
- Aftercare
Mobility ramp slowed; physical therapy consultation at week 4.
Older patients benefit from a guided return-to-activity plan.
