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.
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.
