David J. Antell, DO

Doctor Antell and his staff are incredible. It’s scary to go through with a big surgery but knew it would change my life for the better - they supported me the whole time through and I couldn’t be happier with the results!! From continuous and informative discussions about the procedures, alternative options, tips and tricks to reduce swelling and realities about downtime I felt so prepared for this experience! I

I have now gone through almost 11 weeks of post-operative time and can now begin to share some of my experiences as well as thoughts on the entire process thus far.

I am almost 58 years old, and I went down from a 40DDD/G to a 40B. As for my tummy, I had excess skin and fat from weight gain/loss and childbirth. The surgeon removed 3 lbs from the tummy. I waited too long to do this surgery, partially from fear and partially just my battle with weight gain and loss...I kept putting off the surgery to lose as much weight as possible, and the yo-yo regains kept me on procrastination mode for longer than I care to admit.

I will say that, but for my advancing age, I would have definitely preferred to lose another 25 lbs before doing the procedures. For those who are overweight by more than that, I would strongly urge you to lose the weight first before getting reduced or tucked. There's no doubt that the results would be so much better. Plastic surgery is definitely not a replacement for weight loss. I knew that going in, so I am not disappointed that my results are not perfect insofar as that's concerned. The flat belly will only be as flat as the fat that's inside your visceral abdomen.

I would also urge anyone to do this sooner than later if you are already up there in age, all things being equal. It's a lot for the body to take, and age can play a part in the recovery process, although if you are in good shape, I think the age difference is greatly minimized. I waited too long, again because of the yo-yo weight gain and my fear about surgery and anaesthesia. Once I dropped enough pounds to at least proceed, I decided not to wait until all the remaining weight came off because I personally wanted to do this before 60 years old.

First, let me begin begin by sharing the pros:

I used to have chronic, almost daily headaches, as well as back and neck pain. Since my breast reduction, I have not had a single headache AND my neck and back pain are virtually gone. Those are huge pros!

Second pro: my posture and overall carriage is straighter, making me appear younger and more balanced.

Third pro: my clothes FIT. I can now shop in my correct size without having to overcompensate into a larger size outfit in order to fit on top! I also rediscovered my own existing wardrobe and am enjoying wearing some of my favorite outfits again!

Fourth pro: I feel less self-conscious and can now actually go bra-less if I so choose.

Now for the cons:

Despite all the research I THOUGHT I had done, there were many questions I not only failed to ask, but for whom answers were and STILL are very vague or loosey-goosey within the plastic surgery community. Being a detail-oriented person who wants to know as much as possible during any venture, I have found this entire process to be somewhat lacking in FULL disclosure, FULL clarity, and some measure of greater empathy. In my case, the more I know, the better prepared I am mentally for what may come and the more proactive I am able to be. Since much information was not as available as I now realize it isn't, I did not know a few things that, had I known, would have made this a better experience for me.

The biggest issue for me (no pun intended) has been the level of tightness and swelling that I have experienced and continue to experience, the extent of which I was not prepared for. Despite my research and further inquiry into this matter, the information out there seems to either be very limited or almost non-existent. Can my experience be that unusual, really? I find that hard to believe. I longed for the day when I could feel comfort in my own skin after years of wearing the most uncomfortable, shoulder and rib-cinching, squeezing bras, and now ironically, I still feel that way to an extent, except now it's inside my body that I feel this tightness and there is no bra to take off to get relief like I used to do after coming home from a long day.

What I continue to experience even at almost 3 months, is a "band" of tightness underneath my breasts, from left to right, all the way under my arms, due to the extended sutures in my case. If you have ever worn a tight bra that cinches your ribs, it's sort of like that. Added to that is the usual numbness that comes from breast reduction, and now at this stage some pulling sensation from the scars as they continue to heal, and the whole experience is less than pleasant, putting it mildly.

I have sensed that yes, there is some lessening of this sensation over the past few weeks, but there are days when the breasts swell up significantly and the tightness is even more evident in those instances. When I first brought this to the attention of my plastic surgeon, he reassured me that physiologically all signs were good and that I was healing perfectly.

My PS is a very pleasant and accommodating physician who takes time to speak with me, yet my sense was that each time I brought this up, he interpreted it as a hyper-awareness and hypersensitivity on my part, to all my bodily sensations, basically in effect implying that I was not pain tolerant or the norm. I beg to differ. My pain tolerance is above average...two all-natural childbirths, an holistic approach to pain even when meds were available, support the fact that I am not hypersensitive. Admittedly, I am very body-aware, given my background in alternative medicine...yoga, acupuncture, meditation, massage, et al., but that does not equate to being hypersensitive.

I realize that there is going to be swelling and some tightness, but how much...well, no one told me it would be this much. Why? Well, in part because no two women are the same and the experiences vary from person to person. However, I also think that, in the euphoria that women may experience from finally having normal-sized breasts, and time has a way of making you forget the pain/discomfort...much like childbirth; coupled with the fact that surgeons will not necessarily disclose that this is a possible outcome because they don't want you to possibly dwell on something that may not happen to you in the first place, and thirdly because they themselves do not have a sensory, somatic clue about how it actually feels inside during the post-surgical period, that it's difficult for them to qualify what one will actually feel.

What prompted me to write about this now, is that I just posted a question on Real Self regarding this issue, and the responses from two PS to date, have yielded very obtuse answers, almost as if they didn't even read THE QUESTION! Instead, they focused on the photos I posted and ignored the actual question itself, namely, what is the progression of such a state...how long it might last, and to what extent? I have searched the internet high and low, including REALSELF.com, and have yet to find any definitive answers or elaboration on this topic. The few who have attempted to obtain answers for similar experiences, have also not yielded useful or helpful feedback. Either I am an extremely rare case (which I definitely do NOT think I am), or the plastic surgery community just doesn't want to address this more explicitly, including my own PS. His answer to me? "It takes time...one day you will wake up and notice that the discomfort is all gone." I understand that there is no hard and fast rule about how long it takes for each individual to recover or feel normal again, but is that really the best that the PS community can come up with?..."One day"? Or "Consult your PS." You mean to say, that no one among the thousands and thousands of women who have had breast reductions has experienced this type of unhappy discomfort and that no data or even just anecdotal information exists insofar as this is concerned? Like I said, I searched high and wide on this site and other sites, and could only find a small handful of similar stories; none appeared to provide adequate responses as to what to expect and over how much approximate time. Very frustrating, to say the least.

I also experienced what I now know to be a not-so-uncommon complication, namely an ulceration at the suture right at the pubic line, where the blood supply is most compromised. In my case, what started out as a small blister, grew into an increasingly larger hole that scared the bejeezus out of me because it looked like it would never heal. Thankfully, after more than 5-6 weeks of nursing this wound, it has finally closed up but now I have a larger, darkened scar area where it used to be. What caused this blister in my case? It was friction and over-compression from the binder. I recall exactly how it began and could remember feeling a burning sensation when the binder girdle bunched up in that area especially when I was sitting. Had I removed the binder when this happened, the blister would not have grown. However, upon reading the various threads about the importance of binders for support and drainage, etc..., I only came across a couple of posts by either physicians or REAL SELF members who mentioned that the compression garments can potentially pose this hazard. Even my own PS was somewhat vague initially as to what and how to deal with this, until it became utterly clear that I needed more proactive wound care because the wound was not healing. At that point, he gave me instructions on how to help it along, facilitate granulation, keep it clean,etc. I knew before he even told me, that the binder would have to go if I was ever going to heal this wound, but online, once again, the information was very obtuse and not very helpful on the part of the participating doctors. There even seems to be varied disagreement as to the value of compression garments and how long to wear them.

Folks, if you have a problem like what I just described, I will tell you that what worked for me was to discontinue using the binder girdle, air out the wound by only very loosely covering it, daily cleaning of the ulcer by means of some abrasion with a clean washcloth, and continued use of triple antibiotic. Of course, you need specific and clear instructions from your PS before proceeding, but definitely ask for those specific instructions and take charge of the problem immediately upon first signs of a problem.

Back to my breasts: I have "dog ears" below the armpits due to the longer incisions and sutures that were made in order to remove all the excess tissue I had. Please be aware that if you are extremely large, that this is a probability which may need to be addressed down the road, either by way of "revision" or "liposuction". Unfortunately, most of the before and after photos that are online NEVER show you these. The women's arms are down against the body...the dog ears are therefore not visible. This can be very misleading. I looked at thousands of these photos before my surgery and the results for the most parts appeared so good that it's altogether possible to miss the fact that many of us will or have had the dog ear issue to contend with afterwards. Plastic surgeons do not seem to see this as a problem, from what I can discern. "Revisions" sound like a matter of course to them, and yet to someone like myself who has never undergone surgery, it never occurred to me that there may have to be yet more procedures. This would not be so problematic if I know AHEAD of time, so that I may make an educated, well informed decision. The photos at my PS's office did not reveal dog ears either, so I never thought to ask. It's a very intimidating process to begin with. I spent months reading and researching, but I missed the part about dog ears.

Then there's the issue of bra-wear and fit, post-reduction. I learned the hard way that one of the results of a breast reduction is that not all bras will work well. After shopping and trying on at least 40 different bras, it was obvious that the boobies no longer fill the top portion of a cup if the bra is either foam or solid cotton. The only bras that now work for me were the spandex-type, stretchy bras...sports-like bras, and demi-cup bras. The PS explained something to do with the superior pedicle and how it is now shaped. A couple of other friends who underwent breast reduction confirmed this, but I wish I had known ahead of time that this would be the case, and if so, I might have researched other possible options or approaches.

Finally, there's the abdominal swelling. In my case, I think it's a combination of things contributing to the bulge: a lax core, some visceral fat, and some post-surgical swelling still occurring. It's not horrible given what was there prior to my tummy tuck, but flat it's not. The numbness makes it difficult for me to identify what is underneath, exactly, but my PS says I am fine and everything looks well and is proceeding according to proper healing. I also have two cyst-like balls under my skin, directly behind the pubic scar, which the PS says is the bunching up and scar tissue from the process of re-gathering the tissue when being stitched back together at the tummy line. He suggested deep massage to help reduce it and prevent it from getting worse. Even though these balls are not visible, if they get bigger I will be very upset if they begin to protrude, because at that point I may have no choice but to have another surgical procedure. Both these complications are not readily evident in the array of postings, photos, and ads.

I am still a work in progress. It's clear that my expectations may not have been fully in line with the reality, despite my research, and what would have helped to mitigate my expectations would have been better, more in-depth information from all parties...the membership, the participating plastic surgeons, other online resources, and my own plastic surgeon. Perhaps that isn't possible, given the hundreds of possible variables that would need to be covered, but I hope that my review will at least be of value to others who read it.

I will post updates as I progress. All in all, I am doing relatively well, especially when I compare my situation to others whose experiences have been very complicated and difficult. Just hoping for the best and to have my breasts and tummy feel relaxed and relatively "normal" again one day soon.