Jerry Lugger, MD

Thank you for the question; since it has been some 6 months following your breast reduction surgery, most of the early problems such as hematoma and infection should be past; however, you mentioned moving heavy objects, etc. could you have possible "bruised" your breast?  Occasionally we see areas of "hardness" and tenderness in the reduced breast: also called " fat necrosis" and this could spontaneously appeared or been aggravated by your activity.  I would recommend you see your plastic surgeon, and have him examine the area; he may be able to treat this with antibiotics, and ice/ moist heat in the case of some mild "fat necrosis"; he may also want to image the area with an MRI.  Also the possibility of a fluid collection or hematoma exists.  Definitely would get it checked out.

Dear YBP:

  From what I am seeing, I am guessing that there is no other pigmentation around this indent; that is it wasn't for example a hemangiona that has involuted: if it is not too deep, it might be possible to dermabrade the area (sand it down) however there can be some (usually temporary)  pigment problems that accompany this; another solution would be to do a very concise excision of this "dent" (which will be a little longer than the indent) but it could level the area, and therefore the light reflecting off the small scar should be better than the situation with the "hole".  Sun protection after either treatment is necessary.  I have not had much luck trying to "fill" these holes with a filler; although some people might try this also. Get several opinions regarding this.

                                                                                     Dr. Lugger

Pathology reports can be fairly confusing to patients, and frankly although I spent some time during one of my residencies at  a pathology referral institute; I also find that they often speak a "foreign language".  However in this case your report indicates a lesion or "mole" that has some worrisome features, and while not an invasive cancer (yet) ; because of residual on a lateral margin; it requires further excision.  Don't panic but do get back with your surgeon to complete this ( and have him/her explain this to you in terms you can understand and answer your questions)    Good luck

                                                      Dr. Lugger

Hello VKtoriaG:

       This is a tricky question; in my experience, the septoplasty is often covered because of airway concerns; and some "straightening" would probably occur as result of addressing the previous trauma via "rhinoplasty"; a lot of this would depend on the individual insurance company: how they would view this.  Despite the trauma and the fact that these were accidents, they might still view the rhinoplasty as strictly cosmetic.  I would certainly pre-determine this with them if possible; also have your plastic surgeon go over with you as much as possible his operative plan; e.g. correcting deviation in the "crooked" nasal bones is part of the rhinoplasty, but if some more work is done e.g. on the nasal tip to provide symmetry or projection for example; could this be considered cosmetic? If the insurance company commits to part of the procedure; your surgeon could give you a separate fee for the "cosmetic" part and this might work for you.

                                                                Good luck

                                                                              Dr. Lugger

From your photo, I would agree with others that you have some of the elements of tuberous breast deformity; but it is mild; you  don't have the extremely tight constriction at the base of the breasts, nor the significant herniation around the nipple areolar complex area.  If your desire is to have enhancement of your breasts (augmentation); your plastic surgeon can discuss with you your specific anatomy, and he/she will probably make some adjustments (as discussed by others) including some adjusment of the Inframammary fold (minimal), possible release of breast tissue, and adjustment of the nipple areolar complex. With this in mind, I think you can achieve a nice result. Good luck