Breast Reduction - Scheduled for Tomorrow - San Francisco, CA

I have come to rely on Realself so much to help me...

I have come to rely on Realself so much to help me come to a decision on breast reduction that now that I've decided to do it, thought I should post my own experience. I am 43 years old, 5'4", 135 lbs, with a breast size of 30F. After a lot of research, I decided on Dr. Carolyn Chang. I had narrowed it down to 2 plastic surgeons. My sister has a lot of contacts in the San Francisco medical community, so I asked her to ask three of her doctor and surgeon friends (one obgyn, one oncologist, and one a gp) who they would recommend. All 3 came back with Dr. Chang, so my decision was made. Dr. Chang has been fantastic (and my situation is complicated by the fact that I live overseas so would be flying in for the surgery). The office was also fantastic. They submitted all my documents to my insurance company and worked very hard to get that elusive pre-authorization. Dr. Chang is out of network but having most of the procedure covered has been fanrastic. I just had my last pre-op appointment, so tomorrow is the big day. I will aim to post before photos as soon as possible, as well as report my post op experience along with progress photos. Thank you to all the women who have posted their experiences, which has been an invaluable help to me. Wish me luck and I will post an update as soon as possible!

The surgery

Surgery yesterday went great! It lasted 3.5 hours- I did a short scar reduction and axilla liposuction. Dr. Chang estimated she would remove 400-450 grams of breast tissue per breast. I forgot to ask today how much was removed so will update later. I woke up after surgery with moderate pain but it was quickly handled with IV pain meds. After one hour in recovery, I was wheeled into my room. I was given the morphine pump which I only needed to use sparingly because the pain was not bad at all. I also had "leg pumps" that basically massage your legs to prevent blood clots and feels fantastic. I had some chicken broth at around 1 pm and then picked at a salad at 7:30 pm. The morphine made me dizzy/nauseous and I
vomited but felt fine after. Slept through the night. All in all, a lot less pain than I had expected.

Post Op Day 1

Discharged today and also saw the new boobs for the first time - I am AMAZED! I saw them at the surgeon's office so don't have a picture to post but will as soon as I remove the bandages and bra. I was shocked - it looks like a different body! 2-3 cup sizes smaller, perky, great shape. I'm thrilled and wonder why I didn't do this sooner. My breasts are swollen still and a bit sore, but the pain meds (percocet) take the edge off. The armpit lipo is actually more painful. Also, I had not realized that your body can become quite bloated from the surgery and IV fluids. Hoping that the bloating (not breasts but rest of body) goes down fairly quickly.

Photo post op day 1

Post Op - Day 2

Hi all, I'm not posting any new pictures because they look pretty much the same as yesterday! But I will post maybe tomorrow or as soon as I see any changes. One thing to keep in mind to those of you who are planning a BR is that I've realized that managing the pain is really important. I was reluctant to take the full dose of percocets last night, a mistake I won't make again because I woke up in a lot of pain at 2 AM! Today has been better in that I took 2 percocets in the morning (my prescription says 1-2 pills every 4-6 hours). And then I took 1 percocet 4 hours later and then another single pill 4 hours later etc. I will then take 2 before bed. This seems to work as I think it is important that you not wait for the pain meds to wear off completely before taking your next one. Aside from my breasts, I'm still bloated from the iv fluids and surgery so am trying to drink loads of water, and keep the food really light - mainly fruit and light broth soups. I still think the lipo is causing more discomfort than the actual reduction, something my surgeon said would be the case. Despite a fair amount of pain, this has been so so worth it! I just wish I had done this 20 years ago!

Post Op - Day 3

So surgery was on Wednesday and today is Saturday. Now that I've figured out the pain med schedule, the pain is much more manageable. For sure the lipo areas are much more painful than the breasts (I actually barely feel the breasts!) I have a lot of bruising with the lipo as well - the bruising in the photos is from the lipo as you can see. One of my breasts is larger than the other and I'm really hoping that this is just assymetry from swelling and that they will be even. Originally, my breast were not symmetrical so the surgeon reduced the larger one first, then matched the smaller one to the newly reduced breast. So the breast that now looks larger post op was originally the smaller of the two! I hope this will go down and they will both match - has anyone have similar issues post op? How did it turn out? Other than that, I'm very happy with my surgery and recovery. I'm still bloated from the surgery - stomach, legs, etc. i had not expected that and have been eating very light to try and help things along, but the bloating is still there. I'm also quite constipated from the percocets - I'm on stool softener but no luck so far!

4 days post op - CONSTIPATION!

Wow, last night the constipation really kicked in. I'm on a stool softener, drinking tons of water, eating fruit and veg only, but nothing! I stopped taking my percocets yesterday at 4 pm because pain from constipation is frankly worse than pain from the surgery and I know the percocets are only adding to the constipation problem. After eating prunes, drinking prune juice, and nothing still...This morning I went to the pharmacy and got a constipation suppository. Hopefully that will work. Who would have thought that this was the worst part?! Pharmacist said that if the suppository doesnt work, I would need to go to the doctor on Monday (tomorrow). It is weird, I am so constipated but it feels as if my body has forgotten hoe to "push" the poop out (sorry to be gross but that is the only way I can describe it) - it is clear that I have a BM in there, my body just seems helpless to push it out. Anyone else had constipation so badly they had to go back in to the doctors? Thanks ladies!

One week post op

It has been one week now since surgery and I'm feeling much better. Being off pain meds on day 3 was less than ideal but the constipation was so bad I knew it was necessary. Constipation is resolved now, my bloating is slowly going down, and yesterday I went back to the PS office where the nurse said everything seems to be healing well! My breasts are still swollen and sore but I know that will take some time. The lipo pain is a bit better - but I would definitely say the lipo pain is worse than the BR pain! Will post more photos on Friday, when I may get the stitches around the nipple removed.

Post Op - Day 7

Uploading photos from today - exactly one week post op. The boobs look pretty much the same as they did post op day 1! I'm wondering when I will see some swelling go down. The marks on the breasts are the surgeon's penmarks, and the "wrinkling" is from my bandages! One is still slightly bigger than the other. Lipo bruises still very visible, but pain overall is significantly reduced.

Bandaging Process

For yippee - This is my bandaging process. The abdominal pads are very helpful in keeping the incisions from hurting. Hope it helps you! I think you can buy the abdominal pads and the big ace bandage at a pharmacy or a walgreens/cvs/rite aid.

2 Weeks Post Op

Today it is officially 2 weeks post op! I am still VERY sore but am very pleased eith the healing. One of my breasts is still slightly bigger than the other, but has gone down compared to how it was one week ago. I am still bandaging religiously 24x7, and still on a very strict diet and rest regime. My nipple stitches were taken out last Friday, and the remaining stitches will likely come out this Friday. All in all, I am thrilled!!!

855 grams removed in total weight - 3 weeks post op photos

All - 3 week post op update: I got the results of pathology back and the total amount (for both breasts), including breast tissue, skin, and lipo was 855 grams. A lot less than I was expecting - and though I would have been happy to have been a B cup, I recognize that it was more important to preserve blood flow etc! Right now it looks like I will be a full c cup. Recovery is much improved and I will be flying home in two days (I flew to San Francisco to have the surgery because I used to live here, but I am currently living in Hong Kong). I'm not looking forward to the 15 hour flight but I think it will be ok - I will walk around a lot, drink a lot of water, no alcohol, etc.

I am attaching updated photos (one breast is still a tad bigger but it also feels harder and had more bruising so I'm hoping it evens out in time). Also attaching side view, as I'm really pleased with the projection and I love their perky shape! Yesterday I went to the store and bought some bralettes (I never could have done that before, I almost cried!) and some lovely spaghetti strap tops that I've not been able to wear since puberty. Again, almost cried!

Before and After! (And the joys of bra buying!)

Hi all, I made it back to Hong Kong with no issues, though I think it was definitely necessary to have spent those 3 weeks post op in San Francisco before flying. If I had had to fly back after 2 weeks, I think it would have been too soon!

On my last day in San Francisco I went and bought some super cute spaghetti strap tops and a couple of bralettes (which NEVER) would have been possible before! When I got back to Hong Kong, I put my old bra (30F) back on and was shocked because it was SWIMMING off me.

My goal now is to keep my scars clean and dry (difficult in the subtropical and highly polluted climate of HK) and to start using the silicone strips as soon as all the scabs fall off. I plan to continue to use the abdominal pads under my surgical bra to keep them dry and protected. How long did you all keep using absorbent pads under your bras (especially when being outside?). Also, am thinking of substituting panty liners under the bra because they are thinner than the big abdominal pads - has anyone else done this?

Attaching before and after photos (before and after bra, and before and after breasts)

Thanks!!

8 weeks Post Op

I haven't posted in awhile so thought I would send a new update. I am now 8 weeks post op and still healing well. I had one "spitting stitch" which just came out with a tweezer (no pain) but other than that have had no issues. I hope it continues to go as well! I think the trick is that once you get to 8 weeks, you start feeling pretty good and you have to remember that you should still take it easy! So I have to remind myself of that. I'm flying again for work (Hong Kong to New York) so am hoping the long flight is uneventful and my body feels ok. It is easy to overdo it!

I still have one breast larger than the other and I think it will remain but I will talk to my surgeon as to whether it can be corrected with a little lipo. If it is anything more invasive than lipo (like cutting in again) I won't do it because it is not significant enough!

I have been using the epiderm (biodermis) silicone strips now for about 3 weeks. My scars are healing nicely though it is hard to tell if that is due to the silicone strips or just because. In any event I will keep using them religiously! What I do love about them is that they provide some protection/barrier between the scar and my bra making things much more comfortable!

Silicone stickers

For Jabrody08 - here are two photos of the silicone strip stickers. Sorry for the red marks on my torso - I literally just got off a 15 1/2 hour flight (the boobs held up fine!) The stickers in this photo are a bit wrinkled (again, I think the product of the long flight and changes in air pressure.

So I wear these silicone strips 24/7, only taking them off to shower. I started wearing them about 5 weeks post op. I was them every few days with cool water and a mild liquid soap, let them dry for about 30 minutes and put them back on. They last about 3-4 weeks before I need a new one (you know you need to replace them when they stop sticking well). They are pricey though, like usd 60 for each set! I also have a silicone gel that I can use if I don't want to use the stickers (I used the gel at first because I wanted to make sure the scars were completely healed before I started putting sticky things on them!) It doesn't hurt to remove them, you just need to do it carefully and slowly. Hope this helps!
San Francisco Plastic Surgeon

UPDATE: Dr. Carolyn Chang is the best. I am now over 4 weeks post op and cannot express how thrilled I am with the results. I have had ZERO back pain since the moment I woke up from surgery - that alone is life changing. What i had not counted on was how beautiful my new breasts would be! I'm amazed every time I look down! In addition to her incredible skill as a surgeon, her pre and post op care (and that of her staff) was amazing. I had my first post op appointment the day after surgery, and one every 2 - 3 days until I was ready to fly home. Dr. Chang and her staff were committed to not only ensuring I had excellent results, but that my post op care was perfect - she or her nurse saw me regularly to ensure that there any issues were caught and dealt with quickly. I had no complications (thus far, fingers crossed!) but I thought it was extremely conscientious that she and her staff never waited for a phone call from me but were proactive to ensure they monitored me every few days and saw me in person to make sure everything was proceeding as expected. In addition, both Dr. Chang and her staff were warm and kind and made me feel right at home. In addition, their insurance team is fantastic and will negotiate all the ins and outs of the process (I never spoke with my insurance company a single time!) If I ever needed anything else done, without a doubt, I would go see Dr. Chang. ORIGINAL: Fantastic pre-op experience thus far. Dr. Chang is clearly an amazing surgeon and highly respected, but she os also kind, understanding, and put me at ease (I was very nervous). She clearly explained the procedure, ensured my exoectations were in line with reality, and overall made me feel as if I was in very good hands. I will update more after surgery. Office staff (patient coordinator and insurance team) are also fantastic.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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