Breast Reduction

The reason it is important to start a conversation about breast reduction in the Indian population is because our women are better endowed than caucasian women. Only a woman living with large breasts all her life will understand the problems associated with them, you know who you are. The symptoms may range from the breasts being unproportionately large for your body type, back and neck pain associated with the weight , grooves in the shoulders caused by tight bra straps, poor posture to fungal infections, rashes and inability  to participate in sports and a constant feeling of self consciousness regarding your breast size.

When talking about breast reduction, this is mainly dealing with large breasts with a lot of weight, and not post pregnancy breast deflation which would require a breast lift. An attempt can be made to lose weight and hence lose some breast weight but this most often than not, does not solve the problem.

Well , the only way of relieving these symptoms is by surgery. Of all the surgeries that women undergo , women are happiest with the results of breast reduction surgery. There is an immediate feeling of relief and confidence that is seen after surgery with all that weight gone. Rashes disappear under the breast as hygiene is better maintained. Women who have undergone breast reduction have a new sense of confidence in wearing form fitting clothes and also in working out at the gym as they lose that sense of self consciousness that has plagued them all these years.

The surgery itself has a complete pre-operative and post-operative period which has to be discussed with your board certified plastic surgeon. The scars itself range from around the nipple to a `Lollipop reduction` which is a vertical line from the lower part of the nipple to undersurface of the breast , and an `anchor`shaped incision which is done for even larger breasts.Patients undergoing breast reduction surgery can be back to work in week.

It is important to understand that woman do not have to live with these problems and a solution is available which can help them incredibly both physically and emotionally and help them do things they always wanted to.

Scar Revision

Scars are a testament to a point in time  and  mark as a way to remind us of where our journey has taken us. A scar we are born with is the umbilical cicatrix, a reminder of our first adventure with our mother. Scars have fascinated us from soldiers showing their battle scars to the lightning bolt on a certain wizard`s forehead.

A patient comes to a plastic surgeon for their scars for mainly two reasons, one being a functional deficit where the scar impedes complete movement of the joint and the second being a cosmetic deformity, which impedes their confidence or is a reminder of an untoward incident.

An ideal scar by definition is thin and flat, has good colour match with the surrounding skin,is oriented along the relaxed skin tension lines, and does not produce any distortion of adjacent tissues. A scar can vary from a immature to a mature scar, from a linear hypertrophic scar to a large keloid.

The outcome of a scar depends on three factors i.e the expertise of the surgeon which emcompasses the way of operating and the post-operative care taken, the second being the patient itself which depends on the age of the patient and the presence of systemic diseases like Diabetes Mellitus, Chronic Renal failure and finally the status of the wound itself on presentation i.e presence of infection and its location on the body.

The post-operative  period of healing and its maturity is as important as the surgery itself. Cleaning of the suture line and removal of sutures at the right time with with silicone/pressure therapy  is the way to go.

As it turns out ,if  the scar present on the body turns out unsightly, there are a number of ways of reducing the appearance of the scar. If it an extremely unsightly scar , excision of the scar and resuturing is an option. Other geometrical plastic surgery techniques like Z plasty, W plasty is widely accepted. A depressed scar can be improved by a technique called subcision and the residual corrected with a filler.

A scar is the nature`s way of healing and the process can be improved with adjuvant therapy during this period which usually takes about 6 months to a year. A multimodal treatment which consists of injectables like Triamcinolone, 5 FU are used. The use of Radiotherapy in the treatment of keloids is well established. The use of lasers has added another arrow in the armamentarium of scar management helping scar remodelling and improving their appearance.


In conclusion, you have every right to look the way you want to.

Mommy Makeover (Me Makeover)

“Mommy, Mommy” it’s been years since you’ve been hearing this, having elevated yourself from a woman to a full time mother, yes we all know it’s a full time job despite your career. When did “me” go out of the window and “mommy” become what you are defined by. Your body has changed over the years, remember that pre motherhood body? Pregnancies and lactation has literally and figuratively deflated your body and you, having lost the youthfulness and tone of the younger days. Is it time for these battle scars to go away and bring back the woman you used to be, be it for your husband or most importantly just for yourself – A Me Makeover.

An older mother like you, despite working out, trying a ton of different diets and doing everything possible, loosing all that fat on the abdomen, you still end up having poor abdominal tone & excess skin with a deflated breast with years of lactation and nipples pointing downwards. Those stubborn areas of fat on the lower abdomen, flanks which refuse to go away. It’s time to get your old self back.

A Me Makeover is a tummy tuck, breast lift and liposuction done together to give a beautiful balance to your body. The tummy tuck makes your abdominal muscles tighter and removes that excess skin from your abdomen. A breast lift makes the breasts more perky and lifts the nipples to a pre-pregnancy state. A breast lift does not add volume but if volume is desired, an implant with a lift can be done. Liposuction of those stubborn areas like the flanks, lower abdomen to shape your body.

Now that you have the desire, take a decision to a new you!

“Moobs”- Man Boobs, Does this make me less of a man?

The reason a blog on Man Boobs or Gynaecomastia as it is medically known is pertinent today is because the concept of body image has changed across the world and is fast changing in India. The incidence of Gynaecomastia in the Indian subcontinent is more than Caucasian and African populations.The Answer to the question in the title is definitely ‘No’, it’s not the end of the world. It does make men a little self conscious about taking their shirt off in public or wearing tight t-shirts which makes their chest more prominent. It is more common in teenage boys who might not understand the change & in older men who just don`t care but that opinion is subject to change.

Most men ask why? Why did they happen to me? It is caused by an imbalance in sex hormones testosterone & oestrogen.Oestrogen makes breast tissue(gland) grow. While all men do produce some amount of oestrogen,the testosterone usually overpowers it & stops the oestrogen from causing breast tissue to grow. If this balance changes, it causes breast enlargement.

Obesity,Puberty & Old Age are the main causes of gynaecomastia. Other rare cases include heart disease, alcohol,steroids,testicular masses,cannabis & Klinefelter’s syndrome(genetic). Coming to what is seen and felt ,there is an enlargement of the glandular breast tissue along with a generalised fat around the chest .This is not to be mistaken with puffy nipples which is a different entity where the nipples itself are large and feel like a soft balloon .The treatment for “Moobs” and for puffy nipples are very different.

Who is a candidate for breast reduction?

After ruling out the above causes,if you are a healthy non smoker, your plastic surgeon would decide if you are a good candidate for breast reduction surgery. The surgery itself is a combination of liposuction (an entire blog on the myths of liposuction will be coming up soon) – to remove the excess fat and gland excision-to remove the enlarged gland.The gland excision is a 3-9 ‘o’clock incision around the edge of the nipple which is eventually inconspicuous. The surgery is usually done under general anesthesia and now increasingly under sedation and local anesthesia. Once the surgery is complete, the patient can go home at night or stay overnight.

A pressure garment (a tight corset ) will have to be worn for a month after the procedure. There is no downtime and back to work in a couple of days. Expect sore breasts for a few weeks and a inconspicuous scar which will take a few months to fade. Avoid stretching, exercises, heavy weight lifting for a month. The results are seen in a month and complete results are seen in about 3 months. Today’s advanced technique allows for a short surgery, quick recovery and virtually invisible scars.

Eventually the consultation, surgery and final result is a partnership between you and your surgeon, so do it the right way to create the masculine contour you desired. This teamwork will give the best possible result with an enhanced sense of self confidence to take your shirt off in summers !!