Breast reduction or reduction mammaplasty surgery is one of the most satisfying procedures for women with excessively large breasts who complain of neck, shoulder, or back pain. 

When large breasts interfere with a woman’s quality of life, this procedure may be covered by your insurance company if certain criteria are met. 

Patients who undergo breast reductions are among the happiest of all plastic surgery patients.

The consultation

As both a woman and a plastic surgeon, Dr. Parcells is distinctively qualified to address your concerns and tailor her technique to achieve your desired results. 

During the consultation, Dr. Parcells will discuss your medical history and family history of breast disease. She’ll ask you about your current concerns and desired goals including breast size and shape.

She’ll then complete a physical exam and a member of her team will take non-identifiable medical photographs of your breasts (without your face) for your chart and for surgical planning. 

How to prepare for surgery 

You need to be in good physical shape to ensure proper healing, so follow your surgeon's instructions before and after breast reduction surgery.

Before you undergo surgery, Dr. Parcells will need to review the results of your routine mammogram if you are older than 40. Certain medications and herbal supplements will need to be stopped to reduce the risk of bleeding. 

Additionally, if you require any medical or hematological clearances those will be received prior to your surgery. All women with a history of smoking cigarettes, marijuana, or vaping will be asked to refrain 8 weeks before and after surgery and be tested prior to your surgery. 

The breast reduction procedure itself

For most women, breast reduction surgery is often performed in an outpatient surgical center.  You will receive general anesthesia and in the recovery room an anesthesiologist will administer a pain block to alleviate breast discomfort. 

Dr. Parcells will focus on removing excessive skin and breast tissue and reshaping your breasts into a more youthful shape. Depending on your prior discussion, liposuction of the breasts may be performed in conjunction with the excision of breast tissue to further define your silhouette.  

Depending on how much breast tissue is removed, drains may be placed and they will be removed in the office. You will be wrapped up in a surgical bra and gauze after your procedure. 

Your Immediate Recovery

Most women experience mild to moderate discomfort for several days following surgery and are back to their activities of daily living by about a week. Most patients experience immediate relief of back, shoulder, and neck pain with their new, smaller breasts. 

You will see Dr. Parcells in the office the following day and your breasts will be examined. If drains are in place, they are usually removed a few days after surgery. 

To ensure a healthy and straightforward recovery, it’s important to eat a healthy, high-protein diet, with small meals throughout the day. 

It is normal to feel tired and you should be encouraged to receive plenty of rest. 

Frequent small walks during the day are helpful in improving circulation, but vigorous exercise or heavy lifting is highly discouraged as your incisions (stitches) could pop open into wounds.

Most patients are off pain medications by 3-5 days and are able to drive once they are off narcotics for 24 hours. 

Antibiotics are administered up to 5 days after surgery. 

Most women return to work or school in about 5 days – 1 week. 

Any stitches that are placed are removed 1-4 weeks after the procedure, depending on their location. 

Physical activity at the gym can resume around 4-6 weeks after surgery. Patients are in special surgical bras to assist in shaping for several weeks after the procedure. 

Your new breasts may feel firmer and look rounder. Breast reduction may change the normal feeling in your breast. But in time, some feeling may return.

Breast Scarring

Scars are required in order to reduce the size and reshape your large breasts. These scars are usually located around your nipple, down the bottom of your breasts and underneath your breasts. These scars are not noticeable while wearing a bra and most bathing suits. The majority of the time, the scars will fade over time, but will never completely disappear. 

To learn more about a breast reduction, or to schedule a consultation with Dr. Parcells, please visit her website.

Dr. Parcells is a board-certified plastic surgeon specializing in breast reconstruction and aesthetics. She is a member of The Aesthetic Society and a candidate member of the American Society of Plastic Surgeons. 

This COVID-19 pandemic can feel overwhelming as most of us have had to adjust to a new normal. 

It’s important to understand and identify new stresses that have surfaced over the past few weeks. 

Whether it’s a change in job status, increased responsibilities, or caring for others, it’s important to take a mental and physical check-in and realize the emotions you are feeling are real and often need to be addressed.

During this uncertain time, emotions including, anxiety, anger, and discouragement may manifest as muscle tension, fatigue, sleeplessness, and headache. 

The goal here is to decrease stress (drop your cortisol, or stress hormone level) in order to increase your immunity. We need our immunity to be high to stay healthy during this time.

Additionally, anything you can do organically to boost levels of dopamine and oxytocin (the good hormones) will improve overall mood stability and health.

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Here are some strategies to help you through the pandemic.

Mental Health:

1. Check-in and Take a Self-assessment.

How are things going? How can I make things better?

It’s often helpful to do a self-check in 2-3 times a day to understand when and why you are stressed. Are their certain triggers or parts of the day that deviate from a good flow? Insight is powerful here in making positive change.

2. Establish a Routine

Establishing and maintaining a routine will not only keep you organized and lower your levels of stress, but the predictability of it will make life a bit more enjoyable. Of course, the routine may veer off schedule from time to time, but by focusing on things you can control you will be more able to cope with unpredictable events.

3. Optimize Technology

Technology - it can be helpful, or unhelpful. Identify your emotions as you interact with technology throughout the day. Spend more engaging in joyous experiences (such as facetiming with loved ones) and less so by reading end-of-the-world blogs or catastrophic commentaries. You are the master of your own mind.

4. Listen more

If there was a podcast you couldn’t get enough of, or an audiobook you were dying to start, now is the time. Plan this activity into your routine (cooking, cleaning) so it makes the mundane more exciting.

5. Be grateful.

Chances are, that if you are reading this, that you are healthy and safe. Think about what you can be grateful for. Your health, family, friends, beautiful weather are just some example. Hopefully, you can find something to focus presently on. 

6. Join a support group.

Many support groups are still meeting in parks with social distancing guidelines (AA) and there are many ways to find good support on social media or online. If there is something you are specifically dealing with in addition to this pandemic (i.e. cancer diagnosis), make sure you are touching base with your physicians and social support team to make the best of this unprecedented time.

7. Accept the things you cannot change.

Hair turning grey? Due for a dental checkup? Botox fading? C'est la vie, my friend. 

Physical Health

1. Eat Well & Drink Water

Now is a great time to identify how certain foods make you feel.

Fuel your body with a healthy, well-balanced diet and drink plenty of water. Avoid sugars and processed foods that can lead to mood swings and drastic changes in your insulin levels. Give your body the nutrition it needs to stay healthy.

2. Sleep.

Aim to get 7-8 hours of sleep each night.  Earplugs, eye masks, noise machines or fans - whatever it takes. Zone out street noise and try to obtain uninterrupted sleep if possible. If you can nap, and find that to be a stress reliever, go for it.

3. Exercise and stretch every day.

Spend time outside on a walk or run. Dust off that bicycle or scooter. Get moving!

4. Take care of your skin.

Spring is here and summer is around the corner. Get in a routine where you are using daily SPF (35+) and protective clothing if you are going to have prolonged sun exposure to prevent a burn. 

Parenting

Remember, this pandemic is stressful for both you and your children. 

Children and teens tend to react based on what they see from the adults around them

Providing a calm and confident environment is the best way to support your children. 

Keep with a regular routine that is inclusive of learning and activities and plenty of play. 

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Children, like adults, thrive in an environment of healthy foods, water, sleep, and exercise.

Talk to your child about COVID-19 and answer questions in a way your child can understand. Reassure her or him they are safe and that it is OK to be upset. 

Limit exposure to news coverage as children can misinterpret what they see or hear. 

Lastly, recognize your limitations and be kind to yourself if you cannot accomplish all of the scholastic or other goals you have been tasked with. 

Community

Giving has been shown to increase happiness on a molecular level. Look for ways to contribute to your community. Call or text an older relative or neighbor to check in. Consider donating to a local food bank. Write a card or knit a mask for your local first responders. You may surprise yourself by how good you feel afterwards. 

If it's just not going well, no matter what you try….

If you are experiencing any of the following to the point that they are interfering with your daily ability to function and outside the norm, contact a physician or psychologist for help and guidance

• anxiety that turns into a feel of being “out of control”

• inability to get out of bed in the morning

• emotions that are difficult to manage

• feelings of hopelessness or helplessness 

• trouble focusing on your daily routine 

Do not feel embarrassed if you need help. Be empowered, and get the help you deserve.

Please Stay healthy, stay safe,  and remember, we are all in this together. 

You love your Botox result.  And while you ideally want to keep up the treatment, you may be concerned about the financial cost and time required to maintain its effects. Does this sound familiar? Well, read on for some silver lining.

First of all, how does Botox work?

Botox, a popular anti-aging treatment, has continued to grow in popularity over the last 20 years. This neuromodulator works by blocking the nerves in and around your forehead and prevents those muscles from moving. The result? A softer and more relaxed face. 

Botox is currently approved as a cosmetic procedure for facial muscles including forehead lines (frontalis muscle), glabellar furrows (the combined action of the corrugators and procerus muscles), and crow’s feet (orbicularis muscles) around the eyes.

And while Botox was initially popularized by women in their 40s and 50s, younger patients including millennials are now scheduling regular treatments with prevention in mind. The dosing and location of injection should be tailored based on a patient’s desired goals, skin quality, and muscle function. Learn more about our botox services offered in New Jersey. 

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How often should you get Botox treatments?

While most patients are thrilled with their youthful look, the treatment is only effective for about 12 weeks on average.

However, research has suggested that after two years of treatment, results may last with less frequent injections.

The study looked at 50 women aged 30-50 years who received regular Botox injections every four months for the first two years of treatment. After two years, the injections were reduced to every six months instead of every 3-4 months.

The results? Doctors found that after two years of treatment, reducing treatment frequency to six months led to similar results as the more frequent treatments.

Read more about this in the June 2011 issue of Dermatologic Surgery.

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Can I do too much Botox?

Theoretically, yes. If you continue to receive treatments every 2-3 months for years on end, the muscle will continue to get weaker and flatter. This may give the appearance that the skin can appear thin and lose. 

Additionally, the muscles nearby which have not been paralyzed may get larger as they are being recruited to compensate for the muscles that have been inactivated by Botox. 

What’s the next step?

To avoid a bad Botox experience or a long-term side effect, make sure you research your doctor diligently. See a board-certified Plastic Surgeon or Dermatologist in consultation in order to understand what treatment is best for you and tailor it to your needs. 

Can I combine Botox with any other procedures to improve signs of facial aging?

Botox can safely be combined with skin resurfacing treatments including chemical peels, laser resurfacing, and medical-grade skin care to combat dyspigmentation, fine lines, and wrinkles. Make sure you talk to your plastic surgeon or dermatologist about the timing of these procedures. Many offices have an associated medical spa so you can receive all treatments in the same place.

As always, it’s important to eat a healthy diet, sleep, and wear sunscreen can also help prevent future photoaging changes to the skin.

Dr. Parcells is a board-certified plastic surgeon in New Jersey. She is certified by the American Board of Plastic Surgery.

What is Breast Implant Illness (BII):

Breast Implant Illness (BII) is a combination of various systemic symptoms that women have been reporting and believe to be related to their breast implants.

To date, these symptoms have been reported in women with saline, silicone, smooth and textured implants:

These symptoms include (but are not limited to):

-fatigue

-chest pain

-hair loss

-headaches

-chills

-photosensitivity

-chronic pain

-rash

-body odor

-anxiety

-brain fog

-sleep disturbance

-depression

-neurologic issues

-hormonal issues

At this time, breast implant illness (BII) is not an official medical diagnosis.

Many patients are reporting their symptoms on social media and state their symptoms have been improved and resolved with the removal of their implants.

Common Questions:

1.    Is there a link between BII and silicone?

Silicone is an element that exists in nature as crystalline silica. The silicone used in breast implants is different as it has had antioxidants, dyes, and plasticizers removed during processing.

Silicone gel implants have been studied by the FDA for many years and to date have not been proven to cause any disease.

2.    Can you diagnose Breast implant illness with a test?

Currently, there is no diagnostic test for BII.

Many different organizations in Plastic Surgery, such as the American Society for Plastic Surgeons and the American Society of Aesthetic Plastic Surgery, are funding research to further understand this potential disease process.

There are tests for autoimmune diseases that your plastic surgeon may recommend. However, patients who self-identify as having BII have tested both positively and negatively on laboratory tests for autoimmune disease. So, at this time, there is no causal relationship between BII and autoimmune disease. 

3.    Does implant removal improve BII symptoms or cure patients?

At this time, there is no definitive epidemiological evidence to support a direct link between breast implants and any disease.

However, some women have reported different degrees of improvement in symptoms after implant removal. Improvement may be temporary or permanent. It is unclear what specific symptoms may or may not improve with implant and capsule removal.

4.    what is the difference between BII and capsular contracture?

When a foreign object is placed into the body (hip implant, breast implant, catheter), the body’s response is to form scar tissue around it.

In women with breast implants, the scar layer around the implant is called the breast capsule, and it usually takes 4-6 weeks to form.

In a small percentage of women, the scar capsule can become irritated and can contract tightly around the implant, pushing it up and out and causing pain or discomfort. This is known as capsular contracture. There are many theories as to why this occurs, and there are strategies to decrease the risk of this contracture.

The treatment for this contracture is the removal of the breast implant and the capsule.

In women with BII, there has been no association with capsular contracture. Women do not usually complain about pain and tightness around their implants. Rather, they have systemic symptoms such as fatigue and malaise. However, the treatment is the same – removal of the implant and the capsule (scar layer) surrounding the implant.

5.    What is the risk of developing BII

At this time, because there is no definitive link between symptoms and breast implants, there is no “known risk.”

6.    What should I do if I think I have BII?

There are legitimate concerns about a potential link between breast implants and symptoms of BII.

If you are concerned you may be experiencing these symptoms and feel they are attributed to your breast implants, see your Board-Certified Plastic Surgeon.

Just remember, breast implant surgery is elective surgery, and you can always elect to have your implants and overlying breast capsule removed if you believe doing this will improve your symptoms.

9. How much do the removal of breast implants and capsulectomy cost?

Each patient is different, and your needs are unique. The cost of this procedure will depend on the conversation between you and Dr. Parcells during your one-on-one consultation.

After reviewing your medical history, Dr. Parcells will perform a physical exam to evaluate your breasts as well as skin tone, laxity, nipple position.

She will then provide her expert advice and discuss your surgical options.  She will also address all risks and benefits of the procedures you are interested in.

At the end of your consultation with Dr. Parcells, you will meet with our surgical coordinator who will address the logistics and finances of the procedure you are best suited for.

Dr. Parcells is board certified by the American Board of Plastic Surgery.