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. 

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.

Many people with stubborn areas of fat often consider liposuction as an alternative weight loss procedure. 

There is some truth that liposuction does remove weight, but there is much more to it than that. Read on to learn more.

How does Liposuction Work?

Liposuction is a powerful technique to address stubborn areas of fat that are not conducive to weight loss and exercise. 

Many women complain that despite diet and exercise, they continue to experience unwanted fat in problem areas including the abdomen, love handles, arms, legs, neck, or knees. 

The procedure involves the use of small incisions and cannulas to remove excess fat. 

Downtime is minimal and results are gratifying.  

How much weight can you lose with liposuction?

This question is tricky. While some patients may lose a few pounds, that is not the goal of liposuction. The purpose of liposuction is body sculpting and improving physical physique, not weight loss.

Usually, the maximum amount of fat that is suctioned out is the equivalent of around 5-8 pounds. It is not recommended to have more than 4-5L of liposuction performed in one surgical procedure, and as more is done the risk of complication increases. 

If multiple treatment areas are desired and the overall amount of liposuction is > 5 L, the procedure should be broken down into 2 separate surgeries spaced about 12 weeks apart.

Therefore, patients should not expect to lose a dramatic amount of weight with liposuction. However, because fat is removed from cosmetically important areas, liposuction can produce significant improvements in the way you look and feel in clothing. 

Are the results permanent? Will fat cells grow back? 

After liposuction, you will be placed in a medical-grade compression garment and your surgeon will give you instructions on how to care for your new body. 

If you adhere to your instructions and do not experience a dramatic weight gain, your body’s shape is more or less permanent. 

If you do gain weight after liposuction, then your figure will simply be a larger version of the new body shape. However, the dramatic results you initially saw will be less defining.

Liposuction removes fat cells permanently. However, with an increase in weight, new fat cells can develop in all areas of the body, including previously treated liposuction areas.

That being said, the degree of fat deposits re-growing in a previously treated liposuction area is less than in untreated areas. 

What age-related changes should I experience if I remain weight-stable?

No. If you stay around the same weight, then you should not expect fat cells to redeposit in the area previously treated. 

However, it is natural for the body’s fat deposits to change gradually with age and fluctuations in hormones. However, the results of successful liposuction should remain visible. 

Will I see my results right away?

The majority of patients will see their final results 8-12 weeks after their procedure. Most patients have swelling and bruising that resolves within a few weeks of surgery.

Which is a better choice for me, Liposuction or a Tummy Tuck (abdominoplasty)

Liposuction is a noninvasive (no skin incision and no long scars) procedure that focuses on removal of fat cells, but does not address excess skin. 

Liposuction is intended for individuals with good skin elasticity so the skin can “bounce back” after the procedure. For individuals with excess skin, a Tummy Tuck (abdominoplasty) or total body lift may be a better option.

Liposuction does not address abdominal wall laxity or diastasis recti. 

However, it is considered a body contouring procedure as it will accentuate feminine features such as a thin waistline and hourglass silhouette. It is used to sculpt, or fine-tune, certain treatment areas that do not respond to a healthy lifestyle.

In some patients, it is safe to combine liposuction with an abdominoplasty, depending on where excess fat resides.

We offer a variety of surgical and nonsurgical services in our office.  

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

Breast augmentation is one of the most common cosmetic surgeries performed in the United States every year. Women typically desire this procedure to improve their breast size and shape. 

What is breast augmentation?

There is a lot to understand about the type of breast implants (silicone or saline), where they are placed (above or under the muscle), placement of scars.

Additionally, a breast augmentation can be combined with a breast lift or mastopexy. This surgery changes the shape of your breasts, but it doesn’t alter the size.

How to find a surgeon

The most important part of considering breast augmentation is choosing the right surgeon. Make sure you see a board-certified plastic surgeon. 

Ask questions about your procedure and make sure you feel comfortable with your surgeon of choice 

Surgeons website to find a board-certified plastic surgeon near you.

And while preoperative planning is important to optimize your surgery, recovery is just as essential to ensure an excellent outcome. 

How long is a full recovery?

In general, full recovery from a breast augmentation can take on average 6 weeks. Each person is different, so for specifics make sure you talk to your board-certified plastic surgeon. 

Let’s break down the recovery into a few stages so you can better understand how to prepare.

Acute Recovery:

This period is usually immediately post-operation. 

Your breast will be wrapped and you will be transported to the recovery room, where you will likely feel groggy and sore. 

At this point, your surgeon may elect to give you a local numbing pain block to improve any discomfort you are experiencing and reduce narcotic use. This typically lasts around 12 hours. 

Because you have just woken up from anesthesia, you will need someone to drive you home and stay with you overnight.

The first 3 to 5 days

The first few days after surgery are the most uncomfortable.  

Your surgeon will recommend instructions on how often to take antibiotics and muscle relaxants or pain medications for the first few days after your procedure.

Ideally, any strong narcotic medications should be discontinued within the first few days since they cause constipation and prolonged use can lead to a longer recovery.  

While some patients report pain, most patients experience tightness or muscle aching at this time. 

This can be in the breasts, shoulders, neck, and back. These symptoms are best controlled with a muscle relaxant such as Valium. For most women, this sensation resolves over the next 3 to 5 days.

You will also have instructions on how to care for your incision and what bra or garments to wear.

Bruising, swelling, and minor bleeding from the site is all normal. If something does not feel right, call your doctor.

1 week

By this time, you should have minimal discomfort that can be managed with over-the-counter medications.  

You should be seen by your surgeon within this time frame, and most women are able to resume light daily activities. Women who work at desk jobs are usually fine to return to work and drive. Many physicians encourage a few short walks 1-2 times a day. 

Next few weeks

During this time, you will start to feel like yourself again and get back into your routine. 

It’s important to note that your wound heals approximately 10% per week and so most doctors do not recommend resuming an exercise routine, especially upper extremity focused workouts, until about 4-6 weeks after surgery. 

Additionally, patients with labor-intensive jobs may have to wait 3-4 weeks after their procedure before returning.

If you have a physically demanding job, you’ll need to be out of work for 3 weeks or more. You’ll also need to avoid heavy lifting and intense physical activities, like running.

2 months

After about 2 months, your physician should assess your healing and clear you for all normal activities. 

It's vital to follow your doctor's care instructions closely so that your breast implants heal properly and there are no complications.

Possible complications  

Breast augmentation is a surgical procedure, and every procedure has potential risks. Complications can include

• Unsightly scars

• infections

• bleeding problems, like blood loss. 

• Asymmetries between your breasts

• Implant malposition

• Breast and nipple pain or numbness

• Poor cosmetic result 

• breast cellulitis

• breasts appear to merge (symmastia)

• skin dimpling or visibility of the implant 

• scarring around the implant 

• implant leak or break

• breastfeeding problems

• breast implant-associated anaplastic large cell lymphoma  

• breast implant illness 

Tips for recovery

There are things you can do in order to avoid complications and enhance your recovery experience. 

Make sure you discuss all concerns with your physician before the surgery. 

Follow instructions regarding medication frequency and duration, wear your surgical garments as instructed, and avoid activities that your physician discourages. 

Ask friends and family to help. Prepare healthy meals ahead of time and take the rest you need to heal well.