Why Choose Dr. Chang for Breast Augmentation?
Dr. Chang is trained in the latest techniques of breast reduction surgery, including the Circumareolar (Donut) Technique, the Vertical (Lollipop) Technique, and the T-Incision (Anchor) Technique. Dr. Chang is a Board Certified by the American Board of Plastic Surgery and has trained at some of the premier centers of plastic surgery in the United States including a Plastic and Reconstructive Surgery Fellowship in Rochester, New York and a Cosmetic Surgery Fellowship in Beverly Hills and Newport Beach. Dr. Chang is the owner and medical director of the Aesthetica Cosmetic Surgery and Laser Center as well as Radiance Salon and Medispas with offices Leesburg and Ashburn Virginia.
How Can Breast Reduction Surgery Help You?
- Reduction of shoulder and back pain
- Reduction in bra strap grooving
- Reduction in rashes and irritations beneath the breast
- Clothes and bras fit better
- Exercising is easier (both functionally and psychologically)
- Reduction in anxiety caused by being self-conscious
- Reduction in unwanted stares and unwanted attention
- Reduction in areola size
- Reduction in asymmetry when one breast is larger than the other
- Reduction in asymmetry when being treated for breast cancer
- Breasts are also lifted so that they sag less
What is Breast Reduction Surgery?
Anyone who complains about their large breasts can easily understand that breast reduction surgery is not only a cosmetic procedure, but also a medical and functional procedure. In fact, breast reduction surgery is often covered by insurance for those very reasons. The surgery, which involves the removal of breast tissue from one or both breasts, helps eliminate the pain and stress on the rest of your body that is caused by the disproportionate weight of large breasts. Breast reduction surgery also helps you regain a better sense of balance and allows you to run and engage in active exercises that are impossible to perform with large breasts.
All breast augmentation procedures are performed at either Countryside Ambulatory Surgery Center, INOVA Loudoun Hospital, or INOVA Fair Oaks Hospital. All facilities are accredited and the procedures are overseen by anesthesiologists (not just a nurse anesthetist). No breast augmentation procedures are performed in the office setting.
Candidates for Breast Reduction Surgery
Your consultation will begin with a review of relevant medical history. Patients need to be older than 18 years of age. Most women who desire smaller, more uplifted breasts are good candidates; it is only a question of which technique is most appropriate for you. All women over 40 require a preoperative mammogram, and all women over 45 require an EKG and standard blood work.
Breast Lift Surgery
Breast reduction surgery always includes a breast lift (mastopexy) as part of the surgery. With pregnancy and breast feeding, the breasts engorge and then afterwards lose their volume and start to sag. The nipple-areola complex then enlarge and often, the mother is left with stretch marks. The result is breast sag, loss of upper breast volume and cleavage, and large areolas. During the breast reduction surgery, these things are addressed and corrected.
Choosing a Breast Reduction Technique and Size
During your initial consultation with Dr. Chang, you will discuss your desired breast size post-surgery. While size is a very personal decision, most patients choose to go down to a C-cup. Dr. Chang will then will explain the breast reduction surgical technique that is most appropriate to help you achieve that goal. There are basically three techniques used for a breast reduction procedure. These include:
- Circumareola Technique (Donut Technique)
- Vertical Technique (Lollipop Technique)
- T-Incision Technique (Anchor Technique)
Dr. Chang actually prefers the slang terms in parenthesis and will in general use these terms during your consultation.
It is very important to find a plastic surgeon that performs all three surgical techniques routinely as you will often find some surgeons that perform the Anchor technique on everyone, regardless of size. Small reductions require only a Donut technique, middle to large reductions require a Lollipop technique, and the Anchor technique is reserved for very large reductions. The difference between the three is the degree of skin removed and therefore the degree of scarring.
Circumareola Technique (Donut Technique)
The Donut Technique of breast reduction is a technique which removes breast tissue from an incision around the areola complex. Only a limited amount of skin and breast tissue can be removed through this technique so it is only appropriate for only small reductions and/or breast lifts. If too much skin is removed, the tension around the scar around the areola complex often widens and actually looks less appealing than creating longer scars.
Vertical Technique (Lollipop Technique)
The Lollipop Technique of breast reduction is a technique which removes breast tissue from an incision around the areola complex but then extends downward to appear like a lollipop. This technique is most appropriate for middle to large breast reduction and lifts. Because there is less tension around the areola complex, the scars are more invisible and satisfying. This technique also offers the most breast projection and cleavage.
T-Incision Technique (Anchor Technique)
The Anchor Technique of breast reduction is usually reserved for much larger breasts. It is the best technique for very large breasts but requires the most incisions. Because this technique is often used for the largest reductions, it is this technique that is used when insurance companies approve the procedure.
What to Expect
Patients will recover at home (or at the Lansdowne Resort for out of town patients). Some patients can elect to purchase an On-Q pain pump which will eliminate pain for the first 3-4 days. Believe it or not, breast reduction surgery is a relatively non-painful procedure and most patients are off of strong pain medicine in a day or two. Most patients return to work in 7-10 days and can resume light exercise after 2 weeks. More strenuous exercise may resume in 3-4 weeks. Breast swelling can be dramatic for up to 4 weeks and requires 6 to 12 months to completely resolve. Final breast shape, settling, and size takes up to 6-12 months. Bruising and swelling take 2-4 weeks to improve.
The first postoperative visit is a day or two after your procedure. During this visit, your initial dressings are removed and you may start wearing a sports bra. Underwire bras are discouraged for the first 4 weeks. Incisions are generally closed with absorbable sutures under the skin, so there are no sutures to be removed. The scars normally take about a year to mature.
Will Insurance Pay for Breast Reduction Surgery?
Insurance will often pay for breast reduction surgery if you are at least a DD cup. Most insurance companies will cover the reduction procedure if more than 500 grams can be removed from each breast. Part of your consultation will review the insurance requirements which include the two points above. Your insurance company will generally require a letter stating that Dr. Chang can remove at least 500 grams of breast tissue from each breast as well as pictures documenting your size.
Other Types of Breast Surgery Dr. Chang Performs
- Breast Lift (Mastopexy)
- Breast Lift with Breast Implant
- Breast Augmentation
- Breast Reduction
- Nipple Reduction
- Breast Areola Reduction
- Mommy Makeover
The Mommy Makeover
The “Mommy Makeover” procedure has become a very important part of Dr. Chang’s practice. The majority of his patients are either new moms or women who have had children. Anyone who has experienced the joy of pregnancy could tell you that although their children are a blessing, what the childbearing and childrearing process has done to their body is not. Most would tell you:
- Breasts have lost their volume and roundness
- Breasts are more droopy and often larger
- Areola is larger and nipples are more elongated
- Tummy is stretched and sticks out more
- They have fat in places they have never been fat before
- The face is more haggard (see topics on nonsurgical rejuvenation)
These women benefit from a combination of procedures that Dr. Chang calls a Mommy Makeover, which includes:
- Breast Augmentation with or without a breast lift (mastopexy) or breast reduction
- Full tummy tuck or mini tummy tuck
- Liposuction of the flanks and thighs
- Nonsurgical facial fillers and Botox