Bolitho MD

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9834 Genesee Ave Ste 311 La Jolla San Diego, California
Phone: (858) 458-5100

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9Feb, 2017

Providing patients with calm and comfort

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Providing patients with calm and comfort

Patient concierge Karen Martindale redefines the art of patient care. 

When a person decides to embark on a plastic surgery procedure, it can trigger a sense of enthusiasm, and for some, a feeling of empowerment. Despite these initial feelings, it’s highly important for potential patients to encounter professionalism during a plastic surgery consultation which should also be punctuated by a sense of calm and comfort.

Karen Martindale, who serves as patient concierge for San Diego plastic surgeon Dr. D. Glynn Bolitho, shared the significance of creating this patient atmosphere.

“We really try to put patients at ease through communication and getting to know them better prior to the examination portion of their visit,” Ms. Martindale said.

Both Dr. Bolitho and Ms. Martindale decided to afford patients with a special experience by creating their consultation suite otherwise known as the Clifton Room. This room is utilized for ensuring patient comfort in where individuals have the time that they need to speak with Ms. Martindale and ultimately Dr. Bolitho.

Rather than having patients transfer from the reception room to an examining room, it was decided to have patients relax in a private sitting room. Patients have the opportunity to view a “before-and-after” patient gallery on a flat screen as well as sharing their aesthetic wishes to Ms. Martindale and Dr. Bolitho.

“Our goal was to make the consultation less formal than other medical practices,” Ms. Martindale said. “Dr. Bolitho really likes to get to know his patients. That’s so important to him.”

Ms. Martindale went on to say that the patient experience during a consultation transcends to much more than a potential cosmetic surgery.

“Dr. Bolitho is extremely warm and kindhearted. He likes to know about a person’s general health, their lifestyle, and even their family. For Dr. Bolitho, it’s about building relationships,” she said.

Once a potential patient has had the opportunity to discuss their aesthetic wishes in the Clifton Room, the next step is the examining room if they so choose.

While Ms. Martindale has been in the field of plastic surgery for more than 25 years, her compassion for patient care has never waned. Like Dr. Bolitho, she understands how an examination for a procedure such as a breast lift or tummy tuck can trigger a natural awkwardness. It’s Ms. Martindale’s intention to make patients feel as relaxed as possible, and the Clifton Room serves as a nice segue to the examining room portion of the visit.

According to Ms. Martindale, a plastic surgery consultation lasts roughly about an hour. She also shared how they have a goal to achieve during each and every consultation.

“We want patients to feel totally comfortable and want them to know that they are in wonderful hands because we care,” she said. “Our patients become part of our practice family.”

19Jan, 2017

Plastic Surgery Consultation: Plan Ahead

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Plastic Surgery Consultation: Plan Ahead

For some individuals, a new year means new possibilities. One pathway of possibilities may be aesthetics by way of plastic surgery. When one has located a board-certified plastic surgeon, the next step is scheduling a plastic surgery consultation.

It’s completely normal for a patient to feel a blend of excitement and nervousness at this appointment. Nevertheless, there are some things that a patient can do ahead of time to make the most of their consultation.

Karen Martindale is a patient concierge for San Diego plastic surgeon Dr. D. Glynn Bolitho. Dedicating more than 25 years in the cosmetic surgery industry, Ms. Martindale brings a wealth of knowledge to patients preparing for a consultation.

Ms. Martindale’s sage advice is to plan ahead.

Top plastic surgeons like Dr. Bolitho are going to be booked about four to six weeks in advance. So most of the time, a patient will not be able to walk in and request surgery the very next week,” Ms. Martindale said. “With that said, it’s never too soon to come in for a consultation.”

According to Ms. Martindale, some patients who want to learn more about liposuction or tummy tuck may think that they need to be at their ideal weight before their consultation. Ms. Martindale shared that potential patients do not need to wait.

“It’s always a great idea to come in for your consultation three or four months ahead of time so future plans can be made. Even though you may not be at your ideal weight, coming in and having your consultation is a great start,” Ms. Martindale said. “Many patients have also explained how the consultation served as a great incentive to help them achieve their weight loss goal.”

In other instances, achieving a certain weight loss for a particular procedure may not be necessary. Ms. Martindale shared an example such as for those wanting a neck lift or surgical facial rejuvenation procedure.

“If you’re within 10 to 15 pounds of your ideal weight, having a facelift may not make that much difference,” Ms. Martindale said.

Planning ahead is also needed if one is smoking traditional cigarettes or inhaling e-liquid nicotine while vaping.  Ms. Martindale wants potential patients to know that they need to stop smoking four weeks before and after surgery. And on a side note, Ms. Martindale happily reported how many of their patients never returned to their cigarette use.

Writing down questions ahead of time was also mentioned by Ms. Martindale.

“These questions can vary, but generally they range from recovery, when they can resume their exercise routines, and when they can fly,” she said.

For marathon runners readying for a future event, planning ahead on the opportune timeframe for surgery is important to address.

“Busy moms also need to coordinate their surgery time with their children’s schedules and possible childcare assistance,” Ms. Martindale said. “Another thing a patient will want to inquire is if their plastic surgeon will be out of town during the time they are interested in having surgery.”

In many respects, a plastic surgery consultation can help turn a possibility into a reality.

21Dec, 2016

Plastic surgeons recommend cessation of e-cigs prior to surgery

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Plastic surgeons recommend cessation of e-cigs prior to surgery

In a recent December publication of United Press International, Health Day News reported how two plastic surgeons stated in the Plastic and Reconstructive Surgery December issue how stopping the use of e-cigarettes prior to surgery was highly advised. The doctors highlighted in the piece included Dr. Alan Matarasso of Albert Einstein College of Medicine and Dr. Peter Taub of Mount Sinai Medical Center.

According to Health Day News, the doctors stated, “Based on our current best knowledge, it seems reasonable to advise plastic surgery candidates to cease e-cigarette use,” they said. The doctors continued, “Refraining from [e-cigarette] use four weeks before surgery is a prudent course of action, despite the fact that it has yet to be determined if the effects are similar to traditional cigarettes.”

While the health impacts of “nicotine vapor” continue to be researched, it appears the reason for this medical recommendation underscores patient care. The doctors referred to a study which revealed how stopping traditional smoking three to four weeks prior to a procedure could significantly decrease the risk of postoperative complications.

Blood flow and blood supply is essential following plastic surgery procedures, such as breast surgeries and abdominoplasties. Tissue healing following surgery requires this blood flow.

Erring on the side of caution, it’s believed that e-cigarette users should follow the same protocol as those who use traditional tobacco products. The reason behind this cautionary advice stems from the fact that the side effect of nicotine is best described as a vasoconstrictor.

According to the American College of Surgeons, traditional cigarette smoking does increase complications both during and following surgery. It’s their estimation that following the “no smoking rule” a few weeks prior and after surgery lessens the risk of wound healing by nearly half.

Many plastic surgeons also encompass the cessation of nicotine patches and gum in this medical protocol.

In addition to nicotine, carbon monoxide is also another concern.

While carbon monoxide withdraws oxygen away from the tissue area, as mentioned earlier, nicotine constricts blood vessels which deliver oxygen and nutrients to tissues. Again, this blood flow is vital to the healing process.

If the percentages in oxygen and nutrients drop during the recovery process, there is a risk factor following surgery in areas such as infection, increased chance of scarring, and additional complications.

While some plastic surgeons follow a smoking cessation of four weeks prior and after surgery, others have a more conservative approach of six weeks. A large gap of time is highly recommended and encouraged.

During a patient’s consultation with their plastic surgeon, it’s imperative to be candid regarding any smoking history. And this includes vaping. A surgeon’s top priority is the care of his/her patients and making certain, as a doctor-patient team moving forward, all can be done for an outstanding surgical outcome.

21Oct, 2016

Why a woman may seek a breast revision surgery

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Why a woman may seek a breast revision surgery

When a woman considers a breast augmentation surgery, it’s important that she is thoughtful about the decision. During her appointment with a board certified plastic surgeon, she can inquire about the procedure, the recovery and the outcome. Also at that time she can be candid in regards to why she wants this surgery and her expectations following it.

Excellent communication between plastic surgeons and their patients is imperative.

While a patient may have done their due diligence before undergoing their breast augmentation procedure, there are cases when she may very well consider a breast revision surgery based on either a desire or need. This can occur months or even years later.

These reasons may vary and include the following:

  • Challenges with breast asymmetry
  • Capsular contracture (scar tissue surrounding the implant has tightened)
  • Symmastia
  • Removing and replacing an implant(s) which has ruptured
  • Deciding on a new implant size
  • Implant rippling
  • Interchanging saline with silicone implants (or vice versa)

It’s entirely up to the patient as to whether or not they want to return to their original plastic surgeon for the revision or seek another. If the choice is the latter, it’s highly recommended to research only board certified plastic surgeons that specialize in breast surgery and ones who are adept in breast revision surgeries.  Once more, this is a personal decision. In addition to this, other surgeries they should excel in may consist of a breast lift, breast reduction, and breast reconstruction. Surgical aptitude in breast surgeries can help patients achieve a positive surgical outcome.

As mentioned earlier, there are various reasons as to why a woman may seek a revisionary breast surgery.  Some patients may discover over time that the original size implant they chose years ago no longer fits their lifestyle. For example, when a woman has completed having her family in her forties, she may come to the realization that the implant size she chose in her twenties may no longer be aesthetically appealing to her.

In the same breath, her skin tissue may have transformed over time due to weight gain, breastfeeding and weight loss.

Every patient is different as are their aesthetic needs.

For whatever reason a woman decides that she is interested in pursuing breast revision surgery, always remember that locating a board certified plastic surgeon should be at the top of the checklist.

And truly, this certification cannot be understated. A doctor certified in plastic surgery can help ensure a positive surgical outcome while keeping patient safety in the forefront.

26May, 2016

Considerations for revisionary breast surgery

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Considerations for revisionary breast surgery

Through many years of practice, revisionary breast surgery has evolved into a specialty.  Those who have undergone a breast enhancement procedure will sometimes want–or sometimes need–a revision surgery. Implants may be used in procedures such as a breast augmentation, breast lift, or breast reduction.

It’s important to note that not all patients who undergo a lift or reduction may require an implant – it’s a personal choice that can be discussed at a consultation with a board certified plastic surgeon.

While some patients may be displeased with the aesthetic outcome of their initial procedure, there may be other factors which lead them to seek a revision. These reasons, both personal and medical, may include the following:

  • Symmastia
  • Capsular contracture
  • Implant rupture
  • Bottoming out
  • Symmetry issues
  • Implant disappointment
  • Downsizing implants
  • Replacing implants

 

In some instances, women who are finished having their families may have chosen to have implants placed without undergoing a breast lift. While some patients are content with the results, others may be dissatisfied with the position and want to improve their appearance with a revision.

For mothers who had an enhancement prior to bearing children, undergoing a second augmentation after building their families is also another aesthetic scenario. The effects of bearing children, such as weight gain and breastfeeding, may alter the appearance of woman’s bust line. In some instances, a lift may be recommended to address skin redundancy

Another motive may be when a woman decides that the upper silhouette she wanted to achieve many years ago through implants is not a current aesthetic goal at this point in her life. In these instances, she may decide to downsize.

As one can imagine, revisionary breast surgeries are performed for a variety of reasons.

When electing to undergo a revision for aesthetic purposes, it’s generally advised to wait four to six months following the initial surgery to ensure all healing is complete–this includes any residual swelling. If a patient decides that she does not want to return to her original surgeon for a revision, it’s highly advised that she seeks a board certified plastic surgeon that specializes in breast revision surgery. Surgeons at this level have mastered their craft.

During a consultation with a new cosmetic surgeon, be candid with the doctor when it comes to the reason, or reasons, behind the revision. At this first appointment, clear communication is necessary. It’s important that the surgeon doing the revision surgery and the patient have an excellent rapport.

Following an exam, the doctor will convey their thoughts regarding a revision. The details of the surgery, the recovery process, and realistic expectations will also be discussed.

Before or during the consultation, make it a priority to review their patient gallery photos of women who have undergone a breast revision surgery. If possible, ask the doctor if they have any “before or after” images of patients who were in a similar circumstance(s). This will provide an excellent gauge as to whether or not the surgeon’s talents are aligned with a patient’s goals.

22Mar, 2016

Americans increase the price tag of plastic surgery

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Americans increase the price tag of plastic surgery

Over the years, plastic surgery has been fueled by several factors, but the leading demand stems from individuals who want to look as good as they feel. With that being said, the American Society for Aesthetic Plastic Surgery (ASAPS) recently released some data indicating the amount of money that Americans spent on plastic surgery procedures in 2015 reached an unparalleled all-inclusive price tag: $13 million.

Since ASAPS released this information, a handful of articles have followed highlighting different portions of the study. The data was incredibly concise, revealing the top-tier body and facial rejuvenation procedures that both men and women seek; however, women comprised 90 percent of the procedures underwent in 2015.

In 2015, a total of female Americans had 11.5 million plastic surgery procedures. And men tallied 1.5 million procedures.

Plastic surgery has become an important part of American culture, not to mention around the globe. But here in the states, many have suspected that Corporate America has fueled the desire to seek facial rejuvenation. For many individuals who have worked so hard to achieve their career status, a number of them want to retain their position and not retire. A group in this category view plastic surgery as an asset toward their extended career investment.

In the Washington Times, Jennifer Harper wrote a follow-up piece to the ASAPS data. In her article was a statement by president of ASAPS, Dr. James C. Grotting.

“I personally believe the motivating factors for that are varied, but remaining competitive in the workforce is certainly a common factor. Youth is a commodity, and people are investing in themselves to maintain a younger, healthier appearance,” Dr. Grotting said.

While different age ranges were assessed, 40 percent of patients between the ages of 30 to 50 took part in cosmetic procedures. For women, the top procedure in 2015 was liposuction. Following close behind was breast augmentation, tummy tuck, breast lift and eyelid surgery.

The procedures men sought differed; however, their number one procedure was also liposuction. Next was nose reshaping surgery, eyelid surgery, male breast reduction and facelift.

Although not in the top five for women, buttock augmentation and buttock lifts increased quite quickly in numbers, as well. And the demand is increasing.

Harper wrote, “The surgeons note that fat transfer to the face – a new category – ‘instantly’ landed in the top-10 list, as did nonsurgical skin tightening, a procedure particularly popular among men.”

Fat transfer in the face can be considered by many as being done in lieu of fillers. As one ages, they begin to lose volume in their face, particularly around the nasolabial folds and cheek area. While fillers can last up to a year or more, some patients are welcoming a fat transfer. Fat is extracted from a person’s body and then utilized to add youthful fullness to facial features.

In the non-operative sector, Botox led the way at 4.2 million procedures last year. Fillers trailed close behind as did other minimally invasive procedures such as chemical peels.

Be it operative or non-operative procedures, plastic surgery is filling an aesthetic niche for people of all ages.

17Mar, 2016

Breast Revisionary Surgery Transforms and Corrects

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Breast Revisionary Surgery Transforms and Corrects

Breast surgery is a personal decision which should be made mindfully and thoughtfully. While moving forward with the best of intentions, sometimes a patient’s surgical outcome is not to her satisfaction. Be it a breast reduction, breast augmentation, or breast lift with augmentation, a situation may arise which triggers a patient to consider a revision.

There is an array of issues which may occur following the primary operation.

“There is one issue that we call symmastia in where the skin in between the breasts actually lifts off the sternum and can be challenging to correct,” said patient concierge Karen Martindale, who works alongside renowned plastic surgeon Dr. D. Glynn Bolitho. “And another issue a patient may experience is capsular contracture.”

Other matters patients experience may include symmetry challenges, downsizing or replacing breast implants, and more. Martindale explained that some patients after their childbearing years may have had implants to improve volume without a lift. Patients who want a revision in this case are generally not content with the descension.

Martindale explained that when a woman comes in for a consultation, it is most optimal if they have on hand their previous operative notes and what type of implants they currently have so the doctor can review the material.

“Following this, Dr. Bolitho will perform an examination and will be able to show patients a before-and-after gallery of those who underwent the same type of procedures with outstanding results.”

Martindale attributes Dr. Bolitho’s expertise from years of experience in performing breast reconstruction surgeries for women who had lost one or both breasts to cancer.

And each person is different in terms of how long they will wait until they seek a revision. In addition, they may undergo more than one revision.

“Some patients will travel long distances to find the right surgeon to help them with their issue. We’ve had patients in our practice who find Dr. Bolitho after undergoing several revisions,” she said.

According to Martindale, Dr. Bolitho has helped women achieve the aesthetic symmetry they desired, avoid another capsular contracture, and reverse a host of other issues.

“Many women we see in consultations are so close to taking out their implants completely due to the frustration levels,” she said. “I personally have a friend who had eight procedures before she came here to see Dr. Bolitho.”

Martindale shared how her friend was told by one surgeon that she had to have her implants removed because she was prone to capsular contracture. She would encapsulate weeks after surgery, and her implants would be hard again.

And then she went to Dr. Bolitho for a revision.

“My friend is so happy and there has been no evidence of a repeat capsular contracture,” she said.

Martindale’s friend is one of many patients who has sought Dr. Bolitho for help. Breast revisionary surgery can truly transform a woman’s desired aesthetics.

7Mar, 2016

ASPS Unveils Data

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ASPS Unveils Data

The American Society of Plastic Surgeons (ASPS) is an authority when it comes to collecting information from its elite circle of plastic surgeons so it can generate statistical data. Every year both medical professionals and laypeople are quite interested in the results for their own personal reasons.

For plastic surgeons, they can gauge trends as well as the changes in their own practice. And for non-medical individuals, they have the opportunity to see what is deemed “popular and trendy” in the world of plastic surgery.

According to the press release issued by ASPS, procedures have switched gears in relation to cosmetic procedures since the start of the millennium. And these procedures fall into the categories of operative and other treatments described as minimally-invasive.

The survey revealed a robust total of 15.9 million procedures in both categories. From the data collected in 2015, there was a 2 percent procedure spike in the United States.

In the press release, ASPS president David H. Song, MD, MBA, FACS provided his viewpoint.

“While more traditional facial procedures and breast augmentations are still among the most popular, we’re seeing much more diversity in the areas of the body patients are choosing to address,” he said. Dr. Song added, “Patients have more options than ever, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look they desire.”

While the press release was indeed filled with statistics, on the other hand, it provided an educational outlet. Interestingly the organization pointed out how in the past “plastic surgery” used to be tantamount facelift procedures. Yes, while facial rejuvenation is still a sought after procedure among certain demographics, other aesthetic procedures have made their own significant mark included the following:

  • Brachioplasty (arm lift)
  • Mastopexy (breast lift)
  • Gluteal Augmentation (buttock lift)
  • Lower Body Lift

According to ASPS, they compared patient stats from 2000. The numbers of arm lifts increased 4,959 percent with 17,099 procedures performed in 2015. Breast lifts increased 89 percent with 99,614 procedures performed in 2015, buttock lifts increased 252 percent with 4,767 procedures performed in 2015, and lower body lifts increased 3,973 percent with 8,431 procedures performed in 2015.

In 2015, the top surgical procedures in the lead were breast augmentation, liposuction, rhinoplasty, eyelid surgery and tummy tucks.

In the minimally-invasive category, it’s not surprising to discover that Botox was at the top of the list with 6.7 million treatments performed in 2015. The other procedures that followed were fillers, chemical peels, laser hair removal, and microdermabrasion.

Dr. Song made another critical statement regarding minimally-invasive procedures.

“The number of available providers, lower costs and the less-invasive nature of these procedures obviously appeal to a much broader range of patients,” said Dr. Song. “However, we urge anyone who is considering a minimally-invasive procedure to consult with a board-certified, ASPS-member surgeon.”

While these procedures are not deemed surgical, they are still considered medical procedures and should be carried out in a medical setting.

Like all ASPS members, Dr. Song encouraged patients to seek only the most “qualified and highly trained” medical professionals for these procedures. And of course, this holds true for all plastic surgeries.

As many begin to digest the newest data from ASPS, it will be interesting to see what 2016 brings.

23Sep, 2015

Halting the golden years with cosmetic surgery and procedures

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Sunset

It’s only natural that individuals want to look as youthful as they possibly can. However, coupling this desire with the need to look young in corporate America, there are a slew of baby boomers whose desire turns more into a necessity.

The corporate America playing field is rife with ongoing competition from recent college graduates. Those who have clocked in the years at their career want keep a strong foothold in their position as these new candidates polish their resumes.

While not necessarily politically correct, professionals in their forties and above are experiencing the need to have a younger looking appearance. From cosmetic injections to minimally invasive lower limited facelifts, patients are welcoming a newfound sense of youth.

In the Philadelphia Inquirer, reporter Erin Arvedlund crafted an excellent article related to this topic describing the above scenario as the “top anti-retirement expense.” People are investing in themselves in the workplace.

And this is a valid statement.

She interviewed a county assistant prosecutor who was incredibly candid about how she wanted to look her best in the presence of jurors. Appearance means a great deal to people “looking the part” from head to toe. It is what some professions require.

More importantly, some professionals don’t want to retire because they enjoy their work and current lifestyle. Their work may give them a sense of purpose.

On the flipside, as the cost of living and college tuitions continue to climb, workers may need to punch the time clock a little longer.

Frown lines and other wrinkles may give a stern expression which can be treated with popular cosmetic injections such as Botox and Juvederm. If one feels these injections are not providing an optimal aesthetic outcome, then a lower limited facelift and/or fat grafting is another excellent option.

A consultation with a board certified plastic surgeon can help navigate patients toward the right procedure(s).

In her comprehensive article, Arvedlund also interviewed a representative from the American Society for Aesthetic Plastic Surgery. Leigh Hope Fountain told the reporter, “Baby boomers are having a lot of work done to stay competitive in the workplace.” She continued, “It’s very ageist, but it’s the unfortunate reality.”

Over time, there has been a significant shift in patients. While women still predominately receive facelifts, men are now walking into the surgical spotlight. According to a plastic surgeon Arvedlund spoke with, the patient ratio of 15 women undergoing a facelift is compared to one man. Not too long ago, that ratio used to be 20 women for every man.

Realizing that cosmetic surgery for baby boomers is a consistent trend, it’s important more than ever in choosing the right plastic surgeon that specializes in facial rejuvenation. Microsurgical skills and advancements have been quite impressive over the years as are the swift recovery timeframes.

With that said, finding a qualified board certified surgeon through an organization such as the American Society of Plastic Surgeons (ASPS) is a great starting point for an individual just beginning their due diligence.

20Aug, 2015

Breast Reduction Surgery Brought Into The Spotlight

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Fashion Girl Relaxed With Her Legs Raised Up

Recently, Hollywood celebrity Ariel Winter of television sitcom Modern Family decided to publicly announce her reduction mammoplasty also referred to as breast reduction surgery. Winter was one of many women who suffer with the daily discomfort due to excess weight on their chests.

While most women undergo this surgery at 18 years of age and over, Winter, 17, had the surgery during the early part of summer. The surgery transformed her from a bra cup which was a size 32F to 34D.

She recently told a People magazine reporter, “I was 15 years old with [size] F [breasts]. How do you navigate that?”

Having a celebrity such as Winter convey what she did is helpful to so many women who experience the same troubles she did. They are able to relate to what she has encountered as well as empower themselves knowing that there is a solution and not to discount the benefits of breast reduction surgery.

Numerous women are affected with discomfort due to their breast size. In fact, it is estimated that more than one million American women are encountering this.

Moreover, most women do not impulsively decide on this surgery. They perform their due diligence by researching it, finding the best board certified plastic surgeons, perusing before and after galleries on surgeons’ websites, and visit helpful online resources where potential patients can ask doctors questions such as RealSelf.com.

Despite being fitted for the right bra and undergarments, there still remains a direct link to pain and discomfort due to the heaviness. As mentioned earlier, women seek this breast reduction surgery because of the excess weight on their chest which can cause the following issues:

*Back pain

*Neck pain

*Headaches

*Shoulder pain

*Shortness of breath

*Numbness and tingling in the arms

Headaches may be derived from the tightness in the shoulders and neck.

It is also important to point out that the more excess weight on the chest a woman carries, the more her shoulders tend to lean and roll forward. This may cause anatomical changes to her frame. Her posture may be compromised to compensate for the cumbersome pounds she must carry.

A group of doctors, including Bethannie Snodgrass, MD who authored, “When Less Is More: The Complete Guide for Women Considering Breast Reduction Surgery,” clearly points this out in her comprehensive book.

Snodgrass wanted her readers to know that this position could potentially cause a compression located in the thoracic spine. A culmination of pressure in the shoulder blades, ribs, nerves may theoretically cause this.

Another area of discomfort which cannot be overlooked is the shoulders. By the end of the day, bra straps are embedded so deeply into the shoulders of women leaving red and painful indentations.

Like all cosmetic and reconstructive surgical procedures, the decision to learn more about a breast reduction should be made thoughtfully. And teaming up with the right board certified plastic surgeon can help answer questions and navigate a patient in their decision making process.