Case #1519 · Los Angeles, California
Breast Reduction
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This 53-year-old patient from Los Angeles, California complained of her heavy breasts and asymmetry. Dr. Cassileth performed a bilateral breast reduction making them smaller, lighter, and firmer.
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Reduction.
- Surgical bra continuously for 6 weeks
- Sleep elevated on your back; no side or stomach sleeping for 4 weeks
- Drains typically removed at days 5–7
- Scar management protocol at 3 weeks
- Hyperbaric oxygen therapy in early recovery when recommended, to support wound healing and reduce swelling and bruising
- Medical-grade silicone sheeting on the anchor or lollipop incisions
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- Hydrating body protocol while skin retracts
- Laser or microneedling for scar refinement after 3 months
- LED light therapy weekly for the first 8 weeks
- Lymphatic drainage starting week 2
- Aftercare
Extended hyperbaric oxygen course (10–15 sessions) to support bilateral healing.
Bilateral procedures heal more reliably with sustained HBOT.
Why this approach
The decisions that shaped this surgical plan.
- Both sides treated in the same session, symmetric planning, identical tissue handling, and matched final contour are easier to achieve in one operative window than in two.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Arrange button-front or zip-front tops for the first three weeks, overhead reaching is restricted. A drain holder or apron is provided.
- Confirm a driver for surgery day and a companion who can stay through the first night.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Bilateral healing takes a slower start. Expect more chest-wall fatigue through day 5 and a stricter no-lifting rule for the first 10 days.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Light cardio and most desk-work activities cleared. Lifting limit increases to 15 lb. Scar massage typically starts now.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
