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The following program contains content which is sexual in nature. It is not intended that any viewer rely on the content of the program for medical advice. If you believe you require medical or psychological advice or treatment, please consult your doctor.

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Berman & Berman
For Women Only

01:23:56 Dr. Jennifer Berman OC/VO
Welcome back. Dr. Lesavoy has been telling us about the different options for enhancement, but what if your problem is just the opposite? Can there be too much of a good thing?

01:24:05 Dr. Malcolm Lesavoy OC
Well, there can be, actually, either if the implants are too large for augmentation. Or if a woman is born with very large breasts, they can have quite a bit of, some problems.

01:24:16 Dr. Jennifer Berman VO/OC
And what are the problems that women with large breasts can experience?

01:24:19 Dr. Malcolm Lesavoy OC/VO
Specifically they can have and usually do have, either pain in their breast per say.

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Dr. Malcolm Lesavoy
Plastic Surgeon

They have rashes underneath or between their breasts. They have back pain and neck pain. They have grooving in their shoulders from the shoulder strap.

01:24:31 Dr. Jennifer Berman OC
From the bra, yeah.

01:24:33 Dr. Malcolm Lesavoy OC/VO
And they have very poor posture because they're embarrassed by the size, so they're always kind of trying to hide, or they can't participate in every day sports because of the bras, because of their breast size.

01:24:44 Dr. Jennifer Berman VO/OC
And, speaking from personal experience, I've had reduction, implant, lift, after the baby, but the biggest problem is clothes. You can't wear bikinis. They don't make bras that size, backless things. In high school, as a cheerleader, the little outfits that the girls wear, you know, these little halter things, it's like forget it, you look like one big watermelon.

01:25:07 Dr. Malcolm Lesavoy OC
Especially for younger women, it's emotionally a very difficult thing.

01:25:11 Dr. Jennifer Berman VO
Yeah, it's embarrassing.

01:25:12 Dr. Malcolm Lesavoy OC/VO
And I can tell you that I see patients, and all plastic surgeons see patients from their late teens or early 20's, all their way to their 70's and 80's for reduction mammoplasty. They have their breast sizes reduced. And I can tell you that of all the patients that we have, these patients are the happiest.

01:25:29 Dr. Jennifer Berman VO
Afterwards, yeah.

01:25:31 Dr. Malcolm Lesavoy VO
Afterwards.

01:25:31 Dr. Jennifer Berman VO/OC
We have some pictures, some before and after pictures. Let's take a look at what is involved in the surgery. So, what do we have here?

01:25:39 Dr. Malcolm Lesavoy OC/VO
Well, in general, the, anatomically the nipple and areola level should be about halfway between the shoulder and the elbow crease. One can see here the bra strap grooving. These aren't particularly very large breasts but we want to have the nipple level…

01:25:57 Dr. Jennifer Berman VO
Nipple higher.

01:25:58 Dr. Malcolm Lesavoy VO
…at about this level and reduce the mass, the size of the breast.

01:26:02 Dr. Jennifer Berman VO/OC
So, is she like a double D or even an E?.

01:26:05 Dr. Malcolm Lesavoy VO/OC
I think she was a double D, yes. And she's also a little asymmetric, where you can see her left breast is larger than her right by maybe 100 CCs or so. Next slide.

01:26:15 Dr. Jennifer Berman VO
The after.

01:27:08 Dr. Jennifer Berman VO
<Inaudible>.

01:27:08 Dr. Malcolm Lesavoy OC/VO
…blood supply…

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Vascular pedicle:
Blood supply to the nipple

…and hopefully its own sensation, so that the sensibility of the nipple areola is not decreased.

01:27:15 Dr. Malcolm Lesavoy OC
And women can complain of hyper-sensation or decrease sensation after surgery.

01:27:18 Dr. Malcolm Lesavoy VO
Sometimes, sometimes. But mostly decreased sensation.

01:27:21 Dr. Jennifer Berman VO
Decreased?

01:27:22 Dr. Malcolm Lesavoy VO/OC
Usually with reduction mammoplasty, the operation itself, there is a significant amount of scaring on the outside, and it really reduces the chances of breastfeeding.

01:27:31 Dr. Jennifer Berman VO/OC
We have Carol in our audience, who just went under, underwent reduction mammoplasty. And how do you feel now, Carol?

01:27:39 Carol OC
I haven't stopped smiling. It's been a really positive experience for me.

01:27:44 Dr. Jennifer Berman VO
What made you decide to do it?

01:27:47 Carol OC/VO
I had visited my gynecologist and just telling her about medically about what Dr. Lesavoy was saying, backache and neck ache, and I did have the posture, you know, problem, not standing up straight, but headaches too. I just felt like I had to do it.

01:28:06 Dr. Jennifer Berman OC
So, Carol thank you…

01:28:07 Carol VO
Thank you.

01:28:08 Dr. Jennifer Berman OC/VO
…for being with us. And Dr. Lesavoy, what do we do if you want your breasts lifted up?

01:28:14 Dr. Malcolm Lesavoy OC/VO
Well, it's the same process, pretty much. The scars are not quite as extreme, but there definitely always is a scar around the areola and a scar usually from the areola down to the crease underneath from the breast.

01:28:26 Dr. Jennifer Berman VO/OC
Well, thank you, Dr. Lesavoy. Our top is Breasts and Sexuality. Up next, a breast cancer survivor's inspiring story. Plus, the latest reconstructive techniques, so don't go away.

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Next Surviving breast cancer

01:28:37 Jenny Nash VO/OC
I'm really happy with my reconstruction. I'm thrilled with it, in fact. You can't tell, can you?

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