Case #1552 · Pasadena, California
Breast Reduction


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This 49-year-old patient from Pasadena, California had severe upper back and shoulder pain. Dr. Cassileth performed a bilateral breast reduction to improve breast asymmetry. She loves her results and feels more confident when wearing strappy tops.
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
Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.
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.
- Aspirin, ibuprofen, vitamin E, and fish oil discontinued 14 days pre-op to reduce bruising risk. Acetaminophen is allowed.
- 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.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week is the strictest activity window. Bilateral cases benefit most from staying ahead of swelling with consistent icing and rest.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.





