Case #1581 · Bakersfield, California
Breast Reduction
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This patient complained of large, heavy breasts and had been a size 36E since high school. Dr. Cassileth performed a bilateral breast reduction with fat grafting of her upper pole to provide fullness.
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
- Indiba radiofrequency starting week 2
- Aftercare
Extended hyperbaric oxygen course (10–15 sessions) to support bilateral healing.
Bilateral procedures heal more reliably with sustained HBOT.
- Skincare
Aggressive sun protection on incision lines through the first 12 months.
Younger skin pigments scars more reliably under sun exposure.
Why this approach
The decisions that shaped this surgical plan.
- Bilateral approach chosen to keep the planning, the tissue response, and the aesthetic outcome consistent between sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- Nicotine in any form, cigarettes, vapes, patches, gum, paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- 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
First week is the strictest activity window. Bilateral cases benefit most from staying ahead of swelling with consistent icing and rest.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
