To My Patients and Prospective Patients:
From Alisa G. Rekow, M.D.
This procedure is performed for women who have breast tissue in a quantity greater than they consider desirable.
They may have physical symptoms related to the enlargement of the breasts (shoulder grooving, rashes beneath the breast, discomfort due to the weight of the breast tissue,
nerve compression symptoms and general discomfort associated with normal levels of activity).
This operation is not generally recommended until you have determined that you have completed your family; i.e. there are no future planned pregnancies,
or at the very least there is no near term future planned pregnancy.
Younger women who are able to comprehend the nature of the procedure and its ramifications are also considered suitable candidates.
As the incisions in this operation will divide portions of the gland; disrupting communications between segments of the gland and the ductal system leading to the nipple / areolar complex,
the capacity to breast feed is not assured post operatively. In some very rare instances it is necessary to remove the nipple / areolar complex and replace it as a free graft –
in this instance the tissue will not be truly sensate and will not function at all for purposes of breast feeding.
Furthermore as portions of the operation will potentially occur around or near to the nerves which provide sensation to the nipple and areolar tissue there may be temporary
or permanent loss or altered sensation to these structures.
It is also recommended that you be at or close to your desired weight (one which is sustainable) so that you can derive the maximum benefit from this procedure.
This operation is definitely one of those in which there is a distinct trade-off between benefit and scarring as in most cases the inverted “T” /
anchor incision is most often the one utilized.
Most women derive enough benefit from the procedure to make this a very acceptable trade-off.
A consultation will permit you to speak with Dr. Rekow; at which time you will be able discuss your symptoms and your goals.
Information relating to the procedure will be provided to you and a focused physical examination will be performed.
You will have an opportunity to ask any remaining questions following the recommendations which are made to you.
While we do not accept insurance, nor participate with any insurance program we will provide you with the information that you will need to submit a claim to your insurance carrier
(a form generally accepted by most carriers, codes for the operative procedure and diagnosis, a copy of the operative note, a copy of a pathology report and proof of payment.)
We require payment in full in advance so any payment (reimbursement) from the insurance company should be made directly to you. Levels of coverage vary greatly.
You will need to determine the degree to which your plan will cover this operation if it is performed by us through our in-office ambulatory surgical facility.
Your insurance carrier should provide you with a statement prior to operation indicating what if any benefits will be payable;
such remains at their discretion based upon your plan. All communications with any insurance carrier or company remain your responsibility.
When performed alone this procedure is deemed appropriate to be performed on an ambulatory basis (following your operation you will be discharged to home into the care of a responsible adult care giver on the date of your procedure).
If it is performed with another operation it is possible that hospitalization may be recommended.
You will be marked pre operatively and will be requested to approve certain aspects of the marking for symmetry and the prospective height of your nipples.
You will need to be seen the day following this operation and so the person caring for you (or another responsible adult) should be prepared to be with you for 24 hours post operatively and to return to the office with you the following day.
You will likely have soft drains in place overnight which will usually be removed in the office the following day.
A soft bra to assist in managing your dressings should be worn for your comfort (we provide you with two post operatively).
Prescriptions which are provided should be filled pre operatively and include medications to aid in dealing with post operative pain management, for nausea and vomiting (rarely needed), and an antibiotic.
You will have a six week period of limited activity following which there are no anticipated long term restrictions in either your activity or attire.
You will return to your normal schedule of self breast examination approximately two months post operatively and resume a regular schedule regarding screening mammography; obtaining a new “baseline” mammogram six months to one year post operatively if appropriate.
Routine post operative visits occur as indicated at one day, one week, six weeks, six months and one year post operatively.
If you are seeking a cosmetic surgeon in the Seattle area for breast reduction Seattle, breast lift Seattle, breast augmentation Seattle,
or other cosmetic procedure such as “tummy tuck” (abdominoplasty Seattle), facelift Seattle, browlift Seattle, eyelid surgery, labiaplasty Seattle or liposuction Seattle we would be delighted to see you in consultation.
Alisa Rekow, MD - 1221 Madison St., Suite 1102 - Seattle, Washington 98104 - 206.682.2200