Relieving Pain, Restoring Confidence: A Q&A With a Breast Reduction Specialist

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During the past two decades, board-certified plastic surgeon Forrest S. Wells, MD, has performed thousands of breast reduction surgeries, primarily at Ocean Springs Endoscopy and Surgery Center. Also known as reduction mammoplasty, this procedure removes excess breast tissue, fat and skin to reduce the size and weight of the breasts.

“Performing breast reductions has become one of my favorite surgeries,” Dr. Wells said. “I receive a lot of affirmation postoperatively, which makes me feel good about the service I am providing.”

Dr. Wells specializes in the latest plastic surgery techniques. A 1995 University of Alabama School of Medicine graduate, Dr. Wells continued five years of general surgery training in Birmingham, Alabama, and served as chief resident at Baptist Health Systems his last year. After completing his plastic surgery training at the University of Illinois in Chicago, he moved back to Ocean Springs on the Mississippi Gulf Coast in 2003 to begin his practice.

As the only plastic surgeon at the time in Jackson County, Dr. Wells built a strong cosmetic practice with a wide range of procedures. Today, his focus has shifted to growing his breast-reduction practice to help patients improve their quality of life.

Q: What are the top three reasons patients seek breast reduction surgery?

A: The top three are discomfort, discomfort and discomfort. But there are other reasons that should be mentioned.

The first one that I mentioned, discomfort, is a common complaint because the patient’s large breasts are pulling down and causing back and neck pain. Fungal infections in the fold under the breast are very common for people that have this problem.

There are other reasons, too, particularly with younger patients. It’s not just a physical aspect. There are also psychological and social components, as well. It’s not just discomfort.

As an example, consider high school students who can’t play sports and enjoy other activities because of their large breasts. It’s sort of awkward for young ladies in their teenage years. Their peers are not as mature as they could be about that, and they often get comments. Certainly, mothers tell me that their daughters wear jackets during the summertime because of their large breasts.

Q: Does insurance cover this procedure?

A: I think probably most doctors do know that there is a breast reduction surgery that is available that gives tremendous results, but a lot of them don’t know that insurance covers it. Certainly, many women that have large breasts and would benefit from breast reduction do not know that there’s an option out here, and a lot of them don’t know that insurance covers it in many circumstances.

If you call my office, we can help you determine whether your insurance covers the procedure.

Q: What are some benefits patients experience following this procedure?

A: In their teenage years, patients are quiet, but their mothers are very vocal, and they’re telling me “I got my girl back again. She’s playing soccer, and she’s able to participate in the band, and she’s not wearing a jacket during the summertime, and she’ll go to swimming pool parties with her friends. She can find a prom dress that fits.” All these things that so many people just take for granted. Young ladies, girls with very large breasts, have problems in this area.

Then, as patients get older, they’re not playing soccer in high school anymore, but they might enjoy playing tennis. They might enjoy playing golf. They might like to jog. All that becomes possible again.

Even if they’re not very active, simply not having fungal infections is a great relief. They all hate summertime, because that’s when they get yeast infections underneath their breasts, and they’re sweating. It’s just so uncomfortable.

And, no matter what time of year it is, the back and neck pain is always there. They say they can’t wait to get home and take off their bra and lay down, and that all just goes away after the procedure. Patients say in the first post-operative appointment that they already notice an improvement in their neck and back pain in the first few days.

Probably an important part of this operation to discuss that it’s not just relief of the weight, there’s a cosmetic component. Usually, women with very large breasts also have very ptotic (droopy) breasts. This weight over years causes ptosis (droopiness), the degree of ptosis contributes to the back and neck symptoms along with the weight. Therefore, a lift is performed as well as a reduction that is not just cosmetic but also a very important therapeutic benefit of the operation.

Q: Are there criteria to qualify for these procedures?

A: It depends.

So, if you’re going through insurance, there are criteria that have to be met. Insurance often covers this surgery. It’s a scale. So, it’s based on your height and your weight. A certain amount of weight has to be removed from each breast to qualify for this surgery.

The vast majority of women that come to see me for a breast reduction can easily meet their insurance requirement, and most often exceed them.

When I’m seeing patients with insurance, they’re very concerned about what size they will be. That’s not an issue post-operatively. I’ve never had a woman, after doing thousands of these, ever tell me, “I wish I was smaller. I wish I was bigger.” Afterwards, they’re just very happy with the results and the release of symptoms.

When the procedure is not covered by insurance, then there are no criteria. The decision is made by me and the patient: what they would like or expect, in general.

Q: What is your general approach when preparing for a breast reduction procedure at an ASC?

A: Typically, when I see a patient for the first time for a breast reduction, we have an initial meeting where they get a general outline of the procedure, the recovery, possible complications, what to expect, etc.

And, in fact, we made a video at my office using my staff that explains the process to get your insurance approval. We also discuss what to expect on your day of surgery, the first two days after surgery, the first two weeks after surgery and the next couple of months after surgery.

We typically have three appointments before we do a surgery. And, because I’ve done so many surgeries, it’s gotten to be sort of routine here.

I always do a breast reduction on a Tuesday. I see the patient the day before on a Monday to put the markings on that we’ll use during the operation. We always see them back on a Thursday — postoperative day two — to see if everything is routine, which it is the vast majority of the time. We see them two weeks later and then three months later.

Q. If someone is considering breast reduction surgery, what would you say are the top reasons to choose an ambulatory surgery center?

A: It is my opinion that if you can safely recover at home, it is more convenient to do so and safer to do so certainly. The ASC is a setting where it is geared for patients to go home and recover at home, and everything is more efficient when we are just meeting that requirement and can focus on that. For an ASC setting, it can be less expensive if you have a high deductible, or copays, and it’s certainly more convenient to have it done in an outpatient surgery center.

Q: What do you believe sets Ocean Springs apart from other facilities?

A: I know we have an excellent staff, and I’m really thrilled. I’ve been here for almost 23 years. We’ve had good staff throughout the years, but at this point, I am as pleased as I ever have been. I would probably say the staff is set above, and right now, it is particularly good, and there’s been a lot of consistency.

Q: Why do you choose to perform breast reduction surgeries?

A: There are probably two reasons why. The first is I have no other procedure where my patients are as happy with the results afterwards. It is life-changing for patients. Often, people have suffered with this problem for 20 to 30 years and have it done.

So, I like the variety in ages of the patients that I perform reductions on. I have performed reductions on patients as young as age 13 and as old as 70. I certainly like the patient satisfaction afterwards. It is good to hear some say, “You have changed my life. Thank you very much.” That is very reaffirming for me as a doctor.

Probably the other reason is the staff here. It’s just like anything else. You do a lot of these procedures; you get very good at it. And we’ve done thousands of breast reductions here at the surgery center. So, not just me, but also the nursing staff is very familiar with this operation, and we do it very efficiently and have very good results.

Actors “Lead From Behind” With Colonoscopy Screenings

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A simple bet between friends — and colonoscopy screenings — may have saved the lives of actors Ryan Reynolds and Rob McElhenney.

The co-owners of the Wrexham Association Football Club in Wales made a friendly wager, which Reynolds ultimately lost. McElhenney bet that if he learned to speak Welsh, Reynolds would publicly broadcast his first colonoscopy to raise awareness regarding colon cancer.

The actors’ screening video launched the Lead From Behind campaign in partnership with the Colorectal Cancer Alliance (CCA). The campaign’s focus is to “help people learn that colon cancer is ‘The Preventable Cancer’” through timely screenings.

Research shows more young people are getting colon cancer. Now, leading healthcare agencies recommend screenings begin at 45 for those at average risk.

Both Reynolds (Deadpool) and McElhenney (It’s Always Sunny in Philadelphia) are 45.

“Part of being this age is getting a colonoscopy,” Reynolds said in the video. “It’s a simple step that could literally — I mean literally — save your life.”

Colonoscopy Saves Lives

Colorectal cancer is the second-deadliest cancer in the US. But it doesn’t have to be. This type of cancer is preventable through timely screenings.

Colonoscopy is the only screening method that can both detect and prevent colorectal cancer. The disease often begins as a growth, called a polyp, inside the colon or rectum. Through a colonoscopy, polyps can be both detected and removed before they become cancerous.

Reynolds underwent his colonoscopy first. Following the procedure, Dr. Jonathan LaPook, his gastroenterologist, praised Reynolds’ thorough bowel prep. This preparation helped LaPook find and remove an “extremely subtle polyp” on the right side of Reynolds’ colon.

“This was potentially lifesaving for you,” LaPook said. “This is exactly why you do this.”

Later, Dr. Leo Treyzon, also a gastroenterologist, told McElhenney he found three polyps during his colonoscopy.

“They were small,” Dr. Treyzon said. “They were not a big deal, but [it was] certainly a good idea that we found them and removed them.”

The doctors recommended the actors repeat the colonoscopy in a couple of years.

Young People Are at Risk

The CCA reports one in 24 people gets colon cancer. Colorectal cancer is not just a disease of the elderly. One in 260 people will get colon cancer before they turn 50. This is called early-onset or young-onset cancer.

Research indicates that people who are diagnosed when younger than 50 are more likely to have advanced disease at diagnosis.

For these reasons, screenings should begin at 45 for those at average risk of developing colorectal cancer. Individuals should be screened even if they don’t have symptoms. People with digestive symptoms should be considered for colonoscopy regardless of age.

Don’t Delay Your Screening

By 2030, colon cancer is predicted to be the top cancer killer for people younger than 50, according to the CCA.

If you are 45 or older, don’t delay your colorectal cancer screening. The five-year survival rate is about 90 percent when found at an early stage before it has spread to other organs.

The Affordable Care Act requires most private insurance to cover the costs of colorectal cancer screening tests. Plans vary, so it’s important to contact your healthcare provider to verify your coverage.

If you do not have insurance, there are resources to learn about a low-cost or free colonoscopy. Some resources include the CCA Helpline, ColonoscopyAssist™ or your state’s health and human services or department of health.

A colon cancer screening may save your life or the life of a loved one. Our doctors perform colonoscopy screenings at surgery centers around the country. Search for a gastroenterologist in your area and schedule a colonoscopy.