Meet Dr. Klapper
Dr. Klapper in the News
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Exciting New Techniques for Breast Reduction and Lift Surgery
Sheri Waldrop, RN, BSN
If you live in New York City, then you're probably well aware that New York University Medical Center (Bellevue is one of its satellites) is one of the premier hospitals for plastic surgery in the country-and for local residents. Andrew Klapper is the Chief Resident of Plastic Surgery at NYU, and is nationally known for the seminars that he teaches, as well as for his inventive approach to breast surgery. Dr. Klapper has created two specialized breast operations that could make traditional techniques outmoded in a few years.
Dr. Klapper is well-respected and sought out for a reason: he learned from one of the foremost breast surgeons in the world today, Dr. Elizabeth Hall Findlay from Canada. "We invited her down, and we worked together," he states. "I learned so much from her, and now we share ideas.” In addition, the huge amount of experience that he has gained working with the world class faculty at NYU has been invaluable. This institution houses the busiest plastic surgery residency program in the nation and has helped him hone his techniques, which he used in creating his own unique procedures. He has worked with such faculty as Dr. Christina Ahn, with whom he collaborated in developing these innovative breast surgery techniques.
"I've always been a creative person," states this doctor who has also created two surgical instruments, including specialized scissors used during breast surgery. "This is one reason I help a patient achieve the look they want."
Traditional Versus New Approaches To Breast Surgery
Dr. Klapper does a large amount of aesthetic breast surgeries including breast reductions for women who have suffered from back, shoulder, and neck pain for years because of large, heavy breasts. He states, “I try to keep the aesthetics and the reconstructive outcome on an equal footing when doing this type of surgery.” While most patients are extremely happy because of the immediate pain relief and improved posture after reduction surgery, he was concerned about the large scars and less than pleasing look seen after many traditional reduction surgeries.
“Those days are over, because now there are operations for breast reduction that leave the breasts looking even better than before,” Klapper states. He believes that minimizing the scar, and enhancing the breasts, should be an integral part of any breast reduction surgery. “My procedure enhances upper cleavage, and overcomes the ptosis, or sagging, that can occur over time because of gravity,” he says.
He has created two different and unique approaches to breast surgery to help women look better after either a breast reduction, or a breast lift. “Women often want the lift after they’ve nursed a child,” he states. “Once a woman is done nursing, the breasts reduce in size, and sagging can occur. My operation fixes this and leaves the breasts looking better than ever.”
Dr. Klapper discusses how his surgeries differ from traditional reductions and lifts. “A basic tenet of plastic surgery is slight over correction,” he states. “But we don’t do that with breasts. Instead, traditionally, the surgeon creates the breasts just as he wants them to look, while the patient is on the operating table.” He continues, “I wondered if slight over correction could give better results, and I’m happy to say, ‘Yes, it does.’”
The reason slight overcorrection gives better results is gravity. “While a woman may come off the table looking great with a traditional lift,” he states, “in a few months, gravity will cause sagging. On the other hand, my procedure looks a tiny bit ‘high’ initially, but as the breasts settle, they look fantastic-and women love the results.’
How the Surgeries Are Done
Breast Reduction Surgery-With a Lift
Basically, Dr. Klapper does two different breast surgeries, dependent on a woman’s needs when she consults with him. “If she needs a breast reduction, I have developed a surgery that I call the ‘double stack’,” he states. “The traditional medial pedicle reduction mammaplasty has a scar around the nipple, and a vertical scar down the breast. The blood supply to the nipple, which is vital, is given through a medial pedicle of breast tissue. I’ve taken this traditional approach, and changed it into a bilobed medial pedicle (or flap). I add a secondary pedicle underneath. This adds extra projection and lift to the breast.”
Dr. Klapper states that unlike implants, the body recognizes this extra flap as part of itself, and doesn’t react to it. Most importantly, women who for years may have felt self-conscious about large, drooping breasts are given a new look-and increased self-confidence- with this procedure. “Not only does the reduction take away painful weight, but the breasts look better than before with my procedure,” he states. “This give a woman an improved body image, which can be a big issue for someone undergoing reduction surgery.”
Breast Lifts With an Innovative Surgical Technique
The second breast surgical procedure that Dr. Klapper developed with Dr. Christina Ahn is one that he calls the ‘PUMP’, short for ‘Pedicle Upper Medial Pole Projecting’ Mastopexy. “Most plastic surgical techniques have acronyms,” he states, “so I had to come up with one for this one.” But the name isn’t what makes this surgical technique unique. Instead, it’s the method that Klapper innovated for increasing lift and overcoming the effects of gravity on a woman’s breast.
“Basically, I take the whole breast tissue from beneath, and rotate it up during the surgery,” Dr. Klapper states. “I raise skin flaps around the breast mound, and lift the breast mound from lateral to medial, so that lower tissue ends up in the upper breast area, giving more upper breast fullness. This is unique; no one else does this at this time,” he says.
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| Medial Pedicle | Rotation of underlying tissue to top |
Smaller vertical scar after surgery |
He continues, “People have likened this to a ‘natural pushup’, and after undergoing it, a woman’s breasts look like they did when she was a teenager. This procedure is especially good for the woman who has had children, and wants self-confidence in how she looks again.”
Dr. Klapper believes that body image and self-confidence are important to women, and that this surgery gives it back to them. “I honestly support helping women feel better about how they look,” he states.
Common Questions and Answers About Breast Surgery
Naturally, women may have questions about these procedures, including what to expect when having surgery, and how long it takes to heal. Dr. Klapper was happy to answer these questions below.
- Does insurance cover breast surgery?
- Are there complications to this type of surgery?
- Can I breast feed after breast surgery?
- What happens during the initial visit with you?
- Are there a lot of tests before having surgery?
- How long does breast surgery take?
- How long does recovery take? And will there be a large scar?
Does insurance cover breast surgery?
“Insurance will cover breast reduction surgery if it’s deemed medically necessary to prevent other problems. In general, this means a reduction of about 500 GM, or about one and a quarter pounds per breast. Less than this, and the weight isn’t considered enough to cause significant pain or disability.”
Are there complications to this type of surgery
“There are no complications with the surgical techniques that I’ve created other than those normally expected with any breast surgery. One of the concerns with both traditional and with my surgery is the chance of nipple necrosis (loss of the nipple from lack of blood to it). While the chance of this is small, I do my very best to ensure a good blood supply.”
He continues, “In some cases, there is a small chance of loss of sensation to the nipple with breast surgeries of this type (including the traditional approach). I counsel my patients that if this would be unbearable for them, then they need to rethink having breast surgery. I believe in being very honest about any possible complications, so that a woman is well-informed before having the procedure. “
Can I breast feed after breast surgery?
“With any type of plastic surgery to the breast, both with mine and the traditional approach, there’s about a 30% chance that a woman won’t be able to breast feed after surgery. For this reason, and the emotional investment that breastfeeding can be, I counsel women to wait if they really want to breast feed. I also counsel women that if they are able to breast feed, that the milk supply may be reduced, and they may need to supplement with formula. I tend to be conservative in my approach because I want a woman to know exactly what to expect before having surgery.”
What happens during the initial visit with you?
“During the initial consultation, I sit down and answer any questions that a client has, and discuss the surgery she wants. At this time, I would take the pre-operative photos and measurements, and we would discuss exactly what you want, including the cup size you want to be. Because a woman’s perceptions of size may be different from what her doctor visualizes, I encourage women to bring me photos of the breast size that they would like, and feel comfortable with.
For instance, if a woman needs a breast reduction, I would discuss with her realistic options. Sometimes, she wants pounds off, but realistically, these larger reductions require additional specialized techniques to ensure nipple viability. I discuss all available options and risks with her, to help her know what choices are available to her.”
Are there a lot of tests before having surgery?
Always do thorough pre-operative testing for clients having surgery, whether a reduction or a Breast lift. For instance, if a woman is over age 35, it’s recommended that she have a mammogram before breast surgery, and I’ll order one. You don’t want to do breast surgery on someone with breast cancer or a suspicious lesion, and this helps rule it out. I also do a thorough breast exam on clients, to rule out any breast disorders before surgery. Routine lab tests and EKG’s are done as well.
How long does breast surgery take?
When a woman comes in for breast surgery, she comes in early on the morning of the surgery. The surgery itself takes about two to two-and-one half hours, unless she combines it with another procedure, such as abdominoplasty, commonly known as a ‘tummy tuck’, or liposuction. I can do both at the same time (this is common). It takes about another two hours to do one of the other procedures, for a total of about four hours.
Since the surgery is done with general anesthesia, the client is recovered for about one-and-a half hours, then goes on to the day surgery unit. Most women are able to go home that day, after several more hours. It’s individual; some women take a bit longer to recover, but it’s very rare that they stay overnight.
How long does recovery take? And will there be a large scar?
Normally, a woman goes home that afternoon with a good, supportive sports bra. I don’t put drains in, they aren’t necessary with the procedure I do, so there’s no need for drain care. A woman will usually feel somewhat tender and sore for about a week, so I suggest taking off work for about a week. Most women take some oral painkillers the first days.
A woman can walk the next day, and if she’s had a breast reduction, she’ll notice almost immediate relief of her back pain. But I advise women to take it easy, and not to visit the gym or do heavy lifting for at least the first month after surgery. Also, I advise my clients to avoid manipulation of the breast while making love for the first month, to allow healing to occur.
While classically with traditional breast reductions and lifts there is a large scar that runs to the side and underneath the breast, my approach creates a much smaller, vertical scar. Normally, the breast will look slightly “overcorrected” for the first weeks, then with gravity, by a few weeks after surgery, they look wonderful. Women are very pleased with the results.
Dr. Andrew Klapper is a creative plastic surgeon with two exciting innovative breast surgery techniques. Most importantly, he takes into consideration both the reason for the surgery (pain relief with reductions, correction of drooping with lifts) and combines this with sensitivity and an approach that minimizes scarring and leaves clients looking better than before (which was not always the case with traditional breast reductions).
His goal in creating these new surgical techniques is clear: “I wanted women to feel better about themselves,” he says. “And I believe these surgeries help do this.” Many women who have tried his new procedures agree, and the consensus is clear: we’ll be hearing quite a bit more about this talented young surgeon in the next few years who is already changing the face of breast surgery today.