Plastic Surgery Consults with the McRae Twins

The McRae Twins

Two board-certified plastic surgeons. One family. Unfiltered conversations about the art, science, and ethics of plastic surgery. Hosted by Dr. Mark McRae and Dr. Matthew McRae, University of Toronto professors and founders of McRae Plastic Surgery in Toronto. Each episode of Plastic Surgery Consults cuts through the noise on trending procedures, patient safety, and what really happens from consultation to recovery. Whether you're a med student, a medical professional, or simply curious about going under the knife, this is the conversation you've been waiting for.

Episodes

  1. Sep 30

    Turning Back the Clock: The Benefits of Upper Blepharoplasty

    In this episode of Plastic Surgery Consults, Dr. Mark McRae and Dr. Matthew McRae discuss upper eyelid lift surgery, or upper blepharoplasty, and why it can create a subtle but meaningful change in appearance. They explain how aging affects the facial skeleton, soft tissues, skin elasticity, brow position, and eyelid fat, as well as why natural facial asymmetry matters when planning surgery. The discussion covers brow position, Botox, eyelid creases, ptosis, dry eyes, fat preservation, anesthesia options, scarring, and recovery. They also explain why modern eyelid surgery focuses on preserving important tissues while removing excess skin and maintaining a natural appearance. Key Points From This Episode: [00:00:00] Introduction to upper eyelid lift surgery and its potential benefits [00:00:54] How upper blepharoplasty can create a more rested appearance [00:01:46] Why eyelid surgery can produce a noticeable yet subtle result [00:03:36] How aging changes the upper eyelid region over time [00:04:11] Changes in the facial skeleton and their effect on facial aging [00:05:49] Soft tissue descent, facial fat, and the role of fillers [00:07:33] Why natural facial asymmetry matters when evaluating the eyes [00:10:36] Changes in eyelid fat, skin elasticity, and excess upper eyelid skin [00:12:19] How brow descent contributes to excess upper eyelid skin [00:13:57] Evaluating the brow and eyelid together before surgery [00:15:45] How Botox can affect patients who use their forehead muscles to elevate the brows [00:18:11] Tarsal plate show and how eyelid anatomy affects appearance [00:20:26] Why upper eyelid scars tend to heal discreetly [00:22:46] Eyelid crease position and considerations across different eyelid anatomy [00:23:36] Distinguishing upper eyelid skin excess from ptosis [00:26:08] Dry eyes and other factors to assess before blepharoplasty [00:27:49] Preserving upper eyelid fat and evaluating the lacrimal gland [00:29:32] What to expect during recovery after upper blepharoplasty [00:30:30] Activity restrictions during the first days after surgery [00:32:01] Local anesthesia, sedation, and general anesthesia options [00:32:35] Sutures, postoperative ointments, and early wound care [00:34:13] Why preserving upper eyelid fat is important for long-term results [00:34:44] The goal of eyelid surgery: looking like yourself while turning back the clock Links: Dr. Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Dr. Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)

  2. Sep 23

    Reshaping Expectations: What Breast Surgery Can and Cannot Change

    In this episode of Plastic Surgery Consults, Dr. Matthew McRae and Dr. Mark McRae examine how breast lifts and breast reductions can change breast shape. They explain why natural asymmetry is normal and how the chest wall, shoulders, spine, breast size, inframammary fold, nipples, and areolas influence surgical planning. The discussion covers realistic expectations for repositioning breast tissue, narrowing wider breasts, and improving nipple and areola placement. Mark and Matthew also address internal bras, auto-augmentation, implants, and fat transfer, including where each option may help and where limitations remain. They emphasize the importance of a detailed consultation, accurate diagnosis, and a treatment plan based on the patient’s anatomy and goals.  Key Points From This Episode: [00:00:00] Introducing breast shape and what surgery may be able to change [00:00:19] Setting realistic expectations for breast shape procedures [00:00:43] Breast lifts, reductions, implants, and internal support options [00:01:46] Why natural breast asymmetry is normal [00:03:05] How the shoulders, spine, ribs, and chest muscles affect breast symmetry [00:04:27] Differences in breast size and the importance of the inframammary fold [00:06:26] The limits of changing a naturally high or low breast footprint [00:08:10] Measuring nipple position and identifying breast droop [00:09:23] Determining the most projected point of the breast [00:10:12] Setting an appropriate nipple position during surgery [00:11:20] Reducing and improving areola size and symmetry [00:12:24] Establishing the correct diagnosis and surgical expectations [00:13:35] Narrowing wider breasts and using liposuction around the sides of the chest [00:14:23] Why wider breasts may require an incision along the breast crease [00:16:43] How an internal bra works and why it remains an investigative option [00:18:12] Patients who may benefit from additional internal tissue support [00:19:22] Using internal support during breast implant revision procedures [00:20:34] Why a breast lift alone may not create upper-pole fullness [00:21:51] Using auto-augmentation to reposition a patient’s own breast tissue [00:23:45] How implants can add structure and make the breast appear higher [00:25:00] The difference between changing breast shape and reducing breast weight [00:26:31] Identifying asymmetries before surgery and discussing them with patients [00:27:44] Using fat transfer for subtle changes in breast volume and contour [00:29:02] Why fat transfer is often more effective when combined with another procedure [00:29:56] Matching surgical options with the patient’s anatomy and goals Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)

  3. Sep 16

    Skin Smarts: Dr. Abby on Skincare, Scars, and Healthy Aging

    In this episode of Plastic Surgery Consults, Dr. Mark McRae and Dr. Matthew McRae speak with dermatologist and Mohs surgeon Dr. Abigail Waldman about practical skincare, scar care, and the role of dermatology before and after facial procedures. Dr. Abby explains the core elements of a daily routine, how to introduce retinoids, and why gentle cleansing and sun protection matter. She also discusses the limits of topical skin tightening, the use of microneedling and lasers, risks of over-treating the skin, strategies for hyperpigmentation, and the evidence behind silicone gel sheeting for scars. The conversation closes with straightforward advice for patients preparing for facial surgery: stick with a routine that works and avoid introducing unnecessary new products. Key Points From This Episode: [00:00:00] Introduction. [00:01:39] Dr. Abby’s career in dermatology, Mohs surgery, and medical education through social media [00:06:36] The essential morning and nighttime skincare routine [00:10:41] Choosing a gentle cleanser and avoiding overly aggressive products [00:12:44] When to consider prescription versus over-the-counter retinoids [00:14:21] Why skincare and retinoid use require long-term consistency [00:16:08] The limits of creams and topical products for meaningful skin tightening [00:18:25] How microneedling and lasers can support collagen production and skin quality [00:18:58] Using barrier creams to protect skin while using retinoids [00:21:05] Controlled skin injury, fractionated lasers, and the risks of over-treatment [00:25:17] Preventing and treating hyperpigmentation after sun exposure or surgery [00:29:40] Options for managing post-surgical hyperpigmentation [00:31:04] When to consider laser treatment for scars and how treatments can be spaced [00:33:49] The evidence behind silicone gel sheeting, massage, and scar remodeling [00:37:18] Preparing the skin before a facelift and why Dr. Abby recommends avoiding unnecessary changes [00:38:50] Using basic skincare fundamentals as part of the facial surgery consultation process Links: Dr. Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Dr. Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Dr. Abigail Waldman on LinkedIn: https://www.linkedin.com/in/abigail-baird-waldman-21205b57/  Dr. Abby on YouTube: https://www.youtube.com/@doctor-abby  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)

  4. Sep 9

    The Benefits of Breast Reduction: What the Research Shows

    In this episode of Plastic Surgery Consults with the McRae Twins, Matthew and Mark McRae shift away from the risks and complications they've covered on past episodes to focus on the upside: who actually benefits from breast reduction, and how much. They close with a candid discussion of who may benefit less from the surgery. Key Points From This Episode: [00:00:35] Who benefits from the surgery. [00:01:24] The ASPS' 2022 evidence-based guideline on pain relief, physical function, and psychological well-being in treating symptomatic macromastia. [00:01:24] Macromastia's associations with neurologic conditions. [00:03:28] Kyphosis, and how a 2023 study out of McGill used BREAST-Q patient-reported outcomes and radiographic imaging. [00:05:13] A 2021 meta-analysis of randomized controlled trials on physical function and activity, and how macromastia's mechanical impediment to exercise raises obesity risk.[00:07:08] How breast size changes at different life stages. [00:07:50] Randomized controlled trials showing reduced depression and anxiety and increased self-esteem after surgery. [00:11:55] Lived clinical experience with older patients. [00:12:34] ASPS guidance to counsel patients over 50 on modestly higher risk without excluding them by age, and how complication rates for patients over 60 are driven by comorbidities. [00:13:55] ASPS 2022 findings about symptom relief. [00:16:21] Putting that number in context alongside the more modest QALY gains often sought from cancer treatments. [00:16:50] Reflecting on patient satisfaction rate. [00:17:58] Who may benefit less from the surgery: patients with a high risk of wound healing problems, a BMI above 40, smokers, and those with prior radiation therapy or a history of breast cancer. [00:19:33] A question on pulmonary issues and breast reduction. [00:19:39] How the weight of large breasts can restrict breathing while lying down, and reports of improved sleep after surgery. [00:19:58] A 2003 paper on the effects of reduction mammaplasty on pulmonary function and macromastia symptoms. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/ Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/ McRae Plastic Surgery: https://mcraeplasticsurgery.com/ Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com) Sources: 1. American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty.Plastic and Reconstructive Surgery. 2022. Perdikis G, Dillingham C, Boukovalas S, et al. 2. "The Impact of Reduction Mammaplasty on Back Pain and Posture in Patients With Macromastia: A Systematic Review and Meta-Analysis".Plastic and Reconstructive Surgery. 2025. Böhmer EM, Betsch M, Stumpfe M, et al. 3. Enlarged Breast Size (Macromastia) and Associated Neurologic Risks: A Scoping Review.Neurology. 2024. Pocock KS, Laikhter E, Hardy BW, et al. 4. Effects of Reduction Mammaplasty Operations on the Spinal Column: Clinical and Radiological Response.Aesthetic Plastic Surgery. 2015. Berberoğlu Ö, Temel M, Türkmen A. 5. Breast Hypertrophy: A Real Pain in the Back.Plastic and Reconstructive Surgery. 2023. Lessard L, Papanastasiou C, Fortin M, Ouellet JA. 6. Postoperative Health-Related Quality of Life in Reduction Mammaplasty: A Systematic Review and Meta-Analysis.Annals of Plastic Surgery. 2021. Lin Y, Yang Y, Zhang X, et al. 7. Patient-Reported Outcomes After Reduction Mammoplasty Using BREAST-Q: A Systematic Review and Meta-Analysis.Aesthetic Surgery Journal. 2023. Wang AT, Panayi AC, Fischer S, et al. 8. A Matched Comparison of the Benefits of Breast Reduction on Health-Related Quality of Life.Plastic and Reconstructive Surgery. 2021. Elfanagely O, Othman S, Rios-Diaz AJ, et al. 9. The Effect of Reduction Mammaplasty on Quality of Life in Adolescents With Macromastia.Pediatrics. 2017. Nuzzi LC, Firriolo JM, Pike CM, et al.

  5. Sep 2

    What to Know Before a Breast Re-Reduction

    In this episode of Plastic Surgery Consults with the McRae Twins, Matthew and Mark McRae discuss breast re-reduction, the secondary surgery performed on patients who have already had a breast reduction but return years later for further relief. They explore why breasts can grow back after menopause, weight change, or simply the effects of gravity, and they break down the research behind post-menopausal breast enlargement. The brothers walk through why secondary reductions carry a higher complication profile than primary surgery, including fat necrosis, wound healing issues, and seroma, and explain how blood supply and pedicle selection affect outcomes. They also cover Dr. Elizabeth Hall-Findlay's four key principles for safe re-reduction surgery, how surgical technique has shifted over the past two decades, and the patient factors — including BMI, smoking, and diabetes — that can compound risk. The episode closes with a candid look at how much tissue can realistically be removed the second time around, and why many surgeons approach secondary reductions with extra caution. Key Points From This Episode: [00:00:36] Why patients return for a second reduction. [00:01:42] A common patient question — do breasts grow back after reduction? — and what the post-menopausal research actually shows. [00:05:05] Why patients seek revision surgery. [00:06:17] How the surgical approach shifts for a secondary reduction, with a greater reliance on liposuction. [00:06:46] Why re-reduction is a fundamentally different operation from a primary reduction. [00:08:15] How pedicle and blood supply from the first surgery shape the safety of a second procedure. [00:09:16] Elevated risks of wound healing problems, delayed nipple sensation, and nipple-areola complications. [00:10:36] What a seroma is and why it shows up more often after a secondary reduction. [00:11:01] Why a disrupted blood supply from the first surgery elevates risk across the board. [00:11:45] Weight gain and BMI as the strongest predictors of post-menopausal breast enlargement. [00:12:43] Introducing Dr. Elizabeth Hall-Findlay's four key principles for safe breast re-reduction. [00:17:34] The contributions of Canadian surgeons to safe vertical-pattern secondary reduction technique. [00:18:02] How much tissue can realistically be removed in a secondary reduction compared to a primary one. [00:18:55] Walking through expected volumes in a typical re-reduction case. [00:19:49] Patient factors that compound risk in secondary reduction: BMI, smoking, and diabetes. [00:21:04] Weighing risks and benefits with your surgeon. [00:22:50] Why secondary reductions can be performed safely with thorough counseling and realistic expectations. [00:23:42] Advice for surgeons building experience before taking on secondary reduction cases. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/ Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/ McRae Plastic Surgery: https://mcraeplasticsurgery.com/ Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com) Sources: 1. Increase in Breast Size After Menopause: Prevalence and Determinants. Maturitas. 2004. den Tonkelaar I, Peeters PHM, van Noord PAH. 2. Longitudinal Changes in Volumetric Breast Density in Healthy Women Across the Menopausal Transition. Cancer Epidemiology, Biomarkers & Prevention. 2019. Engmann NJ, Scott CG, Jensen MR, et al. 3. Principles of Breast Re-Reduction: A Reappraisal. Plastic and Reconstructive Surgery. 2017. Mistry RM, MacLennan SE, Hall-Findlay EJ. 4. Secondary Reduction Mammaplasty Techniques and Outcomes: Cleveland Clinic Experience. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2024. Adebagbo OD, Rahmani B, Park JB, et al. 5. Does Knowledge of the Initial Technique Affect Outcomes After Repeated Breast Reduction? Plastic and Reconstructive Surgery. 2012. Ahmad J, McIsaac SM, Lista F.

  6. Aug 26

    Skin Cancer Prevention, Treatment, and Testing with Dr. Christopher Spock

    In this episode of Plastic Surgery Consults, Dr. Matthew McRae and Dr. Mark McRae speak with board-certified dermatologist and Mohs surgeon Dr. Christopher Spock about skin cancer prevention, diagnosis, and treatment. Dr. Spock explains how to select sunscreen, why avoiding sunburns matters, and how patients can protect post-surgical scars. He also compares topical treatments, excision, Mohs surgery, and radiation for different skin cancers. The conversation covers options for patients who develop frequent cancers, including niacinamide and other medical therapies, before examining gene-expression tests that may help assess the risks associated with melanoma and high-risk squamous cell carcinoma. Key Points From This Episode: [00:00:00] Dr. Matthew McRae welcomes Dr. Christopher Spock. [00:00:10] Dr. Spock shares his path from plastic surgery research to dermatology and Mohs surgery. [00:03:24] The hosts introduce skin cancer prevention and post-surgical sun protection. [00:03:58] What to look for in sunscreen, including SPF, broad-spectrum coverage, and mineral ingredients. [00:06:42] Skin sensitivity and inflammatory reactions associated with chemical sunscreens. [00:07:44] Improvements in mineral sunscreen formulations and the value of sun-protective clothing. [00:09:12] Protecting post-surgical scars with zinc-based gels, silicone tape, and reduced sun exposure. [00:10:28] Differences between basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. [00:10:28] How physicians choose between topical treatment, scraping and cauterization, excision, and Mohs surgery. [00:10:28] How Mohs surgery examines margins and allows surgeons to respond to findings in real time. [00:16:55] Differences in access to Mohs surgeons in Ontario and Florida. [00:18:14] Sun protection and niacinamide for patients who develop frequent skin cancers. [00:18:14] Additional medications and oncology treatments for high-risk or advanced cases. [00:20:49] The growth of in-office superficial radiation therapy and questions patients should ask. [00:23:57] When radiation may be considered for cancers that could cause significant cosmetic defects after surgery. [00:24:14] The role of radiation in localized disease and systemic therapies in advanced or metastatic disease. [00:26:45] How Breslow thickness has traditionally been used to assess melanoma. [00:26:45] Gene-expression testing as an additional tool for assessing melanoma risk. [00:30:50] Accessing melanoma gene-expression testing through a physician. [00:31:28] Using similar testing to assess high-risk squamous cell carcinoma and the need for adjuvant radiation. [00:33:03] Dr. Spock discusses how long these molecular tests have been used in his practice. Links: McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Dr. Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Dr. Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  Dr Christopher Spock on LinkedIn: https://www.linkedin.com/in/christopher-spock-md-7942656/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)

  7. Aug 19

    Breast Surgery Recovery: What to Expect Week by Week

    In this episode of Plastic Surgery Consults, Dr. Matthew and Dr. Mark discuss what patients can realistically expect during recovery after breast augmentation, breast lift, and breast reduction surgery. They break down the recovery timeline from the first 24 hours through the first year. The conversation examines evidence-based recovery protocols, factors that can prolong healing, and practical advice to help patients prepare for a safe recovery. Key Points From This Episode: [00:00:19] Why recovery is one of the most important parts of any breast surgery. [00:02:26] Combining procedures to reduce overall recovery periods. [00:03:20] What to expect during the first 24 hours after surgery. [00:04:06] Managing nausea after anesthesia and pain medications. [00:06:58] Returning to work, massage, and activity progression during the first month. [00:08:40] Guidelines for driving safely after surgery. [00:09:28] Returning to exercise and physical activity. [00:11:24] Swelling, bra fitting, and easing back into workouts. [00:12:27] Massage therapy, lymphatic drainage, and evolving recovery practices. [00:13:43] Scar tissue, healing milestones, and normal sensations months after surgery. [00:15:14] Swimming, wound healing, and preventing infection. [00:16:23] Why strenuous activity can increase swelling and fluid accumulation. [00:20:44] Research on returning to work after breast reduction surgery. [00:21:43] Factors that can prolong recovery, including complications and fibromyalgia. [00:25:43] Enhanced Recovery After Surgery (ERAS) protocols and evidence-based recovery strategies. [00:27:48] Nutrition, inflammation, and emerging recovery therapies. [00:29:22] Why pets should stay out of the bedroom during recovery to reduce infection risk. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com) Sources: 1. Return to Activities After Breast Reduction. Breast. 2010. Schumacher HH, Pleat JM, Bailey JM.| 2. Return to Work After Breast Reduction: A Comparative Study. Journal of Clinical Medicine. 2023. Holopainen N, Oranges CM, di Summa PG, Toia F, Giordano S. 3. Enhanced Recovery After Surgery (ERAS) Pathways for Aesthetic Breast Surgery: A Prospective Cohort Study on Patient-Reported Outcomes. Aesthetic Plastic Surgery. 2024. Stahl S, Santos Stahl A, Feng YS, et al. 4. 3-D Analysis of Breast Morphology Changes After Inverted T-Scar and Vertical-Scar Reduction Mammaplasty Over 12 Months.| Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 2013. Eder M, Klöppel M, Müller D, et al. 5. Use of Poly-4-Hydroxybutyrate Mesh to Optimize Soft-Tissue Support in Mastopexy: A Single-Site Study. Plastic and Reconstructive Surgery. 2017. Adams WP, Moses AC. Clinical Trial 6. Delineating Upper Limb Longitudinal Recovery After Simple Mastectomy, Implant or Autologous Breast Reconstruction Using Wearable Activity Monitors. Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 2025. Che Bakri NA, Kwasnicki RM, Giannas E, et al Observational 7. Does Breast Reduction Surgery Improve Health-Related Quality of Life? A Prospective Cohort Study in Australian Women.  BMI Open. 2020. Crittenden T, Watson DI, Ratcliffe J, Griffin PA, Dean NR. 8. Is Time a Factor in Quality of Life Improvement Following Breast Reduction? Aesthetic Surgery Journal. 2021. Yaacebi DS, Oshinka A, Shachar T, et al. 9. Prospective Outcome Study of 106 Cases of Vertical Mastopexy, Augmentation/Mastopexy, and Breast Reduction. Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 2013. Swanson E. 10. Quality of Life Following Symptomatic Macromastia Surgery: Short- And Long-Term Evaluation. The Breast Journal. 2016. Pérez-Panzano E, Güemes-Sánchez A, Gascón-Catalán A.Observational

  8. Aug 5

    Understanding Sensory Recovery After Breast Reduction Surgery

    In this episode of Plastic Surgery Consults with the McRae Twins, Matthew and Mark McRae examine sensory recovery following breast reduction surgery and how anatomy, surgical technique, and patient-specific factors influence outcomes. They review current research on expected timelines for recovery, discuss the nerves responsible for breast and nipple sensation, and explain how different pedicle techniques and the amount of tissue removed may affect postoperative sensation. The episode also covers factors such as age, BMI, diabetes, and hypersensitivity, helping patients better understand what to expect while emphasizing the high satisfaction rates associated with breast reduction surgery. Key Points From This Episode: [00:00:00] Introduction to sensory recovery after breast reduction surgery and why it matters. [00:00:59] Research overview on the incidence of sensory changes and expected recovery timelines. [00:02:24] How monofilament testing is used to objectively assess sensation. [00:02:51] Differences between tactile, thermal, and other forms of sensation during recovery. [00:04:37] Typical nerve recovery timeline and why sensation may continue improving for up to two years. [00:05:57] Breast nerve anatomy and the role of the thoracic spinal nerves. [00:06:49] The course of the intercostal nerves and why anatomy influences surgical planning. [00:10:11] What a pedicle is and its importance for maintaining blood supply and tissue viability. [00:11:29] Superior, medial, and inferior pedicle techniques and how they differ. [00:12:46] Why modern breast reduction techniques often prioritize superior-medial breast tissue for aesthetic outcomes. [00:14:38] Surgical factors that may influence sensory recovery, including pedicle selection and surgical methodology. [00:15:55] How preservation of key nerve pathways may help maintain nipple sensation. [00:17:32] The relationship between tissue resection volume and postoperative sensory changes. [00:18:57] Patient factors such as age, diabetes, BMI, and smoking that may affect nerve recovery. [00:20:55] Hypersensitivity after surgery, including considerations for patients with fibromyalgia. [00:22:15] Aligning surgical technique with patient priorities, including sensation preservation versus maximum reduction. [00:23:07] Preview of future discussions on recovery and breastfeeding after breast reduction surgery. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com) Sources:1. Innervation of the Female Breast and Nipple: A Systematic Review and Meta-Analysis of Anatomical Dissection Studies. Plastic and Reconstructive Surgery. 2022. Smeele HP, Bijkerk E, van Kuijk SMJ, et al.SR 2. Pain after breast surgery: Etiology, diagnosis, and definitive management. Microsurgery. 2016. Broyles JM, Tuffaha SH, Williams EH, et al. 3. The Sensitivity of the Nipple-Areola Complex: An Anatomic Study. Plastic and Reconstructive Surgery. 2000. Schlenz I, Kuzbari R, Gruber H, Holle J. 4. Nerve Supply of the Breast With Special Reference to the Nipple and Areola: Sir Astley Cooper Revisited. Clinical Anatomy. 1997. Sarhadi NS, Shaw-Dunn J, Soutar DS. 5. Anatomical Basis for Sensory Preservation in Robotic Mastectomy. The British Journal of Surgery. 2025. Holley HA, Hembrecht S, Smyth NM, et al.Recent 6. Predictable Location of Breast Sensory Nerves for Breast Reinnervation. Plastic and Reconstructive Surgery. 2019. Knackstedt R, Gatherwright J, Cakmakoglu C, Djohan M, Djohan R. 7. Alteration of Nipple and Areola Sensitivity by Reduction Mammaplasty: A Prospective Comparison of Five Techniques. Plastic and Reconstructive Surgery. 2005. Schlenz I, Rigel S, Schemper M, Kuzbari R.

  9. Jul 22

    Understanding Breast Reduction Scars and Scar Healing

    In this episode of Plastic Surgery Consults with the McRae Twins, Matthew and Mark McRae examine one of the most common questions surrounding breast reduction surgery: scars and scar healing. Key Points From This Episode: [00:00:00] Introduction to breast reduction surgery, scar placement, and why this topic is especially relevant for younger patients. [00:00:57] How the demographics of breast reduction patients have changed over the past decade. [00:01:56] Why more younger women are considering breast reduction surgery today. [00:03:12] The three most common concerns younger patients raise during consultation. [00:05:13] Common breast reduction scar patterns, including the lollipop and anchor techniques. [00:07:27] Differences between incision patterns and how surgical technique influences scar placement. [00:09:40] How skin quality and breast anatomy influence scar length and surgical planning. [00:11:48] Why breast reduction scars are positioned to remain well concealed beneath clothing and swimwear. [00:12:43] The biology of scar healing and how scars mature over one to two years. [00:14:24] What patients can expect as scars change in colour, firmness, and appearance during recovery. [00:16:14] Genetics, previous scars, and the difference between hypertrophic and keloid scars. [00:20:24] Research on scar-related risk factors, including younger age, smoking, and higher BMI. [00:25:19] Why patient satisfaction remains high despite the possibility of scar-related complications. [00:27:08] Scar management strategies, including massage, silicone products, moisturizers, and timing. [00:31:35] The importance of protecting healing scars from UV exposure during the first year. [00:33:42] Preview of future episodes covering sensation and breastfeeding after breast reduction surgery. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/  Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/  McRae Plastic Surgery: https://mcraeplasticsurgery.com/  Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com) Sources: 1. The Role of ACE-Inhibitors and ARBs in Reducing Hypertrophic Scarring Following Bilateral Breast Reduction. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS. 2023. Dow T, Selman T, Williams J, Bezuhly M.Opinion 2. An Outcomes Analysis of 2142 Breast Reduction Procedures. Annals of Plastic Surgery. 2015. Manahan MA, Buretta KJ, Chang D, et al. 3. Complications and Quality of Life Following Reduction Mammaplasty in Adolescents and Young Women. Plastic and Reconstructive Surgery. 2019. Nuzzi LC, Firriolo JM, Pike CM, DiVasta AD, Labow BI. 4. Breast Reduction Outcome Study. Annals of Plastic Surgery. 2000. Mizgala CL, MacKenzie KM. 5. Shifting the Paradigm on Tissue Removal and Postoperative Complications in Breast Reduction: A Systematic Review and Meta-Analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS. 2025. Oliveira JA, Eskandar K, Gontijo LC, et al.SR 6. Risk Factors and Complications in Reduction Mammaplasty: Novel Associations and Preoperative Assessment. Plastic and Reconstructive Surgery. 2009. Henry SL, Crawford JL, Puckett CL. 7. Risk Factors and Complications in Reduction Mammaplasty: A Systematic Review and Meta-Analysis. Aesthetic Plastic Surgery. 2023. Liu D, Wu M, Xu X, et al.SR 8. Risk Factors for Complications After Reduction Mammaplasty: A Systematic Review and Meta-Analysis. European Journal of Medical Research. 2025. Ran R, Wang H, He X, et al.RecentSR

  10. Jul 8

    Meet the McRae Twins: Our Journey to Becoming Plastic Surgeons

    In the debut episode of Plastic Surgery Consults with the McRae Twins, Matthew and Mark McRae introduce their new podcast and explain why they wanted to create it: to give patients and learners a reliable, in-depth source of plastic surgery information. They discuss their combined clinical and academic roles at St. Michael’s Hospital and the University of Toronto, and outline how future episodes will be structured around current topics, deeper dives, and listener questions. The twins then share the personal story of how they became plastic surgeons, from playing varsity hockey at Cornell University and attending Yale School of Medicine, through very different residency experiences at NYU and the University of Toronto, to their fellowship training in San Francisco and at Sunnybrook Hospital. They close by reflecting on growing up as twins, their family background, and the lessons competitive hockey taught them about discipline and character. Key Points From This Episode: [00:00:09] Welcome to the podcast and an introduction to why Matthew and Mark McRae decided to start Plastic Surgery Consults. [00:00:59] How the podcast ties into their clinical and academic roles at St. Michael’s Hospital and the University of Toronto. [00:02:50] Why patients today need more reliable, in-depth sources of plastic surgery information. [00:02:56] How the podcast will be structured going forward, including current topics, deep dives, and listener questions. [00:06:24] Kicking off their personal story: how playing varsity hockey at Cornell led them toward medical school. [00:09:00] Advice for aspiring medical students, including the importance of applying broadly and standing out. [00:12:46] Arriving at Yale University and finding an inclusive, inspiring plastic surgery community. [00:12:55] Why mentorship was critical during medical school and how it shaped their path into plastic surgery. [00:14:38] The small number of plastic surgery residency spots available in Canada and the U.S., and why guidance matters. [00:16:41] Comparing their very different residency experiences: NYU versus the University of Toronto. [00:19:27] How witnessing the intensity of NYU’s program motivated Matthew to pursue an equally demanding fellowship. [00:22:30] What a fellowship year is and why surgeons pursue additional training after residency. [00:22:45] Matthew’s fellowship year at the Buncke Clinic in San Francisco. [00:23:00] Mark’s fellowship year in facial plastic surgery at Sunnybrook Hospital in Toronto. [00:27:19] Matthew’s first job covering plastic surgery call across Toronto hospitals, plus his surgical trips to Ukraine. [00:27:19] Mark’s path to McMaster University, Hamilton’s St. Joseph’s Hospital, and eventually St. Michael’s Hospital. [00:29:18] Growing up as twins: their family background, including their father’s career as a teacher and their mother’s roots in Trinidad and Tobago. [00:30:50] How years of competitive hockey shaped their work ethic, discipline, and approach to life. [00:32:52] Closing thoughts on the episode and a preview of what’s ahead for the podcast. Links: Matthew McRae on LinkedIn: https://www.linkedin.com/in/matthew-mcrae-8750ab75/ Mark McRae on LinkedIn: https://www.linkedin.com/in/mark-h-mcrae/ McRae Plastic Surgery: https://mcraeplasticsurgery.com/ Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)

  • 10 Episodes

About

Two board-certified plastic surgeons. One family. Unfiltered conversations about the art, science, and ethics of plastic surgery. Hosted by Dr. Mark McRae and Dr. Matthew McRae, University of Toronto professors and founders of McRae Plastic Surgery in Toronto. Each episode of Plastic Surgery Consults cuts through the noise on trending procedures, patient safety, and what really happens from consultation to recovery. Whether you're a med student, a medical professional, or simply curious about going under the knife, this is the conversation you've been waiting for.

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