The issue I have is that my PS never talked to me about what size/shape I'd like to end up with. AFter measuring, etc. he told me he wanted to take "500-700 grams" from each breast. I will not get a chance to see/talk to him again until just before the operation. Nurse in his office told me that with insurance approval he was now committed to the 500-700 grams and said that they do not deal in "cup sizes". Does this sound right? Should I be nervous??
Breast Reduction Surgery in 1 Week But Doctor Never Discussed Size - Normal?
Doctor Answers (13)
Breast Reduction and Size?
Thank you for the question.
I would suggest you call your surgeon's office and asked to see him again in the office prior to surgery. In general, it is in everyone's interest for patients to feel comfortable that they have communicated their goals clearly. In my opinion, this should not be left for the day of surgery. But they will be potentially filled with lots of anxiety and distractions.
it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
Congratulations on your decision to undergo the breast reduction procedure; it is one of the most patient pleasing operations would perform.
Breast Reduction - What Will a 500-700 Gram Reduction Bring Me To?
I think you should be able to have this discussion with your PS before you arrive on the day of surgery.
It is true that many insurance companies require a minimum of approximately 500 grams in order for the procedure to be "covered," but you have to make sure that that's about the amount you want removed. Or at least you need to be able to talk to your PS about this.
In GENERAL, it's about 150-200 grams per bra cup size, but it's less at the smaller end, and more at the larger end. In other words, it's less than that to go from a AA to an A, and more from an F to a G (or the other way around). Since a DD is an E, and a DDD is also called an F, you're basically a DDDD, or three bra cup sizes above a D. Depending on your height and weight and your frame, my guess is that a 550 gram reduction would take you down about 2-3 bra cup sizes. Weight also depends on the density of the breasts. For young women and/or dense breast tissue, 100 grams will be a much smaller amount (ie, will not reduce the cup size as much as) than for an older woman and/or fattier breast tissue (nothing personal, of course....)
So I cannot say for sure without seeing a photo and/or being able to examine you and, in fact, it's hard to be exact even if those conditions are met.
Ideally, you should have a frank and open discussion with your plastic surgeon about what you want and then be comfortable accepting a range of cup sizes, as long as you're reduced, lifted and the shape is appropriate for your frame.
I hope that this helps, and good luck,
Breast reduction size
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Get involved in the planning phase of breast reduction surgery
During your initial breast reduction consulation as well as during your pre-operative exam there should have been amble opportunity to discuss your goals and expectations. In breast reduction surgery it can be difficult to predict final breast size in turns of cup size. In general the breast will be reduced to a size and shape that fits your overall proportions. Be sure that you let your plastic surgeon know what your expectations are so that he can plan the appropriate procedure.
Predicting results from a breast reduction
You should never feel that you don't have access to your doctor before an elective operation. All questions should be comfortably answered by them in order to have the optimal relationship and partnership in the process. If you are not getting that, you should consider another doctor.
You can't guarantee cup sizes in reduction other than saying that you won't be a B. Shape is also very dependent on the nature of your tissues, the technique used, and the artistry of the surgeon.
Breast reduction volume
Without an exam I could not tell you if this is adequate to give you a nice shape and size. Many insurance companies want a minimum volume removed to fit their criteria, but it does not always leave a reasonable volume of breast tissue. In many cases, I have taken off more than 1000 gms per side but it is all individualized
Concerns about several issues prior to a breast reduction
From your description of the situation, I would be VERY nervous. First of all, even though cup size can't be predicted, there should have been a discussion with regard to approximately what you should expect with regard to size, appearance and even proportionality.
Second, to remove a particular amount of breast tissue just to satisfy the insurance company is not the right approach if the end result will be breasts that are far too small or deformed. Yes, this is a procedure that is designed to alleviate your symptoms - but it should also leave you with an acceptable aesthetic appearance. Unless there is some communication issue, I would be very concerned if the sole guideline by your plastic surgeon is volume and not also appearance.
You may want to consider one or more additional opinions from other plastic surgeons in the area and see if you feel more comfortable and there is better communication. Seriously consider cancelling surgery if you still feel uncomfortable with this plastic surgeon or you can't see him in the office prior to your scheduled surgery date.
Breast reduction is usually a combination of reduction of weight/volume to relieve symptoms of large breasts (i.e. pain or discomfortin shoulder, neck or back, dermatitis, etc.) and reduction/shaping for cosmetic appearance. Every surgeon approaches the surgery differently. I usually try to get a sense of what is important to the patient (symptomatic relief, size, shape, scars,etc.) and will customize the procedure for each patient. Sometime insurance concerns can influence what you end up doing but you have to have clear pitcure and understanding of what you own personal goals and desires are. If you have cosmeitc concerns that out-weigh (no pun intended) your symptomatic concerns, your insurance coverage may take a back seat, or vice versa.
Robin T.W. Yuan, M.D.
Breast Reduction Size
If you still have concerns about your surgery, then you should make an appointment to talk with the surgery prior to the planned surgery date. It is your body and you should feel completely comfortable with the planned procedure. If they will not meet with you, then perhaps you should look for a more accommodating surgeon. As for the amount of tissue to be removed, if you are having the surgery paid for by insurance, they often stipulated a minimum amount of tissue to be removed to qualify. In most cases it is 500 cc per breast. However, if you need more than that, you should discuss with your surgeon your expectations. However, they are correct that there is not an easy way to predict exact cup size with breast reduction surgery. If you want less than 500 cc removed, then your insurance company may not cover the surgery.
Planning size for breast reduction
You should feel uncomfortable with your surgeon if you cannot see him/her when you need to before surgery. Absolutely do not go to the operating room if questions are unanswered or if the answers you get do not make sense. The nurse's comment that the doctor is now "committed" to a certain volume of tissue for reduction is very worrisome: the surgeon should maintain all flexibility to get the best result and should absolutely not be a slave to his or her original estimate or to the insurance company.
As far as size is concerned remember that you will gain relief from pre-op symptoms (neck and back pain, bra strapping, etc.) not only becasue you are smaller (volume reduction), but also because the breasts will be higher on your chest and closer to your body due to skin tailoring (mastopexy).
The ideal size is proportionate to your frame and figure and will allow you to comfortably wear clothes off the rack without alterations.
All of this shuold be discussed with your surgeon in advance.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.