My PS Only Wants Remove 450-500mg for Both Breasts for my Reduction. Why So Little? (photo)

My PS only wants remove 450-500mg for both breasts. I am concerned for a few reasons: 1) I won't be happy with the my results. 2) My insurance won't cover it if he doesn't remove enough My BSA is 1.73, I am 5'5" 1/2, about 143-145lbs, wear a full 34G bra, and I am 40 years old. According to the Schnur Sliding Scale he should be removing 370-404grams per breast. My surgeon said because I am so wide on top that he can't remove as much as I want him to and I will be a D cup in the end.

Doctor Answers (7)

Weight of removed breast tissue in reduction

+2

Ideally, the procedure should be done for the size and shape of result and the breast tissue removed to achieve it is weighed and it is what it is. There is no way to measure or know what amount of weight a section of breast tissue will have before the surgery just as there is no way to know what effect liposuction on the breast will have because the fat cannot be gauged externally. You don't want the surgeon to go into surgery thinking he or she has to keep removing breast tissue until a certain weight of tissue is attained. This is a good example of insurance dictating the surgery. 

My approach is to reduce and reshape the breast to the patient's goals (as long as they're realistic) and not seek permission from insurance. That way the patient and surgeon are in control. The drawback is that the patient will have to pay for the procedure (which these days can be done under local anesthesia) as with other cosmetic procedures on the breast such as lifts or augmentation. 


Denver Plastic Surgeon
4.0 out of 5 stars 1 review

Second Opinion For Breast Reduction

+1

I would echo getting a second opinion for your breast reduction surgery.  Looking at you photos, I cannot see a reason for limiting the amount of tissue excised to a weight below the threshold for insurance coverage.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

BEFORE your surgery please...

+1

 BEFORE your surgery please express your concerns to your surgeon. You might say “ I really want to be smaller than body size” or, “ I want a C Cup in a Playtex Braw”. See what kind of response you receive. If you are not satisfied their response there are most likely many other surgeons who will be able to accomplish your desires. Consider a second option or consult with a member of the ASAPS in your area. They are experts in Breast Surgery. Best,

 

Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon
5.0 out of 5 stars 3 reviews

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My PS Only Wants Remove 450-500mg for Both Breasts for my Reduction. Why So Little?

+1

Sounds like a typical mis communication between you and your surgeon. I believe he means he will be removing 450-500 gms, as you desired from the Schnur scale for minimal insurance coverage. If you desire more gms removed, which can be done, there could be a consequence of a flatter more pancake appearance after healing. Maybe a few more in person opnions could help you understand these issues. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Reasonable Candidate

+1

I do not understand.  It appears that you are a good candidate for breast reduction.  The should be no special concerns for your reduction.  Consider rediscussing the minimal amount that will be removed per breast with your PS to make sure everyone has the same understanding.

Best Wishes

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
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Breast reduction bleeding after one month

+1

You certainly look like a good candidate for breast reduction. As for final size, it is difficult without an exam.  Usually the more glandular the breast, the heavier they are the more weight can come off.  Best to be seen in person.

Steven Wallach, MD
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How much to remove with breast reduction

+1

The Shnur sliding scale was developed for use by insurance companies to determine coverage for breast reduction but each case is different. Over-reducing wide breasts can leave an unattractive flat shape. Your own plastic surgeon who has examined you is in the best position to make a recommendation.

Richard Baxter, MD
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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.