A frequent complaint after breast reduction
surgery is over resection. Over
resection is performed to meet insurance companies criteria. The best way to ensure you do not undergo over
reduction is to be independent from the insurance carrier. This allows you to select the size you desire,
not what will satisfy the insurance company criteria. After over resection, augmentation or fat
transfers can be performed. Both are undesirable
for a woman who initially had too much tissue.
I recommend a new technique called The Ultimate Breast ReductionTM. This technique reshapes your breast tissue
creating upper pole fullness, elevate them higher on the chest wall and more
medial to increase your cleavage. This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed. The weight of the breast is transferred to
the underlying muscle relieving pain without requiring over resection.
Gary Horndeski, M.D.
Good question. I would certainly recommend you have a detailed discussion with your doctor before surgery to make sure you are both on the same page about this. If you are made too small or too much is left for your liking, it will likely be fairly minor. I always tell my patients that breast reduction is more of a reconstructive than cosmetic procedure, therefore precision in sizing is much more difficult. The key is making sure your surgeon knows what you are looking for. Good luck.
Part of the answer here depends on who is paying for the procedure. Insurance companies will frequently require that a certain amount of tissue be removed to assure coverage. Ultimate size in that case sometimes depends on what the insurance company wants rather than preference of the patient. Depending on your preop size you may be smaller than you preferred. If you are paying yourself the surgeon has more leeway as to how much is removed. Discuss this carefully with your surgeon prior to the surgery. Also keep in mind that weight fluctuations after the surgery will affect the size of your breasts.
Interesting question. Women who undergo breast reduction usually are afraid of too much being removed before the surgery, and after the surgery, if anything, they complain that the breasts are not small enough. So it is very uncommon to resect "too much". However, in the rare event of that happening, the solution is either fat transfer or implants.
The answer is of course, yes, there is a risk of resecting too much breast tissue but good planning and analysis of the existing anatomy should limit this risk. Resecting too much tissue can result in excessively small or mis-shapen breasts but it can also produce healing problems as well as necrosis of skin, fat, or nipple. If one has very large breasts, the more that is removed, the higher the chance that blood supply to critical areas such as the nipple is reduced causing healing problems. These complications can be difficult to correct. That is why it is important to analyze your anatomy and discuss your goals and risks completely with your surgeon.
Robin T.W. Yuan, M.D.