A Thank you for your question and for providing the photos; they are very helpful. Based on the information you've shared, your body surface area is estimated to be between 1.55 and 1.60. This indicates that tissue removal for each breast would be approximately 284 to 300 grams. This amount is typically the minimum required by insurance unless the surgeon submits a note indicating a need for removal of only 200 grams, which insurance may then approve pending other symptoms and treatment failure.
The surgical technique used is important, but it ultimately depends on what the surgeon is most comfortable with. Personally, if the distance from the sternal notch to the nipple is longer, indicating that I need to move/lift a longer distance, I prefer using the inferior pedicle Wise pattern (also known as the anchor-type incision). On the other hand, if the lift needed is moderate—less than 4 to 5 cm—I would use the superomedial pedicle with the same Wise pattern incision, this is my preference, other surgeons might think differently.
While I don't have your exact measurements, my impression, based on the photos, is that an inferior pedicle breast reduction would be appropriate. If your goal is to achieve a reduction that is proportionate to your body and you prefer not to place pressure on your surgeon regarding the required insurance amount of breast tissue removal, you might want to consider consulting a non-insurance-based aesthetic surgeon.
Predicting cup size is quite challenging, even at an examination, as many factors come into play. Breast tissue can vary significantly; for example, it might be heavier if it's more fibrotic. Therefore, without a physical exam, it's difficult for anyone to accurately gauge your size in terms of cup sizes.
