19 Year Old, with 34DD Breasts(almost E Cup)?

You have some of the classic symptoms which are commonly associated with very large, heavy, dense breasts (mammary hypertrophy).  Other common complaints include recurrent headache, shoulder notching/grooving, and numbness or tingling in the little fingers.  Many patients are unaware that all of these symptoms are actually caused by the impact of the constant weight of the breasts pulling on the neck, back and shoulders.  A breast reduction procedure typically results in eliminating essentially all of these problems!  For your small frame, a B cup as final size might be perfect and is certainly safe.

Breast reduction is authorized by insurance companies based on 2 criteria.  First, you must have symptoms related to the enlarged breasts such as neck, back or shoulder pain or rashes.  Second, you must have the amount removed that meets their criteria.  At size 34, each 100 grams is 1 breast size reduction.  To go from a DD to a B, is a 300 gram removal. Your insurance company may not authorize an amount this small.

Best Wishes,

Gary Horndeski, M.D.

It is a common procedure than can give you considerable relief and improve your quality of life.  Please understand you will not be able to fully breast feed, needing to supplement feedings with formula and that sensation could be lost to your nipples.  Your doctor should be able to advise you on whether you can have a vertical reduction (less scarring) or need a traditional anchor reduction.  Regardless, you are an excellent candidate for a reduction if you are willing to accept the risks of surgery.  Best wishes!

A breast reduction is certainly possible.  It is difficult to tell you whether or not you can get down to a "B"ish cup without an exam.

At age 19, I expect your breasts are fully developed.  It sounds as if you have significant symptoms related to your overly large breasts (macromastia).  You are probably a great candidate for a breast reduction surgery.  My breasts reduction patients are some of the happiest women I have met!  Please understand that this procedure does produce scars on the breasts, but they are not generally visible under a bra or bikini top. Sometimes breast reduction surgery is covered (at least in part) by your health insurance.  For that reason, I recommend scheduling a visit with your primary care physician.  Most insurance companies require you to be at a healthy weight (which you are) and that you try conservative therapies - like pain medication and physical therapy first.  Medical records from your regular doctor showing that these therapies have not worked as well as documentation of any skin rashes or shoulder grooves you may have can support your insurance claim.  I recommend you choose a board certified plastic surgeon who performs the surgery frequently.  Best of luck!

 Thank you for the question.

Based on your description, you may be an excellent candidate for breast reduction surgery;  this operation tends to be one of the most patient pleasing operations we perform.

As you think  about  breast reduction surgery make sure you do your homework and understand the potential risks and complications associated with  the procedure.  One of the potential downsides (tradeoff) associated with the procedure is scarring. Make sure you also understand that further surgery may be necessary in the future (for example if your breasts were to grow in size again).

On the other hand, breast reduction surgery is one of the most patient pleasing operations we perform and I think that for the right teenager (enough symptoms) it may be an excellent option (regardless of the age).

In regards to achieving your goals,before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon.  Most patients wish to achieve  enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. 

With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small)  very helpful. I have found that the use of words such as “natural” or “B cup” 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.


Sometimes the breat reduction is covered through health insurance. The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
 This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.  

I hope this helps.

It sounds as if you are very good candidate for a breast reduction.  It probably is possible to safely reduce you to a B or C cup.  The limiting factor is the preservation of sufficient tissue to nourish your skin flaps and nipple-areolar areas.