32H Extremely Dense (75%), Risks of Reducing from H to B? (photo)

Question

I am a lean, athletic, large breasted 5'8" woman with size 32H breasts. The density is level IV, per BI RADS. I would like to reduce them to a B. Aside from the obvious symptomatic problems I imagine a B since I just don't favor larger breasts. I envision a loose button-up shirt, baggy jeans, hanging out in my art cottage, in a mostly private setting. I am a bit of an introvert. Plus, I am a lesbian and more tomboyish. Does this pose special risk's due to density, like to nipples?

Gerald Minniti, MD, FACS · Answer

Hello EmbraceMe,

	I understand your desire to minimize your breasts with your concerns of the safety of over-reduction.  Having dense breast tissue does not necessarily increase your risk of reduction, and in fact gives a nicer appearance to the mound after the reduction and lift.  Your photos are not revealing, but I can still get an idea of the relative size of your breasts and the position of the nipple areolar complex. 

	I would see only surgeons that have a great reputation for breast reduction surgery.  These people would of course be certified by the American Board of Plastic Surgery and also be members of the American Society for Aesthetic Plastic Surgery.

	Although I don't think a B cup is realistic, a relatively high and tight C cup is.  I have posted a link to a photo of a large breasted woman who got a similar result.

	Best of luck!

Tom J. Pousti, MD · Answer

Thank you for the question.

	Yes, it is possible to reduce the breasts size very significantly.   Sometimes  when patients want &ldquo;almost nothing left&rdquo;  the reduction should be done in 2 stages.  The concern with the amount of tissue removed is related to blood flow to the remaining tissue;  if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola)  may be compromised.   Part of the tissue that is left in place is called the &ldquo;pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue. If the pedicle is made too small (in the effort to reduce the breasts as much as possible)  then patient will likely have problems with tissue survival.  Doing the procedure in more than one stage allows the tissues to  acclimate to the surgically decreased blood flow before  further tissue removal (and potentially further decreased blood flow)  occurs ( with the 2nd stage operation).

	I have taken care of several patients like yourself ( who happen to be of same "lifestyle" as yourself) and have achieved very small breasts  using the  staged procedure described above.  This approach avoids the need  for free nipple grafting ( and the downsides of complete numbness//risks of skin grafting...).

	The other concern with overly aggressive breast reduction surgery is patient dissatisfaction  afterwards.  It is not unusual for patients who have lived with very large breasts to want to have as much as possible removed. Care must be taken to be judicious in this removal to avoid an outcome where the breasts  are too small in relation (proportionately) to the patient's other body parts.  Again, it is not uncommon, for patients'  breasts to become smaller ( after the breast reduction procedure) with time and/or weight loss-  breast augmentation may become necessary to achieve the patient size goals.

	I hope this helps.

Robin T.W. Yuan, MD · Answer

The risk in breast reduction is diminished blood flow to the nipple or to the skin edges. The larger the reduction, the more tissue removed, the less blood flow remains, the higher the risk of healing problem, sensory changes, and fat or skin necrosis. The density may contribute to reduction in blood flow but the technique of reduction should take this into consideration. Your surgeon should customize your surgery to your anatomy and desires and will review specific risks with you. The other risk is scarring and calcification within the breast gland that can change mammographic reading of your breasts.

	Robin T.W. Yuan, M.D.

Peter E. Johnson, MD · Answer

Your breast is full and dense and the nipple is pointing to the floor. To understand what a B-cup in a 32 is like, you should go look at one, and try to imagine how you could possibly fit into it. Even with a full 'T' reduction the geometry of your breast will allow a D-cup after reduction, but the loose button up shirt (even without a bra) should be a go.
	Best of luck, peterejohnsonmd.com

Darryl J. Blinski, MD · Answer

Your posted photos are useless. Can not see the appearance of the breasts. Seek in person examination from a boarded PS in your area.

32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

Answers (8)

Answer: Imagine the B-cup after reduction

Answer: Imagine the B-cup after reduction

Answer: 32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

Answer: 32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

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Everything you need to know about Breast Reduction

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32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

Answers (8)

Answer: Imagine the B-cup after reduction

Answer: Imagine the B-cup after reduction

Answer: 32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

Answer: 32H Extremely Dense (>75%), Risks of Reducing from H to B? (photo)

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Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.