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

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!

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.

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

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

A breast reduction is definitely a good option for someone with large breasts; however, it is very difficult to predict cup sizes post-operatively.  As you already probably know, bra sizes vary from manufacturer to manufacturer as well as according to your chest measurements -- for example a 34B is not the same as a 38B.  

That said, there are considerations in how much you can reduce a breast.  A breast reduction removes enough tissue to alleviate your symptoms (back pain, neck pain, etc), but leaves enough breast tissue to achieve an aesthetic and proportional breast and provide a good blood supply to the nipple.  As one of the physicians has mentioned, a breast reduction with a free nipple graft is also an option; but would mean that you definitely lose all nipple sensation and not be able to breast feed.

I would recommend that you discuss your goals with a board certified plastic surgeon.  He or she will then be better able to discuss your options with you.  Good luck!.

A breast reduction sound reasonable, but to go from an  "H" donw to  a "B" and still maintain a nice shape is unrealistic.  To maintain viability of the nipple and skin flaps that close over the pedicle of tissue requires a certain amount of tissue to be maintained on the flaps. 

Thank you for the question.

Yes, it is possible to reduce the breasts size very significantly.   Sometimes  when patients want “almost nothing left”  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 “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.

Without an actual photo of your breasts we can't say for sure and also realize that the bra maunfacturers are not held to standards of sizing.  But to go from an H to a B will almost certainly involve removing enough breast tissue that the blood supply to the nipple will suffer and the chance of the nippla dying is exceeding high.  To minimize this, you might need a free nipple graft where the nipple is skin grafted abck on at the end of the surgery.  This leads to numbness and some color variations and occasionally doesn't survive.