I’m 5’5, 112 lbs with very asymmetrical breasts. Does 400g removal seem appropriate? Or is that too much?

Question

Insurance approved breast reduction a few months ago and surgery is coming up soon. At time of consult, PS recommended 400g be removed from right breast, 300g from left. Since that time, I’ve gone off birth control, and my breasts have gotten noticeably smaller. Now I’m worried the amount he recommended will be too much? (And consequently insurance won’t cover..!) any thoughts- does 300g/400g still seem appropriate?

Farhad Rafizadeh, MD · Answer

It is very difficult to estimate your final breast size after a breast reduction based on the pictures. Especially selfies that distort and make your breast look bigger than they really are. It would be best to examine you to give a valid answer. It will ultimately depend on how big you want your breasts to be and the final shape with correction of asymmetry. The discussion is very important before the surgery as I would not compromise the breast shape and your desired size only based on insurance reimbursement.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures.  I would recommend having your plastic surgeon re-evaluate your breasts to determine if the original plan is still warranted.  Your insurance company most likely will not alter what they require for removal.  If that is the case you will need to discuss what the next best steps are with your surgeon.  Best wishes.

Steven Wallach, MD · Answer

It is difficult to predict the cup size from the amount of volume removed.  I would also have to examine you in person to see how much tissue I think I could remove safely and still provide you with a nice shape.

Larry Lickstein, MD · Answer

Your breast is composed of glandular tissue which is quite dense, and fatty tissue which is less dense.  In general, the closer that you are to reproductive ages, the more glandular, and consequently dense your breast will be, and the older you are, the more fatty and less dense the breast will be.  Of course, at any age, there is some variability.  If you breast is glandular and dense, a small amount of tissue will be heavier.  If you breast is fatty and less dense, a greater amount of tissue will be necessary.  Consequently, with just a picture, and without a physical exam, it is difficult to answer your question.  I would encourage you to discuss your concerns with your doctor, and as my colleague suggests, bring photos of your desired result.  If you are apprehensive or uncertain, consider a second opinion.  Best of luck!

Tom J. Pousti, MD · Answer

Thank you for the question.
There is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery.  There is simply too much variability among bra cup manufactures to make it a useful metric when it comes to preoperative communication and/or post operative predictions.
 
Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). 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. For example, I have found that the use of words such as “natural” or “B or C cup” means different things to different people and therefore prove unhelpful.  
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you with an estimation of how much tissue will need to be removed, in order to achieve your desired outcome.
Best wishes with your breast reduction procedure; hopefully you will be very pleased with the outcome of the procedure performed.

I’m 5’5, 112 lbs with very asymmetrical breasts. Does 400g removal seem appropriate? Or is that too much?

Answers (5)

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