Currently 40DDD and want to be a C cup. Surgeon said he can't safely make breasts that small - why?

Breast reductions may be limited by the preop degree of sagging. When performing a breast reduction, the nipple usually is attached to a pedicle to maintain blood supply to the nipple. If the nipple has to go a far distance to get to the new position, there may be limitation to the amount of tissue removed and ability to keep the nipple viable.
Plastic surgeons often don't guarantee a cup size- each bra is manufactured differently and each patients anatomy is unique.

Hi,
Thank you for the question.
Based on what you are describing, it does sound that you have large/heavy breasts causing physical symptoms, and breast reduction may be an option for you. However, it is difficult to tell without seeing the photos and/or in person consultation.
During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller. It is easiest to think of breast reduction as including the breast lift.
Schnur Sliding Scale is a scale used by many insurance companies as a guideline for how much breast tissue should be removed in order to improve your physical symptoms. In addition, most insurances in order to approve the surgery, will require for 2-3 letters of medical necessity (from your chiropractor, primary doctor, OBGYN, Dermatologist, etc) demonstrating that your physical symptoms due to large breasts are not improving with conservative management.
The goal of breast reduction surgery it to make the breasts smaller and lifted, but also proportionate with the rest of your body. It is reasonable to to expect full C/small D cup breast size after the breast reduction surgery.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Thanks for the question. this this always an interesting discussion in breast reduction consultation. As i explain this operation can not guarantee any cup size. It is done preserving blood supply to the nipple areola complex and desired size can be achieved maintaining adequate breast size suitable for the frame. Cup size C is achievable after breast reduction surgeries and better idea can arrived at following examination and measurements.

Thanks for your question! Depending on how much droop you have, how wide the breast is, etc., that is probably why he made that recommendation. Ultimately, we need to maintain blood supply to the nipple and give you a good aesthetic result as well. You can always seek a second opinion! Good luck!

At size 40, each 300 grams removed corresponds to 1 cup size change. To go from a DDD to a C would require 900 grams removed which corresponds to 2 lbs per side. This is a large amount, may be excessive and may injury the blood supply or nerve supply to the nipple-areola complex. This may also be disproportionate to your body. The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Your surgeon wants to be in the cautious side and I don't blame him. It's easy to over reduce the breasts and if they end up too small they won't look good at all.

There is concern with nipple blood supply when you go too small as compared to the previous size. I would have to examine you to determine if this concern applies to your case. There could also be an issue with your general appearance and not making the breasts to small for your body. Again an examination is necessary to answer this question.

When a surgeon is doing a breast reduction the most important steps in the operating room are to make sure that the tissue you leave behind has enough blood supply to heal. Wound healing and nipple blood supply are crucial to a good result. So resecting too much tissue can thin the skin that we leave behind and then it can necrose or die. Same with the nipple .

That being said I hate promising a cup size, find a surgeon who can show you photos of someone similar in size to you and see how small they can make you. I tell my patients who want to be as small as possible that I will do that without compromising wound healing or blood supply to the nipple. Sometimes its a C sometimes larger, but they are always smaller and lifted. And, I can't remember a patient who didn't get almost immediate relief from back pain. Good luck, Jane

Dear Jen H.,
Breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It's difficult to determine exactly why the surgeon felt you weren't a candidate to reduce to a C cup size without an examination. It could be due to the size or width of the breasts. It also could be the quality of your tissues. Maintaining adequate blood supply to the tissues is essential during this procedure. Removing too much tissue can compromise this. I encourage you to call back to speak to the surgeon again for further clarification.