Size 46L - How Small Can I Get with a Breast Reduction?

I am a 46 L I weigh about 270 and im 5ft 8 in tall. how small can i go realistically after a breast reduction?

Doctor Answers 9

Breast Reduction and Breast Size Afterwards?

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Thank you for the question.

Based on your description you may be a good candidate for breast reduction surgery; it may be in your best interest to drop weight first.

The concern with breast reduction surgery is always related to blood flow to the remaining breast tissue; it is important to perform the operation in such a fashion that the blood flow to the nipple/areola/breast tissue is not compromised.

Communicative goals clearly with your plastic surgeon.

Best wishes.

Weight Loss and Breast Reduction Surgery

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Your body mass index is 41 and you should consider a comprehensive weight loss regimen to get your weight in a more healthy range. Weight loss will help reduce your breast volume to some extent. In discussing breast size after breast reduction surgery your desires are of greatest importance, but bear in mind that with your height and current weight you would not want to reduce your breasts too small.

Leo Keegan, MD
Manhattan Plastic Surgeon

How small can you go with a breast reduction

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It depends upon your goals and body habitus.  If you maintain the nipple areola on a pedicle the pedicle has to be  certain size and thickness to survive. So goes for the skin as well. You would be better off losing weight first.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast reduction has functional as well as aesthetic objectives

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Like the other consultants, I agree that breast reduction has two objectives: a) relief of the functional complaints of musculoskeletal strain, skin rashes and activity restriction; and b) enhancing a woman's sense of balance of her body.  Given your height and weight, reduction to a flat chest might achieve the first objective but completely miss the second.  Consult several PS and formulate a plan of pre-operative weight reduction, prior to proceeding.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Breast reduction volume varies by technique

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The volume of breast reduction is limited by the amount of breast tissue that is needed to give enough blood supply to the nipple.  So if your breast is long and the nipple very low, more breast is needed to maintain a healthy nipple. There are ways to design the breast supporting the nipple, also called the pedicle, to decrease the length of the pedicle. It is also possible to take the nipple off completely and put it back on as a skin graft, reducing the need for the long pedicle.  These are really technically specific things for you to understand, but a consultation with your surgeon should help explain your options.  It is possible to go really small with a nice shape. Bear in mind though that you also need to consider balancing your overall body shape too.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Breast Reduction what size will I be post operatively

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You may already know that a bra cup size varies according to manufacturers.  What is right for you depends on many different factors.  

Some of the important factors in determining your postoperative size:

1.  Patients desires are of primary importance and this is discussed in preoperative consultation.  Some women are really looking for a lift and would like insurance to cover what is considered a cosmetic operation.  Insurance companies may use many different parameters.  One of the primary issues is grams of breast tissue respected and this is often determined by height, weight or B.M.I.   If enough breast tissues is not removed then an insurance company could argue that it was a cosmetic operation.  Some ladies have asked for essentially a mastectomy but In my opinion many plastic surgeons would not do such a surgery.  We can always take more but we cannot easily add your breast tissue.  Generally, women want freedom from symptoms and this normally results in an attractive postoperative appearance that is proportional to your body

2.  Nipple in relation to inframammary fold.  In the ideal setting the nipple should not be below the fold at the bottom of the breast.  We typically use the inframammary fold as a landmark for the repositioning of the nipple during surgery.  The midpoint of the humerus ( bone of the upper arm) is considered to be another ideal location for your nipple.  Nipple location is a critical part of any breast surgery because their location on the breast may enhance but also distract from an otherwise good result.

3.  Distance from collar bone to nipple of over 40cm a limit for pedicled techniques.  Longer distances would need a free nipple graft.  This requires complete removal of the nipple and similar to a skin graft placement on a viable area of breast.  This is now considered more of precaution with surgeons having success with pedicles of greater than 40cm.  Some surgeons may still stick to this rule.

4. Remember that your upper half is giving a balance to your lower half.  I tell women that are about to have a reduction that I did not make their stomach or hips larger.  The reduction of the upper half gives the illusion of the hips and lower torso increasing in size.  So patients may complain that something was added during surgery to their lower half.  

These things I learned as a plastic surgery resident and they hold true today.  I thank everyone who shared a piece of knowledge that stick with me after over 10 years.  

To answer your question, the size is what you and the surgeon can agree upon.  There is no magic device that can give you the exact cup size.   Just the trust that  we are honored to hold fulfill your desires to the best of our ability.  

Dennis J. Bang, MD
Beverly Hills Plastic Surgeon

Size result in breast reduction

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There is no actual limit. The breast can be removed entirely i.e. reduced to nothing, but that wouldn't be a reasonable solution to the problem of overly large and heavy breasts. 

In general, from a functional standpoint, the breast needs to be reduced to a full C cup (for the chest around) to solve the functional problems and get into proportion. The female chest is built to handle A, B, and C cup sized breasts, but not larger. D cups are by definition, out of proportion too. 

From a practical standpoint, average, a mid-B cup, is reasonable but may not be feasible without compromising blood supply to the nipple-areola from an overly large breast. Another factor to consider is weight loss. Losing weight will have some effect on breast size. If the breast is reduced down to a particular size and then weight loss occurs, it could look too small. In the situation you describe, I would recommend reduction to a full C cup relative to the chest measurement.

Scott L. Replogle, MD
Boulder Plastic Surgeon

Proportionate size after breast reduction

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Depending on the technique used, a surgeon can reduce the breasts to as small as size as wanted. Reducing the breasts to a very small size, however, is not usually aesthetically pleasing. It is better to reduce them to a proportionate size to your weight. You can always go smaller.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Limits of breast reduction

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IT depends on what your want and the risks you are willing to take. As more and more breast tissue is resected, there is a greater risk to compromising the blood and nerve supply to the nipple. The more agressive results could essentially be a mastectomy but then the nipple and areola would be treated as a graft and get you down to an A

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.