I Am 5'1" and a 34G. I Want to Be a C, but the Dr. Says D. Doesn't He Do What I Want? (photo)

Hi there-

It is very important for you to understand that while Board Certified Plastic Surgeons may sometimes seem like miracle workers, we are, in fact limited by the human anatomy and the limits of safety.

If the goal is to end up with attractive breasts in which all of the breast tissue is healthy and both nipples are present and alive, there is only so much that a breast can be reduced...

It sounds like your surgeon is simply trying to help you understand that your goals for your breasts may not be safely possible to achieve. 

Your posted photo does not help to give me an idea of the appearance of your breasts. Seek in person second opinions from boarded PSs in Cleveland. 

There are a few issues for you to consider regarding reducing your breasts to a much smaller size. There are no accepted standards that dictate a particular breast volume translates to a specific cup size. That is why one company's "C" cup may fit identical to another company's "D" cup. As a consequence, it is possible that you and your doctor are thinking about the same/similar breast size but are attributing to it different cup sizes. Be clear with your plastic surgeon in regard to proportionality.

The next issue is that the outcome from surgery may not be entirely predictable. You may be in a range that could be "C" or "D" and your doctor is just making sure that you won't necessarily be disappointed if you end up slightly larger.

Finally, given your very large size, a greater reduction may translate to a greater risk of inadequate blood supply issues such as to the nipple where its viability can be compromised. Therefore, reducing slightly less may lower your risk for this problem which is definitely a worthy trade-off. 

I hear you. You would like to go as small as possible because you want more children. Cup sizes vary based on the bra manufacturer. To achieve a smaller reduction, you may need the inferior pedicle approach but this should not be a problem. Since you both may be thinking alike and expressing it differently, I recommend that you ask your plastic surgeon to show you a series of pre and post op photos so you can visualize possible results. Best of luck!

Thank you for the question.

Unfortunately, no plastic surgeon is able to predict exactly what cup size you will be after breast reduction surgery. As you know, cup sizes vary depending on who makes the bra; this makes discussing cup size an inaccurate way of communicating your goals.  

Also, every patient's chest width varies;  if the patient has a wide chest wall it may not be possible to achieve a smaller width  or cup size.

In my practice I use goal pictures to communicate with patients.  With this technique patients are able to demonstrate what they are trying to achieve and what type of looks they do not like as well.   The patient's goal pictures are hanging on the wall, and allow for direct comparison.
 I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 


Congratulations on your decision to proceed with breast reduction surgery;  it is one of the most patient pleasing operations plastic surgeons perform.

Best wishes.

patient Q:  I Am 5'1" and a 34G. I Want to Be a C, but the Dr. Says D. Doesn't He Do What I Want?

Choosing the desired size with a breast reduction is certainly not an exact science.  The patient's body habitus, breast skin, shape and tissue, as well as the patient's desire must all be considered carefully.  It is not simply a matter of choosing what you want.  The determination is made by an interaction between surgeon and patient and you must feel comfortable with that choice.  Also remember, that cup sizes are not strict size determinations as bras differ widely and therefore your cup size may differ significantly based on the type and make of bra you purchase.  The physician may feel that a C cup will be too small for you, but it is not a bad idea to see more than one physician to find one you are most comfortable with, preferrably board certified plastic surgeons to assure that the doctor as the best training possible to deliver the best care possible.

 

good luck

I disagree with the answers so far regarding what a breast can be reduced to. It can be reduced to nothing as in a mastectomy. Using an inferior glandular pedicle technique with or without a vertical skin takeout and resulting lollipop incision (compared to the Wise pattern or anchor skin excision/scar) is should be possible to reduce the breast to a size within the normal range such as a C-cup. An extreme reduction might require a free nipple-areola graft as well. A C cup is appropriate to eliminate size/weight and functional symptoms caused by the breast. The problem is that it is hard to achieve an exact size during the reduction or after the procedure as there is no standard for cup sizes. 

Your photo is not helpful here but please understand that your doctor is trying to be honest in telling you that you can't dictate a cup size to him and that if you have a wide G sized breast the width alone will probably never allow you to get down to a C cup.