Will Taking 800grams off Each Breast Make Me Too Small? (photo)

I am 5'6", weight 200lbs Wear a size 36JJ bra. I have worn the same bra size even when I weighed 20 pounds less. My insurance has approved my breast reduction, for 800grams each. I am fine with that but when I asked the office what size I might end up, she said the Dr. said a Large A to Small B. I'm not a small person nor will I be, this was tramatically small. Other people I have heard of were only a G cup and 800grams each took them to a C. Which is my ideal size. Am I worrying over nothing?

Doctor Answers 11

Will Taking 800grams off Each Breast Make Me Too Small? (photo)

Thanks for the posted photos. I would err on the side of less than 800 gms, maybe around 500 to 600 gms. 

Breast Reduction

Breast Reduction is a complicated procedure that is best done by those with the most training and experience. It is very difficult to determine the resultant cup size and shape based solely on the number of grams that are removed from your breast to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast reduction and lift surgeries, including different approaches, techniques and even fat transfer and implant choices if you are lacking superior breast fullness.
This is because several measurements—not to mention breast characteristics such as density—are needed to determine how much and where to remove breast tissue to meet your goals. Without knowing your existing breast shape, dimensions, and the density of your breast tissue, it would be difficult to make this determination. For example, the same volume of breast tissue will weigh different amounts (measured in ounces or grams) in different people depending on its density. The existing base width of your breast and what you will ultimately want to look like will determine, in many cases, the maximal volume and weight that will need to be removed for the best result.

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Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 102 reviews

800 gram minumum for breast reduction

It is difficult to say but after an 800 gram breast reduction you will probably have a B cup.  If you do not want to be this small, you can have the procedure performed as a cosmetic surgery and the surgeon is then not required to remove a certain amount on each side. Best of Luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 101 reviews

Too small with 800g removal?

It is difficult to say, as the weight of your breasts weight is determined by how dense the tissue is.  I would think a C cup would be best for proportion and I would estimate by your photos that this would be less than 800g per breast.  It is a difficult position for the surgeon to have to take this amount to get insurance coverage and possibly make you smaller than you would like.  It is difficult to accurately predict what size bra you will be, but if you definitely don't want to be an A- to small B, then I would talk to your surgeon to get clarification on the plan. Are you willing to have the insurance company reject the claim and leave you paying for the surgery if 800g are not removed?

Marialyn Sardo, MD
La Jolla Plastic Surgeon
5.0 out of 5 stars 5 reviews

Be careful what you agree to

Hi there-

In my long experience doing a lot of breast surgery, I can tell you that too often it seems patients and surgeons agree to remove amounts of tissue from patient's breasts that precludes their long term happiness.

In other words, I always worry that in the interests of getting the insurance company to agree to pay for the operation, we forget what the patient wants.

This sometimes can lead to you being unhappy with your breasts- or even feeling like you need implants down the road to achieve what you wanted in the first place.

Without examining you, it is difficult to say whether the planned excision is going to achieve your goals or not, because this requires an understanding of the density of your breast tissue (something I could only learn from examining you).

Your best bet is to be open and honest with your surgeon about your goals for breast size AND appearance. Ask them directly- "Do you think that if we do what the insurer wants us to do that my goals are possible or likely?"

If you and your surgeon feel that removing this amount of tissue will still allow the approximation of your goals, then great- but if either of you believe that your goals may suffer in order to make the insurer happy, believe me you are better off saving your pennies until you can afford to pay to have the operation done in a way that results in YOUR long term satisfaction.

Never an A-cup after breast reduction

Given the skin excess and base width of the breast, my bet is that you will still wear a D-cup after breast reduction, even 800 grams. Go out and look at C-cups (an A-cup!) at the store and imagine fitting into one. Your goal with reduction should be comfort with a pretty shape, volume, and projection, in a bra you can buy 'off the rack'.

Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 38 reviews

Breast reduction

Erin, a breast reduction surgery is not about taking off a specified number of grams. The surgery is performed to create a more comfortable and appropriately sized breast. When that is accomplished and the surgery is complete we weight the tissue. The weight should be determined AFTER the operation. That said, the insurance companies often ask the doctor to estimate the weight to be removed so the insurance can tell if the patient is covered based on the insurance company's contract. The weights they require have absolutly no basis in reality and are only their way of limiting who gets the surgery. We give them an estimate of what we think might be removed but do not do the surgery to get that amount of weight off, we do the surgery to get the right size and look. Although a patient may request a cup size, that is only a guideline for the surgeon. There is no way we can guarantee a cup size.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 22 reviews

Insurance vs self pay breast reduction

Dear Erin,

I sincerely doubt removing 800g will leave you with an A cup. However, you are wanting to know what your 'ideal' size would be. That needs to be  determined by you and what your demensions are. That being said, what your insurance co. requires to be removed and what your 'ideal' size would be, may be two very different things. If you cannot finance your reduction, I strongly suggest you come to terms with what your insurance dictates. This is, unfortunately, the ugly reality of our health care system. Best of luck to you, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.5 out of 5 stars 193 reviews

Breast cup size after Breast Reduction?

Thank you for the question and pictures. Congratulations on deciding to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform.

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.  There is also no “ideal size”;  every patient has different goals. I would agree with you that achieving breasts that same proportion to your body type will be in your best interest.

Communication with your plastic surgeon will be important  prior to surgery. 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. 


Best wishes.

You are lucky that 800 gram (per breast) breast reduction should give you a nice size.

Hi.

Anything smaller than a C cup would not look good on you, and your surgeon should not make you too small just to meet an insurance requirement.  But just going by your pictures, I think it won't be a problem and you will be fine.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 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.