Is It Safe to Get DD Cup Breasts Down to B Cups?

Question

Hello. I am a 16 year old, I weight about 150 and I'm about 5'9" with size double D breasts and I was thinking of getting Breast reduction as soon as I turn 19 because a lot of people said I should get it done then because that is when the breasts generally stop growing.My real question is: can I get my double D's to a B cup without harming my body in anyway?

Shahram Salemy, MD, FACS · Answer

The key to determining if breast reduction surgery is right for you is to understand clearly the advantages and disadvantages of having the procedure at a young age.  The advantages include the possibility of reducing your upper back and neck pain, more comfort and symmetry in clothing, and a better, more balanced overall shape and size to the breasts.  The disadvantages include scars that are permanent (although with time they tend to become less noticeable), a risk of loss of sensation to the nipples, and a risk of reducing the ability to breast feed.  These all have to carefully discussed with your surgeon and carefully considered before you go forward with the procedure.
The other part of your question gets to the question of final breast size.  I think it is very difficult to predict or guarantee a final size, and most surgeons instead attempt to creat breasts that are smaller, better shaped, and more in balance with the rest of the patient's body, and to do so safely-- remember, the smaller the size, the greater the risk becomes to the blood supply and the healing of the nipple.
In short, I would just recommend having a careful discussion with your surgeon about the pros and cons of the procedure, take your time in deciding whether or not you want it, and if you do decide to proceed, do so only when you are confident of the results you want and that you can accept the downsides of the procedure.
Good luck!

Tom J. Pousti, MD · Answer

Thank you for the question.

	It sounds like  you are dealing with juvenile breast hypertrophy along with the physical and psychosocial consequences of this diagnosis. In other words, the breasts are too large for the frame causing  both physical and psychological distress.

	As  you think  about  breast reduction surgery make sure you do your homework and understand the potential risks and complications associated with  the procedure.  Unsatisfactory scarring is  one of the potential complications. Make sure you also understands that further surgery may be necessary in the future (for example if the breasts were to grow in size again).

	On the other hand, breast reduction surgery is one of the most patient pleasing operations we perform and I think that for the right teenager (enough symptoms) it may be an excellent option (regardless of the age).

	It is possible to reduce the breasts size very significantly.   Sometimes  when patients want &ldquo;almost nothing left&rdquo;  the reduction should be done in 2 stages.  The concern with the amount of tissue removed is related to blood flow to the remaining tissue;  if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola)  may be compromised.   Part of the tissue that is left in place is called the &ldquo;pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue. If the pedicle is made too small (in the effort to reduce the breasts as much as possible)  then patient will likely have problems with tissue survival.  Doing the procedure in more than one stage allows the tissues to  acclimate to the surgically decreased blood flow before  further tissue removal (and potentially further decreased blood flow)  occurs ( with the 2nd stage operation).

	The other concern with overly aggressive breast reduction surgery is patient dissatisfaction  afterwards.  It is not unusual for patients who have lived with very large breasts to want to have as much as possible removed. Care must be taken to be judicious in this removal to avoid an outcome where the breasts  are too small in relation (proportionately) to the patient's other body parts.  Again, it is not uncommon, for patients'  breasts to become smaller ( after the breast reduction procedure) with time and/or weight loss-  breast augmentation may become necessary to achieve the patient size goals.
	 

	Sometimes breast  reduction surgery is covered through health insurance. The best way to obtain insurance coverage for breast reduction surgery involves some &ldquo;hoops&rdquo; to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance &ldquo;authorization&rdquo; for the procedure. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.

	Make sure you are working with a well-trained/experienced board-certified plastic surgeon. 

	I hope this helps.

Steven Wallach, MD · Answer

A breast reduction should wait in your case until you are of adult size. That may be today or in a few years.  Be that as it may, going from a DD to a B is probably not realistic, because in order for the breast to heal properly you need to have a certain amount of tissue attached to the breast skin and the nipple areola. Probably a "C" cup is more realistic.

Peter A. Aldea, MD · Answer

Yes. It IS safe to do so. Depending on the surgeon, the surgery is usually done with little blood losses.
The OTHER question you touch upon is SHOULD it be reduced to a B cup? And HOW will it impact on your future?
In MY opinion IF large breasts severely limit your life, you should consider having them reduced. The amount removed would depend on your breasts, your size and the requirements of your insurance company. Large breasts should be reduced to an acceptable appearance NOT to a preconceived, wildly inaccurate bra cup size.
You must be aware that a breast reduction MAY make it hard if not impossible for you to breast feed when you have babies.You should consider that carefully before having the operation.
Good Luck.

Steven Schuster, MD, FACS · Answer

Dear MissJoy
A commonly asked question by teens is when can I have the surgery for breast reduction.  A lot of that depends on the individual.  If a patient has symtoms of back pain neck pain and bra strap grooving, and they are of a reasonable weight, they MAY be a candidate.  I also ask if their breast size has been stable for at least six months.
Teenage women are often embarrassed  by overly large breast and request the surgery. It does not sound as if you are overweight so losing weight will probably not have a significant effect.
The breast reduction technique I usually use is a lollipop technique without scars under the breast just around the areolar and straight down.  But sometimes, I can perform a liposuction breast reduction in the right candidate and have used this technique on 6 or 7 young women.
Schedule a consultation with a board certified plastic surgeon to sit down to discuss the procedure and options for you in particular.  Good luck on your quest.
Steven Schuster MD FACS

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