Schnur Sliding Scale for Breast Reduction

My insurance company states according to the Schnur Sliding scale, I would need 527 grams removed from each breast as one criteria. I am currently a 38DD with severe upper back and shoulder pain. What size would I become if the 527 grams were removed from each breast.

Doctor Answers 12

Very small breasts after 527 gram breast reduction.

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In breast reduction, the goal is to create attractive breasts of the right size.  If your measurements are correct, you would end up with a small B cup, based on my experience.  I probably would not do it.  I know this not what you wanted to hear.

Manhattan Plastic Surgeon

Breast Reduction

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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.

Please click on the link below for more information!

Insurance Companies May Use Schnour Sliding Scale for Breast Reduction

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It’s not unusual for insurance carriers to require that minimal amounts of breast tissue be removed during breast reduction. This amount varies from insurance carrier to insurance carrier. Many insurance companies now use the Schnour Sliding Scale to make this determination. This scale adjusts the tissue removal requirements based on weight/height calculations. In many cases, the resultant weight criteria may be in direct conflict with the patient’s aesthetic goals.


         Unfortunately, without the ability to view pictures or perform a physical exam it’s virtually impossible to estimate your final breast size. This is further complicated by the fact that cup size tends to mean different things to different people and is a frequent source of confusion.


         Based on your history it would be reasonable to estimate a C cup, but this is only an estimate. It’s important to discuss this issue with your plastic surgeon. Your surgeon should be able to give you some insight into your final breast size after a 527 gram breast reduction.

Breast Reduction and Resulting Cup Size?

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Congratulations on your decision to proceed with breast reduction surgery. It is one of the most patient pleasing operations we performed. 

Unfortunately, there is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery.

Before undergoing the breast reduction procedure it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

Best wishes.

Predicting postoperative size

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Most women don't wear the correct size bra, so I'm not even sure you're really a DD cup.  Also, skin fills a bra cup, just as breast tissue does.  Without an exam, or at least some good photos, it's impossible to predict a postoperative size after removal of 527g of tissue from each breast.  Your plastic surgeon should be able to give you a good estimate when you meet for consultation, though.  Best wishes!

How much tissue to remove during a breast reduction

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Patients today have many great options to effectively reduce and contour their breasts. In our practice, we work closely with patients to understand what their goals are and how much breast tissue is necessary to alleviate any pain symptoms that they may have and to obtain the look that they are looking for. Before the surgery, we can sometimes give an estimate as to how much tissue will be removed. However, there is no exact way to determine how much breast tissue will be resected. Be sure that you review your insurance policy and how closely with your plastic surgeon about your goals. Remember that these are the breasts that you will live with aunt is more important for you to obtain the results that you are looking for then to satisfy a meaningless number for an insurance company.

Size after breast reduction

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It is very difficult to predict your final cup size after reduction even after examining you.  This is because each bra company is different. However, a rough estimate can be predicted after an exam.

Full C size

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Most plastic surgeons still feel frustrated that they have to change their operative plan based on the number of grams to be removed from the breast.

In general, every cup size is 150-250gm. Your 527 gm excision will give you a full D/Small D cup size. Best of luck!

Schnur Sliding Scale for breast reduction

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Dr. Schnur, former President of the American Society of Plastic (and Reconstructive) Surgeons came up with this formula to get insurance company to stop demanding that 500 gm be removed from each reduced breast regardless of the woman's size. The formula weight with body surface area which is a fairer more accurate way of getting More from larger women and less from smaller women as as not forcing insurance companies to pay for minimal breast reductions / or breast lifts.

Obviously, it would be presumptuous of me without the benefit of an examination, or even several photographs, to predict your post-operative cup size after removal of 527gm. No one can do it. Moreover, even with an examination it would be an educated guess not a promise.

That being said, it has been my experience that it would still comfortably leave you in a C cup range.

Discuss this with your Plastic surgeons and see what he/she says.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Insurance Coverage of Breast Reduction

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Quite often insurance companies today are using the Schnur article, which was written several years ago, to help determine whether or not to cover breast reduction surgery. I cannot state exactly what your cup size would be following a bilateral reduction of 527 grams without a physical exam, but my best guess would be a C cup. You should obtain a consultation with a board-cerified Plastic Surgeon in your community.

John Whitt, MD (retired)
Louisville Plastic Surgeon

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.