Breast reduction a good option for 30ddd? (Photo)

Question

I have always been bothered by the size and asymmetry of my breasts. I'm 26 years old, 5'3", 105 pounds, and my breasts are a 30ddd. I've been considering a breast reduction for many years now. Is this something that could be suitable for my breasts and proportions? Ideally I would Like to be around a 30c. Also, if I did try insurance my provider goes by the Schnur scale, and I would need about 250g taken from each breast. Does this amount seem reasonable for what I want?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your picture.  In my opinion you would benefit from reduction.  If your left breast is the only issue for you then a left reduction to match the right breast would be reasonable.  If your size overall bothers you then both breasts can be reduced for volume and symmetry.  The insurance mandate of 250 g can be accomplished but your size would be considerably smaller.  Consult with several board certified plastic surgeons.  Best wishes.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best size you will need (recommended based on your photos) or the exact size and shape implant you will require 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 augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Gary M. Horndeski, MD · Answer

Thank you for you question and photo,The Horndeski Method/The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Horndeski Method/The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  Unfortunately, we do not accept insurance for breast reductions.  Dr. Horndeski does not remove enough breast tissue to meet insurance criteria.  Instead, he utilizes the breast tissue to reshape the breast.  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Ellen A. Mahony, MD · Answer

A good starting point is to define your goals:  would you like your breasts to be the size of your Right breast?  Or, would you like them both to be smaller?Those issues effect how much breast tissue is removed and the type of procedure that is performed.  It is very common to do two different types of reductions on each side to create symmetry.As far as insurance coverage is concerned, obtaining authorization from your carrier in advance of the surgery is not a guarantee that they will ultimately reimburse your surgery.  In any event, a letter and photographs need to be sent to them in advance of the surgery to get that determination.  Cup size is impossible to predict.  Manufacturers vary between 3 cups sizes - you can test this now by trying on bras from 3 different brands- your size will most likely vary.Good luck!In good health,Ellen Mahony, MD

Curtis Wong, MD · Answer

and estimation of how much tissue can be removed in order to see if you could qualify for a medically covered reduction.  But if you are happy with your perkier side, you could also just have a lift/reduction of your droopier side to improve your symmetry and you will only have 50% of the scarring and risks from having both sides done.  And your untouched side will give you a better chance at breast feeding if that is important to you.  But this would be considered cosmetic.

Jean Paul Giudicelli Saba, MD · Answer

Hi, thanks for sharing your concern and photos with us!
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!
  
Looking at your photos I might say that you´ll be a great candidate to get an entire abdomen, back, back and waist liposuction with BBL, this is because you have located fat that can be done with lipo.
  
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.
  
Have a great day! 
  
Dr. JPG

Angela Keen, MD · Answer

Given that you have both thought about surgical breast reduction for size and asymmetry for many years now, and are also clearly at a very healthy body weight and therefore with no other option to offload pressure on your upper back and shoulders, you are an extraordinarily good candidate for breast reduction. Insurance is becoming less and less reliable as a means to cover your surgery. Without examining you in person, it's hard to guarantee the volume they require. Guarantee of a cup size is impossible and so is perfect symmetry. Having said that, you should expect to have an outcome much closer in symmetry and much more manageable in terms of size. Most breast reduction patients have had a tendency to wear bras that are too small for them in an effort to maximize stability. Don't be depressed if you are still a D after even a significant tissue reduction. I try very hard with my reduction patients to leave them with a size which will maintain its lifted position, which will heal well, and which will have good nipple sensation and funciton.

Terrence Murphy, MD · Answer

Based on your photos I think that you likely would be a good candidate for a breast reduction which would both decrease the size of your breasts and help even out your asymmetry. It is difficult to predict cup size with a breast reduction so be sure to discuss in detail with your chosen surgeon. In my experience removing the amount of tissue required  to please the insurance company is more likely to lead to a dissatisfied patient. Be sure to discuss this with your surgeon as well.

Tom J. Pousti, MD · Answer

Thank you for the question and picture. Based on your photograph and description of concerns, you may be an excellent candidate for breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.
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.  There is simply too much variability among bra cup manufactures to make it a useful metric when it comes to preoperative communication and/or post operative predictions.
Having said that, I would share your plastic surgeon's concerns that the 250 g reduction may leave you smaller than you wish to be (at least on the smaller side).  In other words, you may benefit from a smaller reduction/lifting operation.
Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). Most patients wish to achieve enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. 
With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small) very helpful. For example, I have found that the use of words such as “natural” or “C cup” 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. 
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you with an estimation of how much tissue will need to be removed, in order to achieve your desired outcome.
Best wishes with your breast reduction procedure; hopefully you will be very pleased with the outcome of the procedure performed.

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