Is Breast Reduction of 38I to 38D Possible?

I have had a great deal of neck and back pain for years (I was a DD as a 10-year-old and I am now an I cup as a 41-year-old). I also have rashes under my breasts, and grooves in my shoulders from the weight even though I have fantastic bras.

I know I am a good candidate for reduction surgery and insurance has indicated they will likely approve due to these factors. I have lost 80 pounds and now weigh 190lbs only a loss of one cup size. I am wondering how much tissue is likely to be removed.

Doctor Answers 16

Technique Used to Reduce Breast Size Can Effect How "Small" You Can Go

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As plastic surgeons, we estimate how much breast tissue MAY be removed using a formula called the Schnur is based on BMI ( which is based on height and weight).  Since you did not mention your height I cannot compute the estimated amount per breast that MIGHT be removed.  Sometimes women have very dense breast tissue which weighs "heavy"; sometimes they have very fatty breast tissue which weighs "light"...therefore, sometimes the "estimated" weight does not equal the "actual" weight of tissue removed at the time of the procedure.  Typically, we don't "chase" after a number, we are focused on achieving results that are safe and look good!

That being said, certain techniques restrict how much may or may not be removed during a reduction.  For example, if I am performing a reduction by "inferior pedicle" technique (nipple/areola stay attached to a "stalk" of breast tissue attached to the chest wall, providing adequate blood supply), the remaining breast will be at least as large as that "stalk", plus the overlying tissue that is used to shape the breast.  Usually I can achieve a "C" cup in most breast reductions.  If a patient wants to be smaller than what I can make her with a pedicle technique, then a free nipple/areola grafting technique may be the procedure of choice to permit the breast mound to be made smaller, since the blood supply of the nipple/areola are no longer dependent on the pedicle, but rather will be "attached" by way of grafting.  Good Luck!


West Palm Beach Plastic Surgeon

Massive breast reduction can change your life.

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You probably need to have 1000 grams of tissue removed from each breast, and based on your picture and your story, I recommend that you have a breast reduction.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Breast Reduction Goals and Objectivies

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If you already know that your insurance would authorize your Breast Reduction, you probably already saw a Plastic surgeon who then communicated with your insurer.

First - for insurance to "cover" Breast Reduction surgery you first must have Breast Reduction benefits on your policy. (Not all policies have this coverage).

Second - Regardless of your breast size, most policies in Tennessee (and many other states) mandate you can prove 6 months of "conservative therapy" - visits to chiropractor, bra changes AND a letter from your primary care physician recommending the operation.

Third - Depending on your insurance, your Plastic surgeon MUST remove a set amount of breast tissue for the insurer to pay for it. Some companies set the weight at anywhere from 500 to 1,000 grams PER breast. Others based the amount that has to be removed on the SCHNUR scale which relates your weight and height to a projected body surface area and a pre-determined weight based on the relation of your height and weight.(If you are a BlueCross BlueShield patient this scale is posted on their website)

Your Plastic surgeon should be able to tell you how much weight needs to be removed per breast depending on the insurer.

To learn everything you need to know about BREAST REDUCTION, please follow the comprehensive link below -

Good Luck.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Breast reduction: what is possible

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Candidates for Breast Reduction surgery are women who wish to have smaller breasts to achieve a more proportional appearance or to alleviate physical discomfort. Breast reduction can correct symptoms from excessively large, heavy breasts that may cause the inability to do certain exercises, or create back, shoulder and neck pain, poor posture, bra-strap shoulder indentations and chafing or rashes under the breasts. Women experiencing these discomforts may benefit from Breast Reduction, also called Reduction Mammoplasty. Furthermore, large breasts may interfere with normal daily activities or exercise and will be more comfortable when reduced. Women who feel that their excessive breast size decreases a sense of attractiveness and self-confidence, or results in unwanted attention are also candidates.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Amount of Breast Tissue & Breast Reduction

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         Your history and pictures indicate that you would benefit from breast reduction surgery. This procedure would alleviate many of your symptoms and have long term health benefits as well. The procedure would not only reduce your breast size, but also lift your breast into a normal position.


         Unfortunately, the amount of breast tissue removed from each breast can’t be determined without knowing insurance criteria and the patient’s aesthetic goals. Both of these parameters will effect how much tissue is removed.


         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.


         The patient’s aesthetic goals also impact the amount of tissue removed. One of the most important decisions facing breast reduction patients is the final size of their breast. Most patients are striving for harmony, balance, and proportion with the surrounding anatomic structures. In other words, it’s important that their breasts fit their bodies.


         In addition, patients often have different ideas about what constitutes an attractive breast. Some patients want a natural breast with less upper breast fullness, while others want an artificial breast with more upper pole fullness.


         These factors ultimately determine the amount of breast tissue that will be removed with breast reduction surgery. It’s important to discuss these issues with your plastic surgeon before proceeding with this procedure. Your surgeon will be able to formulate a treatment plan and give you an idea of how much breast tissue will need to be removed. 

Insurance coverage for a breast reduction

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It is certainly possible that a you would be a candidate for a breast reduction. If the breast are excessively large and disproportionate to your body size and are causing neck back and shoulder pain.  All insurance plans are different about qualifying for coverage.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Very large breast reduction.

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You certainly should be qualified to have a breast reduction  because of your size and noted complaints.  The largest bra size that I have ever had for a breast reduction was a 42JJ, and the patient was reduced to a D cup.  The amount of weight removed from each breast was about3000 to 3500 grams( approximately 6.5 pounds each side.  You should be able to have a good result, but the technique may have to be a free nipple technique, meaning that the nipple and areola will be removed and moved to a higher position on the breast as  a graft rather than to remain attached to the breast.  You should ask your local Plastic Surgeon about this.


Good luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

Breast reduction sizing

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Thank you for the photograph. Your objective of reducing breast size from I to D cup is reasonable and, since more than 1000 grams would need to be removed from each side, it is quite possible that your insurer will approve the procedure without mandating physical therapy or other conservative treatment. When breasts are this large, there is only one viable treatment option and that is surgery. Seek a board certified plastic surgeon who performs the procedure regularly. It is one of the most satisfying operations I perform and has an excellent patient satisfaction rate.

Breast reduction

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Congratulations on your weight loss. I'm also happy that that your insurance company has indicated that they will cover your breast reduction surgery. It sounds like it is clearly indicated.

Breast reduction surgery is one of the most patient pleasing operations we do. Patients generally experience almost instantaneous gratification with relief of the symptoms you describe.

Unfortunately, it is not possible (without direct examination)  to give you a  estimation of the amount of tissue that will be removed from each side. Furthermore, discussing cup size is somewhat arbitrary, given that cup sizes very depending on who makes the bra.

I would suggest communicating your goals is clearly as possible (personally I like to see pictures of what breast size  the patient wishes to achieve)  with your surgeon.

Best wishes.

Breast reduction

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Going down to a "D" cup is probably reasonable if you are so larger, but a formal exam would be important to be more precise.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.