Is Breast Reduction of 38I to 38D Possible?

Question

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.

Jed H. Horowitz, MD, FACS · Answer

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.

Richard J. Bruneteau, MD · Answer

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.

Farbod Esmailian, MD · Answer

Once you have seen a plastic surgeon for your breast reduction, they will take pictures and do a write up and submit it to the insurance company.  They will look at your height and weight and come up with body surface area which will translate to how much breast tissue needs to be removed for this procedure to be medically necessary.
If you are  an I cup then I dont think it would be any issue getting your surgery approved under insurance.  Is it possible to get you down to a D cup?  Yes it is possible, difficult to say but it may require a free nipple graft.  Not commonly done, but in order to get your size down all the way to a D from an I cup it may require that.  Hard to say without an exam.
Good luck.

David Shafer, MD, FACS · Answer

Breast reduction is a very common procedure. The amount of tissue to be removed depends on your anatomy and the goal of the procedure. It is impossible to predict an exact post-operative size, but the goal is to meet your expectations while performing a safe surgery. Good luck.

Scott C. Sattler, MD, FACS · Answer

Contact a local plastic surgeon in your area that is board-certified and an ASPS member.
There are a few ways to estimate how much breast weight should be removed to approach a particular cup size. The estimations are based on several variables, including your height and weight, and breast measurements.
These are only estimates, but can give you an idea if the size of reduction that you desire is safe and reasonable. Remember, concentrating on cup sizes can be misleading. Its probably better to concentrate on achieving a breast size that fits your chest dimensions and will fit the clothing you prefer to wear. 
A good board-certified plastic surgeon will help you work through these decisions.

Jeffrey Zwiren, MD · Answer

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.

Robert L. Kraft, MD, FACS · Answer

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.

Tom J. Pousti, MD · Answer

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.

Steven Wallach, MD · Answer

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.

Darryl J. Blinski, MD · Answer

Hard to answer but I sure over 800 grams per side if not more. Go see 3 boarded plastic surgeons in your area to get an in person opinion. This is the best route foryou. Regards!

Is Breast Reduction of 38I to 38D Possible?

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