Breast Reduction Surgery. Second Opinion on Size?

My daughter is 5'4'' tall & weighs 123 lbs. Her breast size is a 30F (or 30DDD). We have seen 2 surgeons regarding breast reduction surgery. One doctor recommended removing 500 gms of tissue per breast. I realize this is a standard requirement for insurace approval. The 2nd doctor said if she had 500 gms removed she would be like a mastectomy patient - she recommends approximately 284 grams per side and would like my daughter to lose about 8lbs. Should we be concerned with doctor 1s plan?

Doctor Answers 12

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.

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Breast reduction 2nd Opinion

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Most likely with a breast reduction you do not need a second opinion on size becasue you can pretty much ask for the size you want within reason and the surgeon can take more tissue if necessary

John S. Poser, MD
Gainesville Plastic Surgeon
3.8 out of 5 stars 11 reviews

Breast reduction

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It would be helpful to see photos to better advise you, but if your daughter is as large as you describe, it would be unlikely that 500 grams removed from each side would make her flat.  I find the predictin of 284 grams per side to be rather odd. How did the surgeon come up with such a precise number?

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 28 reviews

Differing Opinions regarding Breast Reduction Surgery?

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Thank you for the question.

It is unlikely that a patient with your daughter's breast size will “look like a mastectomy patient” with 500 g of breast tissue removed. Based on your description, it sounds like your first consultation was probably more accurate. I would suggest visiting with  additional well experienced board-certified plastic surgeons who can demonstrate the quality of work you are looking for. Additional consultations will give you peace of mind.

Best wishes.

Breast size and breast reductions.

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Many insurance companies do not have a set minimum for every patient (at least in Indiana). Often times it is based on the body surface area (BSA) which is calculated by height and weight. Your daughter sounds fairly petite and may qualify as a reconstructive breast reduction with less than 500 gm removal. A physical exam and predetermination letter to the insurance company estimating the amount to be removed can give good answers to your questions to see if it is covered. Good luck and continue to pursue this as this is a life-changing surgery.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast reduction and sizing

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Starting with an F cup bra, a 500 gram removal will not make your daughter look like a mastopexy patient. 500 grams is the baseline for insurance approval (and one NY carrier has just raised it to 650 grams) The insurance companies do not want to pay for breast lifts. However, and I say this as a plastic surgeon who accepts insurance proceeds for breast reduction, which are a pittance, because the operation is such a life changer, if a plastic surgeon can convince you to have a procedure which isn't covered by insurance, he or she can command 10x the insurance allowance in some cases. I would be more concerned about doctor #2's plan and motives here. I also think that you should see a third doctor in consultation. If you would like more definitive answers, please post photos.

How much reduction for breasts?

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There you have it. If you expect part of the cost to be covered by insurance then you have to comply with insurance company minimums. We don't accept insurance just for that reason. The patient should choose exactly how much reduction she wants. In general breast reduction patients want to be smaller than what's considered average, and breast augmentation patients want to be larger than average. It's the fence and the grass principle. I ask my breast reduction patients to go by a new bra in the cup size they want to be after surgery. I sterilize that bra and use it during surgery like a dress maker uses a pattern. So every patient gets exactly the result she wants, and everybody wants something different. Some want then gone completely and others come back for implants after living with the smaller breast for a while. It's OK for a patient to change her mind later. Styles change and so do opinions. You're not burning any bridges. But make sure she gets what she wants for starters. 


  Dr Foster  

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon

Breast reduction and final size

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Without an exam, it is difficult to say what she will need.  But yes, some insurance companies put a weight requirement on their payment.  

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

Breast reduction, how much to remove

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without pictures or physical examination it is impossible to predict how much can be safely removed. from what you describe your daughter seems to have very large breasts and removing 284 grams from each one will likely make no to little difference. i strongly advise you to get a 3rd opinion from a board certified plastic surgeon and look at before and after pictures of patients that had different weights removed.

Breast Reduction Surgery. Second Opinion on Size?

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It sounds very unlikely 500 gms could be removed from such a small frame, but without at least photos or an exam I really couldn't say much more than that. Many insurance companies make allowances for the patient's over all size and require less weight removal on small patients. But in my practice the majority of breast reductions have become cosmetic procedures with the patient paying just as breast enlargement patients do. The insurance companies are making it more difficult every year to get breast reduction authorization.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 28 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.