Too Small After Breast Reduction

Question

I had a breast reduction almost 8 wks ago and I am not happy with the size my breasts have turned out to be. They are just so much smaller then what I thought I was gonna have. I went from a 42 G to a 42 B. My dr and I discussed the size I was wanting and her and I both decided on a D..but they are no where near it and all she wants to keep telling me is true results won't come for a few months down the road..Is this the case? Thank you.

David Shafer, MD, FACS · Answer

It would be much more helpful if you could post before and after pictures.  While your surgeon cannot be 100% accurate in predicting post-operative size after breast reduction, you should be in the general range that you were expecting.  Hopefully there was not a communication error.  In any case, it is best to wait 6 months or more and see how you feel.  You do need time for the tissues to settle.  If after 6 month, you are still not happy with the volume / size of your breasts, it is possible to have implants placed to increase the size.  

	 

	Good Luck.

Tom J. Pousti, MD · Answer

Thank you for the question.

	I think it is in your best interest not to judge the results of your breast reduction surgery until you are at least 6 months out of the surgery. If at that time you still feel that you are significantly too small then breast augmentation may be a procedure to consider.

	Unfortunately, no plastic surgeon is able to predict exactly what cup size you will be after breast reduction surgery. As you know, cup sizes vary depending on who makes the bra; this makes discussing cup size an inaccurate way of communicating your goals.  
	Also, every patient's chest width varies;  if the patient has a wide chest wall it may not be possible to achieve a smaller width  or cup size.

	In my practice I use goal pictures to communicate with patients.  With this technique patients are able to demonstrate what they are trying to achieve and what type of looks they do not like as well.   The patient's goal pictures are hanging on the wall, and allow for direct comparison.  I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.  

	I hope this helps.

Tal T. Roudner, MD, FACS · Answer

It is very possible to have a reduction that reduced your breast to a smaller size then you anticipated. As time goes by and the swelling subsides you may notice that your breast actually are smaller then the size you have right now. It will take six months to one year to see the final results.

	Although it is counter-intuitive to the procedure you just had and not common, at times a breast augmentation may be the solution to your problem and may add additional fullness at the superior pole of your breast that is usually deficient in sagging or dropping breast.

	A posted picture would have been helpful!

	Good Luck

John P. Di Saia, MD · Answer

Hello,

	 

	It is true that the result isn't mature at this point but it will probably only get a bit larger over time as the skin stretches. You are unlikely to go from a B to a D cup.

	 

	Best Regards,

	John Di Saia MD

Barry L. Eppley, MD, DMD · Answer

While it will take to the six month after surgery mark to get to the final shape of your breasts, the size of your breasts are not going to dramatically change or get bigger as the tissues settle. It may well be over time that you will adjust to the new size and the change may not be as dramatic as it is right now. But it appears that there was a miscommunication as to expectations between you and your surgeon. At 6 months after surgery when all has healed that would be a good time to revisit this issue with your surgeon and see what the recommendations are.

Steven Turkeltaub, MD · Answer

It would have been helpful if you had provided pre- and postoperative photos and the technique used. However, despite this, I would give it about 4 - 6 months and then reassess. It is possible that with some decreased swelling in certain areas along with some stretching of the tissues over time,  you may obtain a more desirable appearance (though there still is a significant difference between a "B" and a "D").

	You should discuss your concern with your plastic surgeon. In the worst case scenario, a relatively small implant can be inserted later on to provide you with a size closer to that which you desired.

Carl W. "Rick" Lentz III, MD (retired) · Answer

While you can put an implant in a stretchy bra and get a good idea as to how much larger the patient would like to be, it is very difficult to actually show the patient the resultant size expected after a reduction mammoplasty. There are a number of different types of reduction mammoplasty but all make the breast smaller and elevate the nipple position. There is science to the design of the different types of reductions with understanding the blood supply and nerve supply. When it comes to the right size it becomes more of an art. It requires an in depth discussion between the surgeon and the patient. I always ask the patient if they were to be unhappy after surgery would they prefer to be left too big or made too small. This guides me in my surgical approach to the breast.

	Now you are post operative and unhappy with the size of your breasts. There will definitely be a settling of your breast over the next 6 months which will actually let your breasts look a little larger. If at that time you are still unhappy and feel you need to be bigger, there are a couple of choices. You could have implants which should work out great because you now have the new shape of your breast with your nipple areolar complex elevated and in a better position. If you want to be just a bit bigger you could have fat grafting to fill out your breasts. If you want to have even bigger breast with out an implant you could elect to use a Bravo Bra and greater fat grafting.

	I would recommend waiting for 6 months before you make any decisions.

Too Small After Breast Reduction

Answers (7)

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