I am an 18 year old girl who is 5'1, 170lbs and a 36I cup; would I be able to go down to a small C cup or is this too drastic?

Thanks for your question.After having analyzed all the information provided to us, i can realize that you have very large breasts for your height and weight, and can be responsible for head, back, neck and shoulder pain.

In the future may cause  permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts). For for this reasons, certainly you need a breast reduction surgery.I recommend you to send your photos to us to give you the advice you need and want. Respectfully Dr. Emmanuel Mallol

You sound like a great candidate for a breast reduction.  Often, your insurance will cover the entire cost of the surgery.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery.

Best wishes!

Dr. Desai

Obviously you sound like a good candidate for breast reduction but it is best to meet with a board certified plastic surgeon to determine if the breasts can be reduced that much. It is possible, but the anatomy has to be favorable and the only to determine that is with an exam.

You would have to be seen in person to determine if it is possible to reduce your breasts to that extent. Difficult to say without an exam.  I will say if you are truly that large, reducing you to that size might be difficult.

The goal in a patient your age is to go as small as possible. Most insurers use 19 as the cutoff point and will also require documentation of conservative medical management regardless of size. You may also face the BMI hurdle given your weight and height. Some companies will waive this for gigantomastia as opposed to conventional macromastia. See a board certified plastic surgeon who can discuss your options and is knowledgeable about insurance rules.

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery. You may be surprised to know that your goals/requests are not that unusual.   I see several patients every year who wish to achieve as small of a breast appearance outcome, for a variety of personal reasons.









 Generally speaking, it is possible to reduce the breasts size very significantly.  The concern with the amount of tissue removed is related to blood flow to the remaining tissue; if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola) may be compromised. The part of breast tissue that is left in place is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue. If the pedicle is made too small (in the effort to reduce the breasts as much as possible) then patient will likely have problems with tissue survival.    















Careful preoperative communication is critical when it comes to achieving an outcome that you will be pleased with. In my opinion, successful outcomes with  etc. surgery depend on:











1.  Careful selection of plastic surgeon (and from the surgeon's  standpoint, careful selection of patient).  I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. ***Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.











2.  Careful communication of goals ( which I will discuss further below).











3.  Skillful execution of procedure ( preoperative, intraopererative, and postoperative patient management).











In my practice, I would ask that you NOT communicate your goals, or evaluate the outcome of the procedure performed, based on cup sizes.  There is simply too much variability when it comes to bra sizes between bra manufacturers and even store employees doing the bra fitting measurements.











 Generally speaking,  for the benefit of patients undergoing breast reduction surgery:  it will be very important to communicate your size goals with your surgeon. Most patients wish to achieve a enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. Again, I suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, a “C cup” may mean different things to different people and therefore may be a source of miscommunication.











In my practice, I ask patients to communicate their goals with the help of  computer imaging and/or goal photographs,  as you have done here.  Obviously, the outcome associated with the breast surgery will not necessarily match that of goal photographs perfectly, but they do serve as a better communication tool that subjective terms such as "natural", "proportionate", "C cup"… Evaluating goal photographs also allows for a plastic surgeon to determine the consistency of the patient's goals and allows for a discussion of realistic expectations as well.  











***Needless to say, when it comes to achieving patient satisfaction with the outcome of surgery,  it is very important that a patient has consistent goals (fully decided on what she would like to achieve) and a good understanding of realistic expectations (what outcomes can and cannot be achieved). 







 Best wishes with your decision making and for an outcome that you will be very pleased with.