Reduction question, how much is too much to reduce? (photos)

I am scheduled to have my breast reduction in about 6 weeks. My stats are female 55yrs old, 5'6, 205 lbs, 38DDD and I want to reduce to a full size B or small C. Nothing larger than a C, I explained this to my surgeon and he said to me to get the bra size I want and he will do everything he can to make it fit. He stated he will remove 819gm from each side. Question' is it reasonable for me to ask my doctor to reduce me so much? I have been enormous my entire life.

Doctor Answers 4

Reduction question, how much is too much to reduce?

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Dear lamUR2,
A fair amount of excess size that you are experiencing is due to skin redundancy or droop, and the lifting portion of the procedure will also reduce the apparent size without adding a lot of volume to the scale. It can be very difficult to communicate size goals, so there are a few things that I like to do with my patients to be sure we are on the the same page regarding results. First I like to use my hands to cover a portion of the breast and reshape what is visable to get an idea of what the patient likes on their frame. I also like to speak in terms of percentages of what will be removed (for example a patient can say they would like to be half their current size). Lastly I like patients to look at bra's that have an appropriate band width that fits them comfortably (the same as their current bra or even one size larger since large breasted women typically pick a very tight band width for increased support). Within that band width find the size that fits, then look at the smaller cup sizes in that same band width and see what you think might be appropriate for your frame. Bring the "goal bra" to the pre-op and day of surgery so that it can be used as a point of reference.
This is a great surgery! Best of luck,

Denver Plastic Surgeon
4.8 out of 5 stars 25 reviews

Breast reduction and how much is too much to reduce.

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Thank you for your question and it sounds like you are good candidate for this procedure.  Your surgeon is right about what he wants to do and the amount removed is an estimate based on what you start with and what you want as a final result.  The number grams removed is not as important as shape and proportions of your body.  You want something that is proportional to you.  Focusing on the cup size may not look good on you if that is your only concern.  The purpose of this surgery is to remove the weight and secondly to give you a better shape.  Since you did not show photos of your body shape it is difficult to tell you what should be done.  I would focus on the improvement of your life, ability to be more active and where comfortable clothes.

John D. Smoot, MD
La Jolla Plastic Surgeon
4.7 out of 5 stars 14 reviews

Reduction question, how much is too much to reduce?

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While I have done a lot of breast reduction procedures over the past 30 years I can tell you for a fact we plastic surgeons cannot tell you an exact amount of weight we are going to remove, nor can we create a specific cup size. Our goal in this operation is twofold - looks and comfort for the patient. But there is a limit as to how much we can remove on a specific patient because tissue has to be left behind in specific areas both to create shape and to make sure adequate blood flow remains to allow the tissues to heal well. The weight of the tissue removed and the final cup size are not related and will differ with every patient. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Reduction question, how much is too much to reduce?

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Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.

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. Part of the 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.

There is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery. There is simply too much variability among bra cup manufactures to make it a useful metric when it comes to preoperative communication and/or post operative predictions.
 Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). Most patients wish to achieve enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small) very helpful. For example, I have found that the use of words such as “natural” or “B or C cup” means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you with an estimation of how much tissue will need to be removed, in order to achieve your desired outcome.
Best wishes with your breast reduction procedure; hopefully you will be very pleased with the outcome of the procedure performed.

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.