I am a full 38D cup & will be having a breast reduction soon

The amount of breast tissue that must be removed to fulfill insurance requirements is based on not only a whole list of subjective symptoms (that every woman with large breasts pretty much have), but also on objective factors, including height and weight (BMI). You do not give a height or weight, so your first step would be to go to an ABPS-certified plastic surgeon (preferably one who offers no-charge consultations, as I do in my office) and have an examination and the formula computed for your height and weight.Unfortunately, even if you are short and petite, and the formula comes up with a certain number of grams per breast that is the minimum to be removed in order for you to qualify form insurance coverage, most insurance carriers have a 400g (per breast) minimum that must be removed. That is nearly one pound per breast.For example, if you are 5' 3" tall and weigh 115 lbs., the formula specifies that a minimum of 270 grams per breast would need to be removed. This means that the insurance company-mandated "minimum" of 400g per breast removal would kick in. If you are taller or weigh more, then you may have to have even more than 400g per breast removed in order to qualify for insurance reimbursement. This is something you do NOT want to find out AFTER you have had the surgery and get the entire bill because your surgeon did not take off "enough."Especially because you had prior breast lift surgery, you may indeed end up being "too small" if your surgeon removes the amount mandated by the insurance company's requirements. See one or more ABPS-certified plastic surgeons who can figure out what needs to be removed based on your insurance company's requirements, and then ask to see a breast implant of that volume and try to imagine taking that amount in your hand from each breast, and what will remain. There is your answer to "Too small or not?" I suspect you may be correct in your concern, but would need your height, weight, and present breast size (as well as desired "after" size) to give you meaningful advice. Since bras all differ so much, and patients choose how they "fill" their bras differently, a "full 38D cup" really is meaningless in helping with this determination. Best wishes! Dr. Tholen

Thank you for your question and congratulations on qualifying for a medically necessary breast reduction. It is common for insurance companies to require a certain amount of
breast tissue be removed from each breast in order for the breast
reduction to be considered a medically necessary procedure covered by
insurance. The proposed amount or weight of breast tissue to be removed
is determined based on your height and weight. Often this weight
requirement is in conflict with a woman’s aesthetic goals. Insurance
companies are less concerned with the way you look. Yet physical
appearance after breast reduction surgery can have an impact on quality
of life regardless of the weight of breast tissue removed. Breast
reduction surgery is often performed as an elective procedure
without insurance coverage. Patients choosing elective cosmetic breast
reduction have control of the volume of breast tissue removed.It's not possible to estimate your result without  a consultation and a physical exam. Bra sizes are an unreliable way of measuring breast size as cup size varies with each bra manufacturer. I encourage you to seek a consultation with more than one experienced plastic surgeon to discuss your goals and to determine whether you would be satisfied with having one pound of tissue removed from each breast. Breast reduction should be considered within the context of each
individual woman’s quality of life. If you disagree with your insurance
carrier’s decision, you are entitled to multiple levels of appeal of
which you should take advantage. I wish you the best!