Do I need a breast reduction if I want to only lose a cup size? (Photo)

The amount of tissue removed during a breast lift is minimal, therefore you may be about the same size as you are now. However, some women find that after a lift, their bras don’t fit comfortably. While technically, their breasts have the same volume, they may find a different sized bra fits more comfortably.

A lift reshapes the breasts so they’re perkier, therefore implants may not be necessary if your goal is to add volume to the upper pole. A lift alone may be sufficient.

When we perform breast uplift surgery, your breasts automatically go down a size as we are removing considerable amounts of tissue from your breasts. Due to excessive sagging in your breasts, I recommend getting implants at least 6 months after your breast implant surgery.

If you only want to go down one cup size and wish for more upper pole fullness, a mastopexy or breast lift would be a better option. During this, plastic surgeons remove mostly skin and a small amount of breast tissue to reshape the breasts. Depending on the amount of lift needed, an implant may be delayed to a second stage 2-3 months after the first surgery to preserve the blood supply to your nipples. Another option for more superior pole fullness during the time of a breast lift or reduction is performing fat grafting. This is where we harvest fat using liposuction and then inject it into another area of the body. Generally, about 50% of the fat transferred melts away and 50% stays in place.

Thanks so much for your question,

If you want to go down a cup size and improve upper pole fullness, the ideal approach might be a combination of: Breast lift to achieve the desired shape and positioning, a minor reduction to remove a small amount of tissue for a one-cup-size decrease and Implant placement for upper pole enhancement, especially if volume loss is a concern.

Remember that bra sizing isn’t standardized. A reduction to a "D" cup may not be dramatically different in appearance, depending on your body frame and ribcage width.

Schedule a consultation with a Board Certified Plastic Surgeon to discuss your goals. They will evaluate your breast tissue, skin quality, and body proportions.

Sincerely,
Dr. Emmanuel Mallol

When looking at your photo the first thing I would recommend is a breast lift. A lot of times women do not realize that the majority of their cup size is all of the excess skin, and just by getting rid of all of that excess skin and bringing the breast tissue back up to where it needs to be will make you lose a cup size alone. I would recommend a lift with a small implant to give you the upper pole fullness. It is always best to see a licensed professional in person before making any final decisions. Could you also do a reduction along with all of that, yes you could. It would best be determined after examination at an in office visit.

Breast reduction and breast lift procedures have many similarities, but the main difference lies in their objectives. The goal of breast reduction surgery is to make the breasts smaller and lifted and address issues like discomfort from their weight. In contrast, a breast lift focuses on improving breast shape by correcting sagging or droopiness (ptosis) without making significant changes to the overall size. With both procedures, your breasts and nipples would be in a much better position and higher on your chest.
For insurance-based breast reduction surgery, the Schnur Scale is often used as a guideline for how much breast tissue to be removed for the surgery to be considered a medical necessity (demonstrating that your physical symptoms due to large breasts are not improving with conservative management).
You should not need implant if you desire to go down in breast size, because a breast implant will increase your breast size.
Make sure to consult with a plastic surgeon specializing in breast reduction surgery to discuss the best approach for your unique anatomy, concerns, and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

To rejuvenate your breasts, you will have to lose some volume. But the volume lost is the heavier, lower part of the breast. Generally speaking, you will end up a "C" cup with improved shape, better proportion and lift and less skin-on-skin contact. The usual scenario is that we cannot make patients small enough in one operation. I would not hesitate to proceed, but it would behoove you to look at some before-and-after photos so you can be confident in moving forward. Thank you.

Hi Faye. By your photos, you are a great candidate for a breast lift! The actual procedure will really depend on what your ultimate size goal is. If you generally like the size of your breasts (ie, do you like they look in clothing in a supportive bra), then you may only need a breast lift (mastopexy). For these patients, I do a tissue sparing technique, which essentially an auto-augmentation, conserving all of your breast tissue, but lifting the overall breast and bringing the nipple-areola to a higher, more aesthetic position. I typically use some type of absorbable mesh with this procedure to create an internal support bra and maintain the results over time. If your goal breast size is indeed smaller than your current volume, then a reduction, removing a certain amount of tissue is your best bet.
I would still perform the lift and use mesh for internal support. Either way, the procedure would result in a lifted breast with a rounded upper pole of your breast without needing an implant. Hope this helps! Best of luck in your aesthetic journey!

Thanks for your question! You are going to need a reduction and not just a lift. Almost all of your breast tissue is below the inframammary fold so a lot of that needs to be unloaded. Then, you can come back in 3 months for an implant of a moderate size to get some upper pole fullness. Good luck!

Hi,

Thank you for the question.

Based on your photos, you appear to be a great candidate for breast reduction surgery. During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller. It is easiest to think of breast reduction as including the breast lift.

Schnur Sliding Scale is a scale used by many insurance companies as a guideline for how much breast tissue should be removed in order to improve your physical symptoms. In addition, most insurances in order to approve the surgery, will require for 1-3 letters of medical necessity (from your chiropractor, primary doctor, OBGYN, Dermatologist, etc) demonstrating that your physical symptoms due to large breasts are not improving with conservative management.

The goal of breast reduction surgery it to make the breasts smaller and lifted, but also proportionate with the rest of your body. It is reasonable to to expect full C/small D cup breast size after the breast reduction surgery.

You should not need implant if you desire to go down in breast size, because breast implant will increase your breast size.

I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.

I hope this helps.
Best regards, Dr. Karanetz

Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon
Queens, New York
(516) 833 0309