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Do you want to just be smaller or as free as you can from your fibrocystic disease/tissue? If the former, a reduction is indicated, assuming the weight removed will meet your insurance companies minimums. If the latter, a SQ mastectomy with reconstruction would be suggested with nipple and skin sparing if at all possible. Choose your surgeon wisely and make sure he/she understands your goals and concerns.
Fibrous mastopathy is a condition, which is characterized by dense, lumpy, painful, excessive breast tissue. Subcutaneous mastectomy used to be recommended but this operation has largely been abandoned because it created more problems that it solved. If you have excessive breast tissue, whose weight approximates the amount specified by your insurance company, then a breast reduction may partially alleviate your mastalgia (breast pain). That being said, all surgery involves pain, so you may trade cyclic pain for short-term post-op pain. Do consult a PS who has an active interest in breast surgery to discuss all the options. Good luck..