Do I need a breast reduction?

You need a formal evaluation by a licensed plastic surgeon and expert in breast reductions to determine what is best for you and your goals.Breast reduction is one of my favorite surgeries as it allows me to dramatically improve a woman’s breast appearance as well as alleviate many physical symptoms of large breasts, such as back, neck and shoulder pain, bra strap grooving, and rashes under the breasts. When I perform breast reduction surgery, I generally use a superomedial pedicle to provide blood supply to the nipple while maintaining fullness in the upper and inner breast. Excess lower and outer breast tissue are removed. Breasts are often asymmetrical, so I remove more tissue from the larger breast. The final scar pattern is a circle around the areola, down the breast, and possibly under the breast, depending on the degree of skin excess.
For me, breast reduction is not a one-size-fits-all surgery. The size and shape of the breasts are customized to each patient depending on her goals and desires. Some women want a significant amount of tissue removed while others prefer to have a more limited reduction. Regardless of the amount of tissue removal, I perform the maximum safe amount of lifting and tightening for each patient.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Reductions. - Dr. Cohen

Hello and thanks for your question. Do you feel like your breasts are too large? Are they causing you discomfort? Do you have any back or neck issues related to the size of your breast? Each bra company vary in sizes. What is a 34 D at one manufacturer may be completely different than another. If you are wanting to reduce the size of your breasts I would talk with a board certified plastic surgeon to discuss all of the available options, risks, and requirements for that particular surgery.

Bra sizes vary by manufacturer so no conversion table exists where one can interpolate the appropriate bra size with the data you have provided.  A BMI of 35 is probably the upper limit that a plastic surgeon would consider for a BR. It is best to be within 10 pounds of your goal weight for six months prior to your surgery.  This reduces the risks of complications during and after surgery and enhances results. A PS cannot guarantee that a breast will be a specific cup size after reduction.  Very large breasts rarely are reduced by more than two or three "cup" sizes. Going too small can sacrifice the shape of the breasts.  The nipple has to have a blood supply to survive from the underlying tissue. Schedule a Skype consult with photos or an in-office exam with a board certified PS who has before and after photos on his/her website and patient reviews.  This is the most efficient way to have all your concerns addressed.

Dear B4376,
breast reduction is an elective procedure so there is no real measurements which determine the candidates for surgery. If your breasts cause you pain or discomfort, then you might be a candidate for a surgery. Breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.
If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

This is a question for the individual as this is an elective procedure. There is no standardized cup size to body size correlation.Candidates for reduction will typically have documented evidence of neck/back and shoulder pain as well as rashes and bra strap grooving attributable to the increased breast weight. They will often demonstrate that these symptoms have been resistant to more conservative measures like therapy, weight loss and pharmacologic intervention.
In addition to establishing a case for medical necessity, there are also requirements for resection weight (when covered by insurance). This may be a standard "500 gm per side" stipulation or a more variable standard based upon body surface area/Schnur scale. It is important to realize that these weight requirements can occasionally exceed your goals for size reduction. Insurance coverage is contingent on these requirements being met, thus cosmetic concerns become secondary(i.e. cup size goals).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Hi and welcome to our forum!Actually, there is no normal bra size! There is no standardization of sizing among various bra manufacturers. One company's "B" is another's "D". "Normal" size would be in proportion to the rest of your body.Your candidacy for cosmetic surgery requires consideration of many
factors. One is measurement of your BMI (body mass index equals weight in kg /
square of height in meters). You can find BMI calculators on the internet. If
your BMI is > 30, the cosmetic result will not be optimal. If your BMI is >
35, your operative risk will rise.Your BMI is 35.51. Weight loss through diet and exercise is
recommended. If not achievable, a bariatric procedure (such as a gastric
sleeve) will result in significant weight loss. If you suffer from neck pain, shoulder pain, back pain, bra strap grooving or chronic rashes beneath the breasts, it may be wise to consider the procedure when at a suitable weight. Seek advice from a board certified plastic surgeon.Best wishes...

Thank you for the question. Based on your description you may be an excellent candidate for breast reduction surgery at some point.   However, much more information is needed to determine whether you should proceed with surgery, and if so when (timing).  In my practice, I individualize the “timing” of surgery based on a lot of information that is transmitted during the consultation process.
“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.
Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.
Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well.. Poor scarring, for example may be associated with the procedure.  Additional surgery may be necessary in the short or longer term for a multitude of reasons.Although the breast reduction surgery may help you at this point, if you are contemplating the weight loss then it would be in your best interest to have the breast surgery after you have  reached your long-term stable weight (if possible). This will improve your chances of achieving your goals and minimize the chances that revisionary breast surgery (to treat “sagging” for example) will be necessary afterwards.  
 Sometimes, patients who are overweight benefit from breast reduction surgery. As you stated, these patients are then able to continue their work out regimen with less difficulty. Of course, patients who undergo breast surgery while overweight need to understand the surgery itself is riskier (peri-operative complications) and the outcome may not be the same quality of an outcome.  The potential need for revisionary surgery is greater in these cases as well.
When the time is right, 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.
Then, it will be important that you communicate your goals clearly with your plastic surgeon and make sure that you have realistic expectations prior to proceeding with any type of surgery. In regards to breast size desired, also communicate carefully. In my practice the use of goal pictures are helpful in this regard; a discussion of cup size can be confusing and imprecise.   Therefore, I would not suggest that you communicate your goals and/or base your satisfaction with the outcome of surgery on achieving a specific cup size.  I also find that the use of pictures is more helpful than the words “natural” or "proportionate” etc., which can mean different things to different people.
 
I hope this helps.  
 

Thanks for writing,Patient with large breast complain of back, neck, shoulder, arm pain and even numbness in their forearms and hands. Cup sizes change so much between manufactures what you need to do is simply find one that is comfortable and it will be expensive. With a weight of 5'6" and a height of 220 pounds your BMI is over 36 and that is obese. For your long term health benefits you should loose a lot of weight. Get with your primary doctor to help you understand this. Insurance companies will cover breast reductions but many rely on BMI and that determines coverage. I hope this helps.Stephen M. Davis, MD, FACS
Green Hills Plastic Surgery
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery
Member: American Society of Plastic Surgeons
Member: RealSelf Hall of Fame

Hello! Thank you for your question. Based on your post, it sounds like you may be a candidate for breast reduction surgery. This surgery results in a smaller, perkier, and more youthful look. If you also have neck, shoulder, and/or back pain, this surgery may help as well. This procedure is straightforward, is relatively painless, and has minimal downtime. But, before you make any decisions, it is important that you know one thing: There is no ideal breast size. What is ideal for one woman (based on height and weight) may not be ideal for another woman. Shoulder width, chest girth, body shape, and a patient's personal preference all impact what a woman feels is ideal for her. So it is best to have an in-person consultation with a plastic surgeon who can evaluate you, assess your concerns, and tailor an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.