Can I have a double mastectomy for personal reasons?

Question

I am a 42-year-old woman looking for breast reduction or removal. My bra size is 32/34DD. I am 5 foot 9 inches tall and weigh 120 pounds. Two cosmetic surgeons said they could reduce my breasts to about a C cup. That is not small enough for me; I would like an A or small B cup. That said, will a cosmetic surgeon remove my breasts completely? I don't plan to have children, so my breasts have no medical purpose. All they do is make my life miserable.

Natalie Ngan, FRACS (Plast) · Answer

Thank you for your question. Sorry to hear that you have such issues with your breast size. I perform breast reconstruction surgery after mastectomy and I perform breast reductions. Mastectomy surgery is performed by a Breast Oncology Surgeon and may take place when there is no breast cancer only in the setting of a strong family history or genetic mutation (e.g. BRCA like Angelina Jolie). Based on your bra size, I would expect that a B cup would be possible, however it is difficult to comment without photos. There is definitely a limitation to the size you can be reduced to, but depends on how ptotic ("droopy") the breasts are, and how large they are to begin with. In some cases, patients who present with very large breasts and who want to be much smaller, I have recommended 2 breast reduction surgeries to achieve a B cup. I am not sure who you have seen previously for an opinion, it may help to seek advice from a Plastic Surgeon - their credentials should state FRACS (Plast). Best of luck.

Ram Kalus, MD, FACS · Answer

Thank you for your question. A complete removal of your breasts without a clinical indication other than wishing this to be done is indeed unusual. That said, a thorough clinical evaluation by a board certified plastic surgeon is in order. A recursion to an A cup or B cup is indeed theoretically possible. Best of luck to you.

Connie Hiers, MD, FACS · Answer

Yes, if you truly want to remove your breasts, you can have a simple mastectomy. However, with a mastectomy, you will have numbness and may have some pain from scarring. A reduction taking you down to a B cup might feel better in the long run with fewer risks. Nipple grafting may have to be done if you went to a B or a cup, otherwise, the reduction could later be redone to go smaller and preserve blood supply to the nipple area.

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