How can I correctly communication my breast reduction goals to my surgeon to avoid disappointment?

I find that communication is key with your surgeon. Visuals usually help as well! I always direct my patients to the real self before and after photo gallery and have them provide me with 2-3 “goal” or “wish” photos of the size they desire prior to surgery.

Hello and thank you for your question.
Schedule an appointment with the surgeon to discuss your goals again. Bring along some wish pictures of the size you would like to be. Best wishes!

Tank you for your query. The best option for you may be to get 3D pictures of your breasts with morphing , which can give an idea as to the amount of tissue would need to be removed to get you to your desired size. Then you can have a more educated discussion with your surgeon about the possibility of achieving your goals. All the best!

There has always been a great deal of difficulty talking about breast size after breast reduction. I think talking about bra cup sizes is futile, given bra sizes are non-standardized, the 'correct size' is subjectively determined, and they don't really measure breast volume. I understand your serious concern about not being either too big or too small after surgery. I try to help patients visualize the amount of tissue I could remove by standing in the mirror with them and isolating portions of the breast between my thumb and fingers; the tissue seen within this area could be excised if agreed upon. I also look at patient selected goal photos too, something that is not necessarily problem free, but in aggregate can be helpful. And finally I ask the conceptual question, imagine how much smaller you want to be in percentage points, e.g. 40%, 50%, 60% smaller. Spending time with the patient in this regard is worth it. In the end, getting close or within the immediate 'ballpark', combined with improved breast appearance, symptom reduction, and overall improved body proportion makes for a happy patient 98% of the time.

Hi,

Thank you for the question.

Based on what you are describing, it does sound that you have large/heavy breasts causing physical symptoms, and breast reduction may be an option for you. However, it is difficult to tell without seeing the photos and/or in person consultation.

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 2-3 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.

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

I would go back and revisit with your surgeon or meet with another. Usually, your size would go to a C or D. We do need to keep a certain amount of breast tissue to keep the nipple alive. Going down to a B cup is usually not a viable choice. Should you decide you are too small, implants can be added later.

It is so important that you feel comfortable and confident when speaking with your surgeon. Find photos of those with a similar size and shape that you are hoping to achieve. Be sure to keep in mind that you want the breasts to be harmonious with the rest of your frame. Discuss your concerns and surgical goals.

You go back to the surgeon and ask all your questions and you keep asking until both of you are satisfied that you both understand. If that is not possible you look for a second opinion.