In a breast reduction, how many grams of tissue should be removed from each breast if I’m a 34DD wanting a 34C?

Question

I have 34DD breasts and want a breast reduction that will result in 34C breasts max. I’m also looking into having a very small implant placed during the reduction for upper pole fullness. From what I’ve researched so far a small 165cc implant would achieve that. My question is, how many grams of tissue in total should I expect be removed from each breast in order to place a 165cc implant and still come out a 34C?

Gary M. Horndeski, MD · Answer

At size 34, each 100 grams removed corresponds to 1 cup size change.  200 grams would take you down from a DD to a C.  However, I do not recommend removing breast tissue and placing an implant.  The better technique is a breast reduction using The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of breast is transferred to the underlying pectoralis major muscle resulting in pain relief and long term stability.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.Best Wishes,Gary Horndeski, M.D.

Peter A. Felice, MD · Answer

Thank you for sharing your question with the panel! 
When counseling patients regarding breast reduction, I clarify that I do not operate with the goal of achieving a specific cup size but rather to create an aesthetically pleasing reduction that doesn’t impair blood flow to the nipple-areolar complex or the remaining breast skin and soft tissue. With respect to wanting an implant for upper pole fullness, your desired postop results may be more achievable with a mastopexy/augmentation as compared with a traditional reduction. In any event, I recommend a consultation and physical exam with a Plastic Surgeon to discuss the best operative options to get you your desired results. 
I hope this is useful, best of luck to you! 
Peter A. Felice, MD

Diane I. Duncan, MD, FACS · Answer

Thanks for your question! As is frequently noted in the augmentation questions, cc's don't really translate to cup sizes. Bra sizes vary tremendously between manufacturers and so aiming for a label isn't highly realistic. I have my patient bring in a 'goal bra' so I can see what their idea of the label is, and we can go from there. Since you will be dramatically altering the shape of your breasts it can also be hard to assess the size. Many times perkier breasts look 'big' without making you look overweight like many extreme bra sizes can. Talk with a surgeon to see what their expectations would be - without an in person consult and an assessment of approach there's no way to determine an implant size. It may be helpful to know that it can be possible (tissue type dependent, usually) to get that upper pole implant look with just a good full anchor mastopexy! Best of luck!

Tom J. Pousti, MD · Answer

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.
 There is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery. There is simply too much variability among bra cup manufactures to make it a useful metric when it comes to preoperative communication and/or post operative predictions.
For example, I do not think that the generalizations of "200 cc equates to 1 cup" hold any validity or are helpful in any specific or practical way.  In my practice, I ask patients not to communicate their goals, or evaluate the outcome of the procedure performed, based on cup size references.
 Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). Most patients wish to achieve enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. 
With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small) very helpful. For example, I have found that the use of words such as “natural” or “C cup” means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you with an estimation of how much tissue will need to be removed, in order to achieve your desired outcome.Sometimes, breast reduction AND augmentation (use of breast implants focuses can be done safely at the same time.   In these cases, it may be the appropriate operation given a patient's anatomic starting point and desired outcome.  During this operation, some breast tissue is removed and breast implants are utilized for volume/fullness.
 In other cases, patients are better off under going to breast reduction procedure first;  longer-term determination of whether breast augmentation would be beneficial may be appropriate.
 In other words, best individualize every patient's treatment plan  based on her unique circumstances,  anatomy, and goals.   During this decision-making, safety consideration and avoidance of complications, should be paramount.
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as discussed above. Working together you will come up with a good plan to achieve your goals. 
 Best wishes.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Without photos to demonstrate a rough approximate amount of tissue to be removed, or height /weight information, I cannot guess an amount, especially since there is no standardization of cup sizing among various bra manufacturers. One company's D is another's DD.
From an insurance standpoint, most will cover costs if >500 grams are removed from each breast. In my personal experience, I have removed >2000 grams / breast in some instances.
Seek a board certified plastic surgeon for evaluation and discussion.
Best wishes...

In a breast reduction, how many grams of tissue should be removed from each breast if I’m a 34DD wanting a 34C?

Answers (5)

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