Breast reduction- how small can you go for dense breasts?

Question

I am 5'5, about 113lbs and have 32E breast size. I am 39. They are still not sagging, but I feel they are HUGE for my body frame and they sit low on my chest (not sagging just set low). I have constant neck and shoulder pain and finding bras my size is difficult. I am extremely self conscious. I have hardly no fat in the breast. They are extremely dense. I want a reduction but can I go smaller with no fat to remove? I really wanted a full C cup, but not sure if that would be achievable.

Jed H. Horowitz, MD, FACS · Answer

Hello, thank you for your question. #Candidates for #BreastReduction surgery are
women who wish to have smaller #breasts to achieve a more proportional
appearance or to alleviate physical discomfort. Breast reduction can correct
symptoms from excessively #largeheavybreasts that may cause the inability to do
certain exercises, or create back, shoulder and neck pain, poor posture,
bra-strap shoulder indentations and chafing or rashes under the breasts. Women
experiencing these discomforts may benefit from Breast Reduction, also called #ReductionMammoplasty.
Furthermore, large breasts may interfere with normal daily activities or
exercise and will be more comfortable when reduced. Women who feel that their
excessive breast size decreases a sense of attractiveness and self-confidence,
or results in unwanted attention are also candidates. In my opinion, you are a great candidate for a #breast #reduction surgery! I will attach a website that lists all of the Board Certified Plastic Surgeons in your area. Best wishes on your journey! Many women are quite pleased with their results and wish they would have done a breast reduction sooner!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  Based on your description, you should qualify for an insurance-covered breast reduction.  Your goal of a C cup is very reasonable.  The most important aspect is to find a surgeon you are comfortable with.  With good surgical technique, you could have an outstanding result.  I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.Best wishes and good luck.Richard G. Reish, M.D.Harvard-trained plastic surgeon

John Michael Thomassen, MD · Answer

A breast reduction is limited by the amount of tissue needed to be kept in place to supply the nipple/areola with adequate sensory innervation and blood supply.  Nonetheless, even with large breasts, reductions can typically reach the large C cup range.  You should be able to meet your goals even with a history of dense breasts.  You should undergo a mammogram/ultrasound or even MRI prior to the procedure.

Emmanuel Mallol Cotes, MD · Answer

Thanks for sharing your concerns with us. First of all I recommend you to send your photos to give you better advices and recommendation of your interest. Kind regards, Dr. Emmanuel Mallol.-

Megan Jack, MD · Answer

Even with dense breasts, a breast reduction can be performed as the tissue is still removed.  You certainly would need an in-person examination to determine if you are a reasonable candidate for the surgery and to have a conversation regarding the risks/benefits of such a procedure.  That being said, cup size for bras are fairly relative on an individual basis as well as a bra manufacturer basis.  A C in a bra from Nordstrom or Macy's will likely be sized differently than a bra from Victoria Secret, etc.  Just keep that in mind.  The most important thing is to have a cup size that is proportionate to your body and with which you are happy.  Showing your surgeon photos of women with a similar body type as yours and with the approximate goal post-operative size/shape from plastic surgery websites will help your surgeon get into your head and have a better appreciation as to your goals.  Please make sure to consult with board-certified plastic surgeons for best recommendations!  Good luck!

Darryl J. Blinski, MD · Answer

Without posting any photos very hard to respond. Best to see in person only boarded PSs in MIAMI. .....

Lavinia K. Chong, MD · Answer

Breast reduction in a dense breast thin individual is often really successful, as long as the communication between patient and PS is excellent.  Liposuction is proposed for fatty breasts, however this wouldn't be ideal for dense breasts, which also don't diminish with weight loss (because density represents glandular and fibrous tissue, not fat).  Ultimately when the aggregate musculoskeletal load, position, need to purchase extra supportive, matronly bras and low position aggravate you sufficiently, you may explore options by consulting with PS.  Technically, the aesthetic results of reduction mammoplasty in the dense breast are longer lasting and, in my opinion, more compelling, especially in a slender patient.  Fatty breasts tend to "relapse" or settle faster than dense ones.  Breast reduction to a full C cup is absolutely feasible.

Zachary Farris, MD, FACS · Answer

Thank you for your question.  Sorry to hear about your problems associated with your large breasts.  There are a number of different breast reduction techniques.  Even if your breasts are dense, it is possible to reduce them to an appropriate size.  As part of the procedure, skin flaps around the breasts are elevated and the breast tissue/fat is reduced to the right size.  It doesn't matter if the breasts are dense.  Be sure to communicate well with your surgeon about the breast size you desire and don't just rely on stating a particular cup size.  Showing pictures of your preferred breast size can be very helpful.  Good luck with your surgery!

Tom J. Pousti, MD · Answer

I am sorry to hear about the problems your disproportionately large breasts have caused. Based on your description, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations to perform.  “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.When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with.
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.Once you have chosen your plastic surgeon carefully, it will be important for you to communicate her goals carefully as well. In my practice, I asked patients to use as many “visual aids”, such as goal photographs, during the communication process. Avoid the use of subjective terms;  for example, "C cup” and/or “proportionate"… these terms can be confusing, since they may mean different things to different people.  Generally speaking, significant breast reduction surgery to relatively small sizes is possible in most cases.Once you have communicated your goals, your chosen plastic surgeon will be able to give you an estimate of how much breast tissue will likely need to be removed to achieve your goals.I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

Breast reduction- how small can you go for dense breasts?

Answers (9)

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