How long to wait if I want Breast Reduction Revision? Breast too small

Question

My breast appears too small after Breast Reduction. I was a 36H before my breast reduction and it appears that my breast are size 36c. I'm 10 days post-op. I told the surgery I did not want small breast. I just wanted 2 fibroadenoma removed from my left breast in the outer quadrant and more so a lift. In addition, the incision scars are very high on the chest. Is it possible to have breast size increase during revision with fat transfers? I do not want implants.

Kenneth Hughes, MD · Answer

The best way to determine what your breast size should be with respect to your anatomy and give true advice would be another discussion with your board certified plastic surgeon. Not only does proportion depend upon the aesthetic balance of your breasts with your shoulders, waist, hips, and buttocks, but also upon your objectives, active lifestyle, soft tissue quality, muscular anatomy, and long-term concerns. A breast reduction also includes a breast lift.
There is also a limit to how small you can go due to tissue that needs to be retained for the nipple/areola to maintain a good blood and sensory nerve supply. 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. I never promise a cup size because bras manufacturers do not follow a standard size.
 In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons. It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer. Multiple transfers would be required for additional cc's. In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used. Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival. Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant. Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat stores.

Richard A. Bartlett, MD · Answer

Dear Compassionate796712, 
Thank you for your question. I tell all my patients that they must wait at least 6 to 12 months following the surgery the the final outcome. At 10 days post op it is too early to tell your final results, but if you are having concerns I suggest following up with your Board Certified Operating Surgeon. Best of luck to you!

Gary M. Horndeski, MD · Answer

At size 36, each 200 grams removed or added corresponds to 1 cup size change. If you are currently a 36 C and want to be a D you would require 200 cc of fat. Unfortunately, not all the fat survives so you will need approximately 300 cc of fat for 200 cc to survive. I usually recommend waiting 6 months for the date of your previous surgery before doing another surgery. I do not recommend implants. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Compassionate796712,
I understand your concern and it is quite normal to be concerned about the outcome following a breast reduction surgery. However, you are still in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues are still swollen. Once the swelling subsides, you will be able to see the final result of your surgery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.
You are very early in your healing process. You will need to wait at least 6 months to a year for a revision. Consult with a board certified plastic surgeon to discuss your options. Best wishes!

Patrick W. Hsu, MD, FACS · Answer

Hello and thank you for the question. It is still very early. You should wait several months before you consider a revision, in order to allow for the healing to take place. There are several options with regards to the revision that you are looking for, and I recommend speaking with your plastic surgeon about this. Best wishes and good luck!

Darryl J. Blinski, MD · Answer

Usually 4-6 months wait after surgery. But fat grafts will NOT increase volume the amount you desire. You unfortunately DID NOT post photos??? Best to seek virtual or in person second opinions from private practice boarded PSs.

How long to wait if I want Breast Reduction Revision? Breast too small

Answers (7)

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