Breast reduction with possible lift. Thoughts or advice? (photos)

Question

I’m looking into get a breast reduction & I’ve been doing research for 4 years now. I’m 5’4 & my breast are a 42H in size. As well as my left breast being significantly bigger than my right breast & both breast drop down. My straps always dig into my skin. I also found out that I have PCOS 5 years ago which I feel like contributed to the size when I graduated high school when I was a size 38DD & 160lbs. I’m now 5’4 & 245lbs. I would like to atleast be a nice full & round D or DD.

Richard A. Bartlett, MD · Answer

Dear LeiaD, Thank you for your question. While it does seem possible for you to be a candidate for a Breast Reduction, at my practice I do not perform surgery on anyone with a BMI greater than 30 due to safety reasons. Your BMI is currently around 42, which means you would have to lose about 75 pounds to qualify for surgery. I suggest losing weight and if you are still interested in a breast reduction, to find a Board Certified Operating Surgeon and setting up a consultation with him or her. Best of luck to you!

Donovan Rosas, MD · Answer

Candidates for breast reduction will typically have documented evidence of neck/back and shoulder pain as well as rashes and bra strap grooving attributable to the increased breast weight. They will often demonstrate that these symptoms have been resistant to more conservative measures like therapy, weight loss and pharmacologic intervention.
In addition to establishing a case for medical necessity, there are also requirements for resection weight. This may be a standard "500 gm per side" stipulation or a more variable standard based upon body surface area/Schnur scale. 
With regards to your specific questions, reduction and lift are intimately intertwined procedures. A reduction will result in a lift as well. With this in mind, insurance providers have weight requirements to ensure procedures are performed for medical and not cosmetic indications.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
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Keith M. Blechman, MD · Answer

From the info you’ve provided it sounds like you’re a great candidate for the surgery. Removing about half of your breast tissue should give you an excellent result. In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Keith M. Blechman, MD
New York, NY

Keith M. Blechman, MD
New York, NY

Scott C. Lindsay, DO · Answer

Hello and thank you for your question!
Based on your photos , you appear to be a good candidate for breast reduction surgery. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Robert L. Kraft, MD, FACS · Answer

Perhaps NC criteria are more flexible than those in NY but here you would be denied based on BMI criteria.The asymmetry can be corrected during reduction surgery. Review your insurance rules to assess whether this is a covered service.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your description you seem to be an excellent candidate for breast reduction surgery.  In my practice, I individualize the “timing” of surgery based on a lot of information that is transmitted during the consultation process.
“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.
  I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
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.
Then, it will be important that you communicate your goals clearly with your plastic surgeon and make sure that you have realistic expectations prior to proceeding with any type of surgery. In regards to breast size desired, also communicate carefully. In my practice the use of goal pictures are helpful in this regard; a discussion of cup size can be confusing and imprecise.   Therefore, I would not suggest that you communicate your goals and/or base your satisfaction with the outcome of surgery on achieving a specific cup size.  I also find that the use of pictures is more helpful than the words “natural” or "proportionate” or "D or DD cup" etc., which can mean different things to different people.
Many of my patients choose to have enough breast tissue removed to help alleviate symptoms while retaining enough breast tissue to remain proportionate to the remainder of their torso.
I hope this helps.

Breast reduction with possible lift. Thoughts or advice? (photos)

Answers (6)

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