Breasts too perky to reduce! What can be done? (photo)

Hello,
Please visit a few ABPS certified/ASAPS member surgeons who specialize in breast surgery.  Although your nipple position is relatively high, a properly performed surgery will give you a beautiful and smaller breast without symmastia. Best of luck!

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. See the below link on some suggestions on finding the most qualified Plastic Surgeon for a BBL Always insist on a board certified plastic surgeon.

I think you have very clearly told your surgeon that your breasts aren't perfect for you.  Though other women may ask for breasts of your size and shape, they are large for your frame.  I don't think your closely-spaced breasts are the reason they haven't sagged and I think it's very reasonable for you to consider breast reduction.  The surgery would have to be planned to remove much less skin than is done in most breast reduction surgery, which I think would minimize any tension on the skin of the center of your chest and avoid an unnatural shape that could be considered a uniboob.  I suggest seeking a second opinion.

Thank you for you question and photos,         The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Hello,I do think you have breasts that many patients would like to have and doing a reduction will leave you with scars so it is important to consider the trade-offs. However, you should be able to have this surgery without the symmastia that you mentioned. It is likely a good idea to get a few in-person consults to fully evaluate your options. All the best,Dr. BlaggAustin, TX

Hi, JHarp. Thank you for sharing your pics and your concerns. I would say that the surgeon that you consulted with was being very upfront and honest with you, looking out for your best interest. (Although, I would disagree in part with his/her assessment regarding the potential for resultant symmastia/"uni-boob" -- I do believe that there could be some mild potential cosmetic contour concerns due to the medial position and increased width of your breasts, but not likely an issue with symmastia.
In my opinion, a breast reduction (or a breast lift for that matter), does not often result in a superiorly attractive breast, including results shown by eminent experts in the field. The nipple-areola complex, even with a near-invisible scar, has a somewhat "pasted on" appearance, and the breast shape is not completely natural.  When working with a breast that has become more unattractive for whatever reason, the resultant breast shape and position following a breast reduction or breast lift may be a beneficial improvement, and the obligatory scars a worthwhile trade off. The same would be true for a woman with bothersome symptoms due to large breast size and/or elongation.
I personally would not desire breasts as large as yours, from both a comfort standpoint and a cosmetic stanpoint. But you do have attractively-shaped breasts, and a breast reduction (again in my opinion) would result in a deterioration of your overall breast contour.  At the same time, however, because your breasts are attractive and you appear to have better-quality tissue, and providing you had no major complications or unexpected healing issues, your results following a breast reduction would likely be superior to many.  The balance of a more comfortable and attractive-to-you breast size vs, some compromise of your breast contour and scars will determine whether a breast reduction is suitable for you. 
Good luck if you decide to proceed with a breast reduction, and I hope you have a smooth recovery and the results you were hoping for. Dr. Ghafoori

Hi, thanks for sharing your concern and photos with us!
Looking at your photos I might say that you´ll be a great candidate to get a breast reduction because you have enough tissue to reshape to reduce and lift it.
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine, please also look for a board certified plastic surgeon that helps to get what you are looking for, remember that your safety, always, must be first.

Good luck and have a great day!

Dr. JPG

The decision to reduce breasts is done for unhappiness with size or neck and back pain or other symptoms.The surgeon is trying to relay, that a breast reduction is not the opposite of a breast augmentation, we do not have a way to just shrink them. Breast reduction carries the trade offs of scars, potential nipple numbness and inability to breast feed. Some patients with attractive breasts, but large decide to delay the procedure until the symptoms are more severe, because of the scars. Others either dont mind the idea of scars, or the risks, but either have severe symptoms or are very unhappy. For someone with very large, but perky and attractive breasts, the surgeon is always trying to relay the risks vs the benefits. If you are willing to accept scars and feel your breasts are too large, or have symptoms you may be very happy with the surgery. Another option, that could result in some droop and one cup size smaller would be liposuction alone, which would reduce the breasts without scars.

You may wish to seek more opinions. Liposuction of the breasts can be performed. It is true that a significant reduction in breast volume will cause some modest drop (ptosis) of your breasts but this can avoid scars and produce a moderate reduction for you as well. 

If you have good breast skin (not stretched out), consider breast liposuction (see link below for an example) which would make the breasts a little smaller with only a few tiny scars. Otherwise, a breast reduction can be done.