I want a Breast Reduction from 32G to 32C/D. Is it better to remove as much tissue as possible and then go with an implant?

Since
you have more tissue than you desire, implants are not required.To change from a 32 G to a 32 D would require
300 grams removed.Women undergo breast
augmentation after breast reduction because of the lack of upper pole
fullness.For that reason, a new
technique wall developed called The Ultimate Breast ReductionTM.Your breast tissue is reshaped creating upper
pole fullness, elevated higher on the chest wall and more medial to increase
your cleavage.This is done without the
ugly vertical scars of the traditional technique, maintains nipple sensation
and the ability to breast feed.The
disadvantages of the Wise pattern (developed in 1956) are the lack of upper
pole fullness, nipple numbness, the inability to breast feed and the ugly
vertical scars.Using newer technology
it is possible avoids implants altogether.Best Wishes,Gary Horndeski, M.D.

I would not recommend a radical reduction.  Radical reduction has a higher chance of poor healing and poor outcome.  An implant is not a safety net for a reduction.  Allow your surgeon to perform the appropriate reduction for the best long term outcome.

Thank you for your question.  It sounds like your best option would be a breast reduction.  I recommend you schedule an in person consultation where you can be examined and then have the options explained.

A breast reduction is meant to decrease volume of the breast tissue.  Its added benefit is a lift as breast tissue is removed as well as skin.  A breast lift does not usually remove  much breast tissue, and does not significantly change the size or the weight of the breast.  Personally I would not recommend removing tissue only to replace it with an implant.  Implants are not meant to last forever, and most people do not require a second reduction in their life, unless their weight significantly changes.  You do not list your age, but you should anticipate implants to require another procedure in about 10 years.  I think your odds of preventing future breast surgeries are better with a regular reduction and no implant, than to remove too much and replace it with an implant.

Your question is very insightful. I'm not sure what you mean by "radical resection" . What about the nipple?  I like Dr. Seckel's idea. Why not just start with a regular reduction and see how it goes?

When we receive a Gygantomastia patient in our office, depending of the technique to be applied, we have to explain carefully the surgical options. Sometimes we can't use the implants in the first stage, due that we can cause a compression of the pedicle and a necrosis can occur. As big at your breast are, as big the scar will be, maybe an inverted T. Many patients come six month after the reduction for an implants placement under the gland.

A breast reduction sounds like all that you need. Putting in an implant would not make sense to me if you have enough tissue. Best of luck.

You should have breast reduction down to your desired size and no implants.  Natural biological breast is always preferrable to breast implants and is more trouble free.

Hi,  A breast reduction is a good way to reduce the size of the breast and reshape it at the same time so that an implant is not required.  In experienced hands a full shape can be achieved without an implant.  The key is not to remove too much tissue superiorly or if the superior part of the breast is flat to start with, it would be important to reposition tissue in that location.  Your concerns can be addressed during your consultation, but unless your breast currently looks like a "ball" in a long sock, you should be able to get a nice shape as long as you don't have to remove too much tissue for reimbursement purposes.  Good Luck.  Dr Bev 

I recommend only doing a reduction - NO implant. After 3 months healing than you can see if implant acceptable...