Do Not Want Reduction To Make Me Too Small- G Cup

I am 45 y/o and wear a 40G bra size. I am looking at a breast reduction and lift. I have always been large on top and do not want to go so drastic in a reduction to where they are too small. Would a DD cup do the job? Insurance is with BCBS of Kansas City and after finding the scale used by them, my number was 2.0865. So 687 grams. What would this be? Thanks for your help.

Doctor Answers 6

Breast Reduction without drastic change

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I see many patients who have interest in a breast reduction, but desire to maintain a significant amount of their volume.   I ask that you assess your size and shape goals individually with your surgeon.    Based on this, they can help you determine how much volume must be removed and how much lift is necessary to achieve your goals.    

Without seeing your pictures or asking further questions,  it would be hard to determine whether you meet criteria for an insurance breast reduction.   Be prepared that if you receive an insurance denial or do not meet insurance criteria, you can still obtain a very pleasant result with a cosmetic breast reduction/lift.  

I wish you a safe and happy recovery. :)

Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Discuss breast reduction shape with your surgeon, not only size

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Final breast size, based on what bra you will wear after surgery, is not the best way to plan your operation.  The surgeon cannot change your chest circumference nor the width of your breasts very much.  Thus the important thing is to correct your symptoms and have a nice shape.  The right resection weight will follow.  It is important not to be too small--as you have recognized, too large a body-image change.  It is also important to be reduced enough, or you will have new scars without the symptomatic benefit.

Find a surgeon whom you like and who understands your concerns and can show you photographs of his or her results that please you.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

Breast reduction insurance coverage

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I think your question is whether removal of a certain weight of breast tissue will correlate with achieving a certain cup size.  Unfortunately, there is no direct correlation of breast weight and cup  size. Your best bet is to be examined by a well trained/experienced board-certified plastic surgeon–he/she may be able to give you good advice and an estimation of the final cup size that will be achieved after excision of a certain amount of breast tissue.

You are smart in avoiding too much of a breast reduction (that would cause you to be disproportionate and dissatisfied with the results.

Best wishes.

Insurance requirements for Breast Reduction may make you too small

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I have been doing this for many years and I have come to one conclusion. If you can afford it-pay for a breast reduction yourself. This will eliminate having to 'meet' unfavorable  requirements. Unfortunately, I know this is not feasible for many  patients which leads me to my next statement. You must decide whether this is acceptable to you or not.  Insurance requirements for breast reduction may make you too small for your body type. This is not an aesthetically pleasing result. I often ask my patients the following question to help them decide. Are you doing this to relieve painful symptoms or for cosmetic improvement? Best wishes, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast reduction insurance requirements may make you too small.

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The exact amount of tissue that must be removed by your plastic surgeon to satisfy insurance company requirements is based on the Schnur formula, which uses height and weight (to calculate BMI) and uses this to determine  the minimum amount of tissue per breast that must be removed. One gram less than this calculated amount and the entire bill becomes your responsibility (regardless of what your surgeon told you or you thought). So this is an important number!

When breast reduction patients come into my office I first calculate the minimum amounts of tissue removal required (some insurance companies may use a variation of this formula, but most use this--I am an insurance reviewer for BCBS and Medicare). I then hand the patient a breast implant as close to that size as possible.

Assuming your calculations are correct, I would hand you a 700cc implant and ask you to mentally subtract that amount from each of your breasts. What remains becomes your new breast, and you can pretty easily decide if that is too small for you, or not proportionate to the rest of your body.

A surprising number of women (with undoubtedly large, hanging breasts) actually have breasts that are more droopy and saggy than truly huge from an insurance standpoint. These patients may have large breasts because they themselves are large, and reduction of the insurance-mandated minimum would leave them essentially mastectomized, and certainly disproportionately small. Or, they really need somewhere in-between a cosmetic breast lift that keeps the breast size the same (minus about half an ounce of skin) in a tighter higher skin brassiere, and the too-small-after-reduction mammoplasty. Insurance does not cover these breast reductions, calling them "cosmetic."

Of course, since "cosmetic" reductions are not covered by insurance, the patient self-pays, and can therefore choose whatever size she and her surgeon feel is best. No insurance guidelines to meet or fail.

It's time for you and your surgeon to look critically at your present breast size, mentally estimate what removal of nearly 700grams per breast would leave you with, and decide if that is OK with you. Cup sizes and calculations only tell part of the story--please do this simple estimating procedure with your doctor. Good luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast reduction to satisfy you, not insurance

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Insurance companies may have a formula upon which they base approval or denial for breast reduction. The truth is there is no data which can tell just how much the breast must be reduced to relieve symptoms. If you wish a DD-cup stick with your plans and see what your surgeon can work things out on your behalf.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.