Should I Go for a B or a C? (photo)

I am 28 years old, 5'6'', 125 lb. My breast barely fit in 32DD now (I had to start on birth control pills a few months ago to improve hormonal acne, and the pills made my breast even more swollen and painful). The plastic surgeon I have seen mentioned that my breasts are fibrocystic and that the surgery should bring a big relief. What size should I go for? Also, I have inverted nipples. Can anything be done to improve them during the breast reduction surgery? Thank you.

Doctor Answers 4

Breast Reduction and Resulting Breast Size?

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Thank you for the question.  Based on your description, you may be an excellent candidate for breast reduction surgery;  this operation tends to be one of the most patient pleasing operations we perform.

The first/ best step would involve meeting with well experienced board-certified plastic surgeons to discuss your goals. Learn about the breast reduction procedure and the potential risk/complications associated with the procedure. The attached link may be helpful to you in this regard.

Once you have decided to proceed with breast reduction surgery it will be important to communicate your goals clearly. With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small)  very helpful. I have found that the use of words such as “natural” or “B or C cup” etc. means different things to different people and therefore prove unhelpful. 
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

Most of my patients patients wish to achieve a enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso.

Sometimes the breast reduction procedure is “covered” by health insurances. The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
 This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.

I hope this helps.

How much to reduce?

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Assuming your procedure is being covered by insurance, they will dictate the minimums that you need to meet in order to have your procedure covered.  And you simply have to accept whatever cup size results from that.  If you have dense breasts, you may be able to preserve more volume.  If your procedure is cosmetic, then you must decide what will work best for you in terms of how much volume to remove.  If breast feeding is very important to you and you plan on having children in your future, realize that reductions will impair your ability to breast feed fully where supplemental formula will be needed.

Breast reduction

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The inverted nipple can be treated but I would probably treat it after the reduction.  Good luck with your surgery.

Breast size and inverted nipples

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Breast size is a very personal choice.  However, with insurance breast reductions, many carriers require a certain weight to be removed.  Also, cup sizes vary depending on your bra manufacture.  I would encourage you to have a conversation with your plastic surgeon about your breast size.  You guys should be able to come to an agreement on what size breasts would suit your frame and make you happy.

As far as inverted nipples, there a surgeries that utilize small flaps to improve the inversion.  However, I would not do that at the time of your reduction as it may place your nipple in jeopardy.  These nipple inversion surgeries have a fairly high recurrence rate.  An alternative is to pierce the nipples and leave a stud in the nipple for 1 year.

Best wishes

Patrick C. Wilson, MD
Huntsville Plastic Surgeon

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.