Going down from a 28DD to a 28A. Would doctors consider reduction for me, or am I out of luck?

Question

Yes, these measurements are accurate; I have used many different calculators and they all come out the same. I'm 171.5cm (5'7.5") with a very small frame & naturally underweight. They don't carry my size so I've tried going up and it's never comfortable & does not fit. My breasts have always been so much larger than the rest of my body and it looks very disproportionate like implants. My waist-line is naturally 25-26 inches as well. Would doctors consider reduction for me, or am I out of luck?

Urmen Desai, MD, MPH, FACS · Answer

A more realistic final size may be a C.    I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Jeffrey A. Sweat, MD · Answer

Based on what you have described, it would sound as though you could definitely benefit from a reduction.  If you want your insurance to pay for it, there may be some specific criteria you would have to meet to qualify, but if you plan to pay for the surgery yourself, there are no restrictions and you could certainly have a reduction.  However, going from a DD to an A cup might present a bit of a challenge as an A cup is really quite small.  An average cup size is considered to be a C and achieving that or a little smaller, perhaps a B cup, shouldn't' be a challenge.  Best of luck!

Daniel Barrett, MD · Answer

Dear Yuuknow,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Curtis Wong, MD · Answer

but your case may not qualify for insurance.  In addition, an A cup is really really hard to accomplish with a reduction and have it look like a good A cup... more realistically you could get a large B cup.  If you were in my practice, I would be charging you a mastopexy fee (must less than a reduction fee) and if tissue was sent in for pathology, that would cost you more as well (estimated $250 for both sides).  The only thing you must be certain of is that you are not interested in having the ability to fully breast feed any children that may be in your future as this procedure will diminish your ability alot and that you could lose sensation.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your description you may be an excellent candidate for breast reduction surgery.   However, much more information is needed to determine whether you should proceed with surgery, and if so when (timing).  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.
When the time is right, 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” etc., which can mean different things to different people.
 
I hope this helps.

Susan Buenaventura, MD, FACS · Answer

If your breasts are too large for your frame, heavy, straining your neck back and shoulders, and if you desire smaller breasts, you are a good candidate for a breast reduction.  It is important to be at a healthy weight and non smoker to undergo the surgery and minimize complications.  Breast reduction is a life changing surgery!  See an ASPS board certified plastic surgeon to discuss the procedure in more detail.

Cisco Sanchez-Navarro, MD · Answer

Hello and thank you for your question.  All of these measurements are very helpful and give us some idea of your dimensions.  An in person physical exam with a plastic surgeon is very important to further delineate what can be done.  Overall, yes a breast reduction can safely be performed.  The most important question would be if your insurance would cover the procedure.  Often times it is very difficult to get approval from the insurance companies to perform breast reduction, and every insurance company is different.  If you cannot get it approved through your insurance company, you have the option to pay out of pocket for the procedure.  Be sure to get a consultation with a Board Certified Plastic Surgeon through the American Board of Plastic Surgery.  I hope this helps, and good luck!

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem and I would go on some complimentary consultations with experts in your area and compare recommendations after a full examination and become fully informed about the desired procedure Dr Corbin

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

Thanks for your question.  The limiting factor for breast reduction is the amount of breast tissue needed for the nipple to maintain circulation and innervation.  In large breasts like yours, especially if there is considerable sagging, this chunk of breast tissue (we call it a pedicle) will likely be larger than an A.  There is a procedure called a "free nipple graft" breast reduction where no pedicle is needed because the nipple is detached from the breast then re-attached after the breast mound is reduced.  This leaves the nipples without zero and often somewhat flattened.   I would highly recommend you DO NOT go this route.  I think your breasts will look like fried eggs!  My advice would be for you to accept maybe a full B or small C cup.  Best of luck!I have a nice video showing the pedicle on my Instagram@sowdermd.  It's the May 9, 2018 post.  Check it out.

Going down from a 28DD to a 28A. Would doctors consider reduction for me, or am I out of luck?

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