What can I expect at my appointment? What size should I go down to? I'm currently a 38 DDD/E.

I've always been big breasted to the point that my boobs literally hang to my waist after 2 children. (I could breast feed both my boys while they were in their strapped car seats as my husband drove us around. 20 years later I have to wear a bra or my boobs and neck hurt from hanging and the divots in my shoulders and the neck and back aches cause migraines. I welcome any advise or stories to help me.

Doctor Answers 7

Breast reduction results depend on what's 'left behind'

Based on your self-description - you are probably a good candidate for a breast reduction procedure. This surgery has both functional and aesthetic benefit and patients are generally very pleased with their surgical results. The shaping of the breast is very important, is relies on the breast tissue that is 'left behind' and how the remaining breast tissue and nipple/areolar complex is reconstructed.

Breast reduction and lift. A great operation!

You sound like a great candidate for breast reduction which also always includes a breast lift.  As far as what size, what technique and so forth - those are things to discuss at your consultation.  Size can be a little tricky because unlike a breast enlargement consult, you cannot "try on"  smaller breasts.  Also, there is a limit to how small a large breasted lady can go if nipple sensation and circulation is to be preserved.  All of this should be explained to you at your consultation.  Make sure you go to someone who does a lot of reductions and can show you examples of his/her work.  Breast reduction has a very high patient satisfaction rate which is one reason  why most of us really like this procedure.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

Candidate for a BR

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 breast reduction.

Also known as reduction mammoplasty, this is an operation intended to reduce the size of a woman’s breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation.
Women who have large, heavy breasts, which may be the cause of movement difficulties, back, shoulder and neck pain, poor posture, bra-strap indentations and chafing under the breasts will benefit from reduction.
Women with excessive breast size, which may decrease a sense of attractiveness and self-confidence, are candidates.
Large breasts that interfere with normal daily activities or with exercise will be more comfortable when reduced.

What can I expect at my appointment? What size should I go down to? I'm currently a 38 DDD/E.

Thank you for your question.  Sounds like you would be a good candidate for breast reduction.  It's important to have clear communication with your surgeon regarding your goals and expectations.  Cup size can mean different things to different people.  Sometimes, it's helpful to provide goal or wish photos to your surgeon of what breast size and appearance you would like to have.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 14 reviews

What can I expect at my appointment? What size should I go down to? I'm currently a 38 DDD/E.

There is no way to predict your outcome without a consultation and examination. Even then no one can guarantee cup size as there is no standardization of cup size in the fashion industry nor medicine.

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 16 reviews

What size should I go down to with breast reduction surgery?

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. Of course, definitive assessment and advice would require in person evaluation.

“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.

When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with. Ultimately, careful selection of your plastic surgeon will be the most important decision you make.
To this end, 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.

In regards to breast size desired, careful communication will be key. 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. For example, a "B or C cup" may mean different things to different people. I also find that the use of pictures is more helpful than the words “natural” or "proportionate” etc., which can (again) mean different things to different people. Many of my patients choose to have enough breast tissue removed to help alleviate symptoms while retaining enough breast tissue to remain proportionate to the remainder of their torso. Again, preoperative communication will be critical.
I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

Consultation will Determine if You Are a Breast Reduction Candidate

Candidates for #BreastReduction surgery are women who wish to have smaller #breasts to achieve a more proportional appearance or to alleviate physical discomfort. Breast reduction can correct symptoms from excessively #largeheavybreasts that may cause the inability to do certain exercises, or create back, shoulder and neck pain, poor posture, bra-strap shoulder indentations and chafing or rashes under the breasts. Women experiencing these discomforts may benefit from Breast Reduction, also called #ReductionMammoplasty. Furthermore, large breasts may interfere with normal daily activities or exercise and will be more comfortable when reduced. Women who feel that their excessive breast size decreases a sense of attractiveness and self-confidence, or results in unwanted attention are also candidates.

Large breasts (#macromastia) or #breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive #breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual i company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 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.