I have 34 B breast and I need to know if it's safer to get a mastectomy or just have my breasts reduced to completely flat?

I am a female with 34b breasts and I'm 5' 9 and 130 lbs. I know my breasts aren't huge but I feel upper back pain all the time and my shoulders get sore if I go without a bra for too long. I want them to be completely flat but I want to keep my nipples.

Doctor Answers 2

Breast reductions

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A reduction can help reduce upper back and neck pain in patients with larger pendulous breasts.  There maybe other issues in you neck and back that have to do with your spine that should be evaluated.

If you really don't want breasts at all anymore...(or as little as possible..)

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I have some questions for you - what do you mean by "safer" ? are you concerned with surgery success? making healing the fastest? having the flattest appearance? ...or having the least chance of breast cancer after surgery? There are many ways to get rid of breast tissue and have a flat appearance after surgery. There are also many reasons patients want this done - Some have pain and discomfort with the tissue and just want it gone, some don't feel that having breast fullness matches who they are as a person and their appearance is the thing that concerns them the most, and some have anxiety and fear associated with breasts/breasts cancer and they have in their mind that they will be healthier with a flat chest. Some people feel that having reconstruction is dangerous or unhealthy or impossible. We need to know exactly what you really want and is what is most important to you in order to give you the options that will accomplish your goals. Your question leads me to believe that you want less tissue to relieve pain, but I am concerned that removal of this little amount of tissue will not have enough impact on neck and back pain. So f that is your true goal, then breast surgery may be a poor use of time, money, and could invite even more problems if you have complications from surgery - numbness, pain or infection. There are exceptions, though - so feel free to talk to a plastic surgeon about what they think the impact may be. There are several patterns for breast reduction that a plastic surgeon could discuss with you. Talking with them about how extremely small you want to be is important for managing your post operative expectations. While plastic surgeons are comfortable getting a large amount of tissue removed, they usually shy away from true mastectomy surgery, leaving that to a general surgeon. Of course they have the skill sets to do so, but for a variety of reasons in the US, the majority don't. If you had concern for breast cancer risk and wanted the breast tissue removed as a priority, you would need to work with a general surgeon and could ask them about a Goldilocks Mastectomy with a free nipple graft, or if your breasts are small enough, it might be possible to leave them in place. We do have techniques for men with gynecomastia that can also be used on very small breasted women that use a non-invasive approach - the nipples are left in place, and if we take it to the max as far as tissue removal is concerned, they even appear masculine. This approach is essentially scar-free. It may take more than one attempt to remove the tissue, and it depends most on how large you are to start with and how small you want to be as a final result. It would be difficult for me to say without meeting you if you are a candidate for this approach. Good luck with your investigations!

Heather Richardson, MD, FACS
Beverly Hills General Surgeon
5.0 out of 5 stars 2 reviews

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