My breast reduction wound has opened up 20 days post op while in Thailand for a vacation. What should I do? (Photo)

A physical exam coupled with your surgeon's experience will best answer your question.  Cup sizes are not the best measure of the final size.  The breast should be proportionate to your frame.

Since you are having symptoms due to your large breasts, you are a good candidate for a breast reduction surgery.  It will help with your back pains, but will not improve your asthma symptoms.  This procedure has one of the highest patient satisfaction ratings as there is usually...

You should be able to get up and move around the next day.  Depending on how well you are healed you should be able to attend a function 2 weeks after the procedure.  Your stamina may be reduced so the length that you stay at the function may be shorter than desired.  Please ask...

Based on your photos, it appears your nipples have had some superficial sloughing. This is where the outermost portion of the graft falls off. As long as the underlying tissue survives, the nipple is actually still there even though some of the pigmentation may be lost. In my experience, this...

You can reduce the breast size with minimal incisions using liposuction techniques.   The main challenge with this is that it doesn't lift the breast much and doesn't help with any redundant skin.  You could try some non-invasive methods to tighten the skin but it would be very limited...