I Understand That Skin is Removed During a Breast Reduction. How is the Amount of Skin Removed Determined?

I am a 38DD with breast ptosis, looking to be reduced to a large B/small C cup. I am interested to know how this is determined in a general sense. Thanks!

Doctor Answers 10

Skin removed in breast reduction

This is a very perceptive question and the answer if one looks back over the history of breast reduction surgery is that we've learned a lot but some are still following a rigid pattern rather than a custom approach to the patient's situation (end result size, degree of lift, and management of the two dimensional excess skin areas). In general, reducing the size (volume) of the breast and raising it up to the appropriate level along with the nipple-areola is one thing and then rearranging the skin around it to accommodate the new position and size is another. Fixed patterns of skin removal like the old Wise pattern are not customized enough and don't maximize what we now know about minimizing scars in breast reduction. The surgeon should be able to measure, mark, and draw where the incisions will be, what skin will be removed, the planned diameter of the areola, and where the scars will end up. The skin within the incisions is what is removed but will vary from patient to patient and even from one side to the other. Ultimately, if the size and shape was what the patient expected and the scars are where the patient was told and she feels acceptible, the outcome should be satisfactory and exactly what skin is removed doesn't matter much. Exceptions might be specifics of skin marking such as stretch marks, scars, or tattoos. 

Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

The reason you have ptosis is the extra skin

If you had a tighter skin bra, then your breast would be higher and firmer.  When this skin stretches out over the breast tissue, either through breast feeding or from heavy tissue underneath, then the breast will look saggy.

When a breast reduction is planned out your surgeon will take measurements and make some marks.  This is usually done in the upright position.  Ever notice how different your breasts look when you lie down?  Well that is how they will look during surgery too.  So the marks are pretty critical to outline how much skin is going to come off.

The more skin and breast tissue removed, the smaller the cup size afterward.  But with bra makers changing how they measure their cup sizes you shouldn't be surprised after surgery that you fit into a c cup at one store and a b cup at another.  Just be sure that the person helping you find the best fit knows what they are doing and don't fret if the bra you love is a bigger cup size than you expected after surgery.  it happens to lots of our patients.

Phillip C. Haeck, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 37 reviews

I Understand That Skin is Removed During a Breast Reduction. How is the Amount of Skin Removed Determined?

Generally speaking a diagram is best to show the operative techniques. This is in most Plastic Surgery textbooks that can be reviewed with your boarded PS in an in person evaluation. Basically, the skin is removed inferiorly in the form of an inverted triangle from the N/A complex to the inframammary crease. The elevation of the N/A complex is determined by measurements. Hope this helps. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Skin removal during breast reduction

Some skin removal is necessary with a breast reduction so the skin will fit the new, smaller breast. How this is determined depends on a number of factors probably most important is the technique the surgeon uses. When you have your consultation with a board certified plastic surgeon, make sure you discuss with him or her how the surgery is done and what will be removed as this will determine where the post-operative scars are too. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon
3.6 out of 5 stars 13 reviews

Determining skin excision for a breast reduction

The amount of skin removed is related to the amount of breast tissue removed necessary to obtain the desired cup size and appropriate breast shape. You need to vocalize with your plastic surgeon exactly what the proportionality or relative size is that you want. Unfortuntately, there is no uniform definition of a particular cup size. For example different companies make "C" bras but they may all fit differently - a C cup from one company may fit exactly the same as a D cup from another company.

The second issue is that most women do misinterpret what volume/size a particular cup size actually is. Ultimately, it is the surgeon's understanding of your stated goals/desires that are used to help determine the final breast (volume) size.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Skin removal in reduction mammaplasty

There are a host of techniques available for surgeons. Each technique involvesa certain pattern for skin excision. Most surgeons mark the breast pre-operatively to determine the pattern of incision and skin removal. You can ask your surgeon to demonstrate how the surgery will be performed and you can get a general idea of what will beremoved. The pattern can be modified so that sometimes it is possible to include or exclude specific areas, for instance if you have a scar or mole or tattoo.

Robin T.W. Yuan,M. D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast reduction

The skin removed for a breast reduction really depends upon the laxity.  It is usually in a "T" type pattern or a lollipop type pattern.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast reduction skin removal

The important issue in a breast reduction is removing enough tissue and then elevating the nipple areolar complex. To the extent that there is extra skin, this is removed but I never think about the amount of skin to resect because it is secondary to the operative process. My concern is removing the appropriate amount of breast tissue and recreating a breast that is placed properly on the chest.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Breast Reduction skin removal

Thank you for your question.

For breast reduction surgery, I discuss with the patient what her goals are for after surgery and after taking measurements, we can go over what tissue / skin will be removed during the surgery.  Each patient is different with what their goals are so each surgery needs to be adjusted accordingly.

The tissue removed will be determined by how much breast tissue is removed.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Breast Reduction is also Skin Reduction

 Dear Pearls_77:

There are two components of breast reduction: the reduction of breast tissue and the reduction of breast skin. Reduction of the the breast tissue is what gives the smaller cup size, while reduction of the breast skin reduces sagging and improves the shape of the breast.

The amount of skin removed is the difference between the amount of skin present before breast reduction, and the amount needed to cover the new smaller breasts. While the excess needs to be removed, exactly how the breast tissue and skin is removed determines the shape of the new breast. This is part that requires practice. Be sure to find an experienced Board Certified Plastic Surgeon in your area for an evaluation of how this can best be accomplished in for you.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 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.