Why was I not able to choose my size? (Photo)

Thank you for your query. The fact that your surgery was covered by insurance means you had medical issues and needed a significant reduction. When we do breast reductions at a very young age we try to leave as much of central glandular breast tissue as possible, so that lactation would be possible later. This would be my best guess as to why your surgeon did not reduce your breasts more. Also losing weight is especially difficult with large pendulous breasts. It may be best that you have a discussion about your concerns with your surgeon. All the best!

The original size and shape of your breasts affect the process as well as your height and weight into deciding what size will be proportionate to your body shape and frame. In general, patients will go down at least one or 2 cup sizes after breast reduction surgery

First, when performing breast reductions, surgeons often consider both the physical and aesthetic aspects of the procedure, as well as your body’s ability to heal. Surgeons might be hesitant to remove too much tissue, especially if they think it could affect the stability of the breast structure or result in complications, such as poor healing. Your surgeon may have taken into account that your body composition might change over time, and keeping your breasts at a D might have been a balanced option, given your weight at the time.


As for not requiring weight loss before the procedure, many surgeons are focused on helping you achieve a result that’s best for your health and well-being. However, they typically recommend weight stability (at least 3-6 months) before surgery to ensure the most predictable and lasting outcome. If you were overweight, they may have felt that your body might undergo further changes as you lost weight, and they didn’t want to make irreversible changes to your breasts before knowing what that would look like post-weight loss. Weight fluctuations after a breast reduction can affect the final result, as you’ve experienced with the sagging after weight loss.


You will want to discuss with your surgeon your goals after weight loss (for example, if you want a breast lift with the same volume, or want the breast to be larger). There are also options for some patients using their own tissue (like the side breast or back roll) to augment the breast without an implant. It will be helpful to have an open conversation with your current surgeon to discuss how you feel now and explore options that might be better suited to your current body and goals.


ABOUT DR. VYAS
Dr. Krishna Vyas, MD, PhD, MHS, is a highly trained plastic surgeon specializing in aesthetic surgery and breast surgery, including breast augmentation, reduction, lifts, and gender-affirming surgery (such as chest masculinization and feminization). With advanced training from institutions like Harvard, Mayo Clinic, and Johns Hopkins, Dr. Vyas is recognized for his expertise in breast and chest sensory nerve restoration. His PhD in clinical and translational science focused on stem cells, fat grafting, and improving outcomes in aesthetic surgery and breast surgery. Dr. Vyas has served on the editorial board for several medical journals and platforms and has over 200 research papers and talks. His research focuses on aesthetic surgery, regenerative medicine, stem cell biology, fat grafting, breast surgery, and gender-affirming surgery. Recognized for his expertise, Dr. Vyas was appointed an Instructor of Surgery at Mayo Clinic and served as an Assistant in Surgery at Harvard Medical School and Massachusetts General Hospital.


Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained
Aesthetic Plastic Surgeon
New York, New York