What Are Your Thoughts on my Breast Reduction? (photo)

I am a 27yr old, 5'5" 177lb with dense glandular 34DDD(previously 42/44 before weight loss).I saw a endocrinologist for lactation whom said that surgery is fine since my leaking is non-spontaneous. My doctor recommend anchor incision to a D but I prefer to get a C cup, so she said she would remove 500-600grams per breast. She said that she would not put in drains n that they only give me antibiotics through the IV? Will like to lose 20/25lbs after but worry about sagging? What are your thoughts?

Doctor Answers 8

Thoughts on breast reduction

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The choice of procedure for breast reduction is up to the plastic surgeon but it appears that you could have this done with a lollipop incision rather than an anchor incision approach. There is a difference between the external scar technique and the internal reduction technique of the breast although many plastic surgeons still treat them as if they must go together. 

The size you end up with (within the subjectivity of breast sizes) should be up to you (within reasonable bounds) and should not be based on weight of breast tissue predicted to be removed during the surgery. It is not possible to know the weight of tissue removed before the surgery and it should not be determined by the insurance company either. The way to approach this is to remove tissue to get down to the desired size and then find out how much the tissue removed to achieve that goal weighed. In breast augmentation, this is similar to figuring what size/dimensions of breast implant will fit and give the desired effect and then finding how many cc's that is rather than starting from the cc's and working backward. 

Drains are used to avoid blood or fluid collections that would compromise the blood supply or healing of the breasts and are not determined by antibiotics. Most plastic surgeons use drains for sizable breast reduction procedures such as yours. I would recommend it. 

I would lose most of the weight before the reduction procedure. More than a 10 lb weight loss after surgery can affect the size/shape of the result in unpredictable ways. 

Boulder Plastic Surgeon

Lejour breast reduction gives best long term shape.

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1)  The important thing is NOT to rely on pulling the skin to get a lifted breast shape, because skin stretches and you do not get good long term shape.  Lejour technique shapes the breast internally.

2)  C cup is good endpoint.

3)  Sounds like you can do surgery anytime.  Having smaller perky breasts can actually be an incentive to more weight loss.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Loosing Weight After Breast Reduction Surgery-Will Breasts Become Saggy?

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Thank you for your question and photos.

Conventional Wise, Anchor or Lejour breast reduction techniques are not designed to counter the effects of time, gravity or weight fluctuations. The Ultimate Breast Reduction, however, was designed using engineering principles to reshape the breast internally, permanently secure it and successfully transfering the weight of the breast on to the chest muscles. The concept of weight transfer has proven effective in eliminating pain immediately after surgery without removing vast volumes and maintaining an acceptable lift despite large weight loss. Another architectural improvement is that of eliminating the vertical scar which inherently weakens the skin envelope allowing the weight of the breast to 'bottom out' with time. I encourage you to do your research. This is a great start.

Kind regards,


Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast Reduction Candidate?

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Thank you for your question and pictures.

Congratulations on deciding to proceed with breast reduction surgery - it is one of the most patient pleasing operations we perform.

I would recommend that you be at a stable weight prior to surgery to achieve the best results. Achieving this long-term stable weight prior to undergoing surgery will help minimize the chances of complications and to potentially for further surgery comes along. 

Communicate your goals clearly with your plastic surgeon;  I prefer the use of “goal pictures”  to aid with this communication process.

Best wishes.

Breast reduction / reductio mammoplasty

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You are a good candidate for reduction mammoplasty now. Your Right breast apper to be slightly larger than the left one, therefore I recommend more breast tissue to be removed from the right breast 600 -700 gram sounds reasonable. If you are plannining to loose another 20 pounds, it is to your advantage to postpond your operation until your weight become stable aroud your ideal/desired weight. This amount of weight loss will make your breast saggy and may require revisional surgeries.

Weight loss not necessary mandatory prior to breast reduction

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Thank you for your question.  It is true that if you lose weight after breast reduction and some of the weight is lost from your breasts, your may sag a little.  Keep in mind that your breasts will always sag with time.  In addition, there are 2 considerations.  One, if you lose weight, do you lose weight from your breasts or not?  Were your breasts the same size at a lower weight?  If your breast size does not fluctuate that much with weight changes, then it probably will not make that big a difference if you lose weight after the surgery.  Two, many patients find it almost impossible to lose weight with large breasts but are able to lose weight more easily after breast reduction surgery.  For example, I just had a patient who came in first in her age group in a triathalon after breast reduction.  She is able to do the bike-riding part of the race so much more easily after her surgery.  Before surgery, literally her breasts hit her knees as she cycled.  So having surgery before losing weight is an option.  As far as how much weight to remove, it depends again on how much your breasts change with weight loss and your goal for cup size.  If your breast size does not change much with weight changes, then I would be fairly aggressive about removing enough weight.  I would probably suggest more than 500 grams per side.  However, you really have to discuss this with your plastic surgeon.  Also, remember that breast feeding may not be possible after breast reduction surgery.  Good luck.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Breast reduction

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If you are planning to lose weight, then I recommend you do that first before undergoing breast reduction surgery.  If you have the surgery first, the breast might become smaller and sag a bit.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast reduction suggestions

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I recommend that you first lose the weight because otherwise, you will have additional sagging issues to contend with and correction would not be covered by insurance. I personally use drains; if you have questions about why your surgeon does not do so, then these should be addressed prior to surgery.

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.