American Society of Plastic Surgeons
For Medical Professionals
 
Veda20
one year ago
Answered

Choosing size of reduction

Age 54, current size 34E/F like to be a B cup but my PS said I'd look better with a C cup to go with my body. Normally I am smaller but not being able to work out I've gained weight. I'm looking to the future of losing that wieght. I've only gained weight do to inactivity because my breast perspire and I get a rash. I don't want my PS choosing my cup size on my current weight.

Procedure: Breast Reduction
Type: Question

Replies 5

Debra Johnson
ASPS Surgeon
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Ideally, you would like to be as close as possible to your desired weight before you embark on breast reduction surgery. The breasts have a fair amount of fat mixed in with the breast tissue, so if you lose weight after a reduction, your breasts will lose fat as well. You may end up with a deflated breast that is too small for your frame. That is perhaps why your surgeon is suggesting a larger size than you desire. Remember, the surgeon has to leave enough tissue behind to support the remaining breast, skin, and nipple with adequate blood supply. Good communication is key. If you are willing to go to a B now, knowing your breasts might shrink with more weight loss, then be firm with your surgeon, and explain that you understand you might end up smaller if you do lose weight after surgery.

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Jeremy Sanderson
ASPS Surgeon

Yes, I completely agree with Dr. Johnson. I would add cup size can never be guaranteed because all bras are different, however if you want to go smaller you can. If you go from an E/F cup to a B cup you may need a slightly different type of reduction surgery, but it can certainly be done.

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Michael Carlisle
ASPS Surgeon

Sounds like you need to have another consultation with your surgeon before your surgery. You want to be on the same page. I hear your concern and going smaller for a future size goal is possible, but also someone unpredictable. I agree with the others. I would add that there is a certain proportion of breast tissue (therefore volume) that needs to be left in place to allow the skin and nipple to heal well. This tissue carries the important blood flow to those areas. Just keep that in mind. The more aggressive the reduction, there are more potential complications as well. Hope this helps.

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Lawrence Glassman
ASPS Surgeon
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There are limitations to final breast size following Breast Reduction. I recommend discussing the following points with your chosen Plastic Surgeon.

1. When reducing large breasts using a pedicle technique, there is a limitation of how much breast tissue can be removed and therefore a limit of how small a breast can be. The advantage of a pedicle technique is that the nipple and areola remain attached to the underlying breast tissue which allows for a more natural looking and functioning nipple areola as well as better sensation. The alternative is an "amputative " reduction with free nipple graft. This technique can achieve a smaller size but requires complete removal of the nipple areola and replacing it back onto the reduced breast as a free graft.

2. In patients with a broad chest and large breasts, reducing the breast to the volume of a "B", may produce a flat (pancake appearing) breast.

Learn your options and the limitations of each technique of breast reduction surgery.

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Nelson Castillo

Thank you for sharing your excellent question. I agree with you the the best, most predictable outcome will be when you are at your goal weight. Any significant weight loss after your breast reduction would lead to further tissue sagging and impair your surgical results. I would recommend losing the weight first, and then revisit sizing. Hope this helps.

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