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Breast Augmentation

Too small after Breast Reduction

cnicole
10 months ago

I had 2 consults with my PS to be sure about having the reduction & approximate a size. However, I am still left with them being much smaller than we discussed. I was a 40H/I before the Reduction & measuring 38 D now. I am 6 weeks post op & I was expecting to be E/F cup minimum. He removed 2850grams total. Insurance only required 700grams.

What options do I have as far as a revision?


Shashidhar Kusuma, MD Plantation, FL
10 months ago
SURGEON PROFILE PROFILE

In these cases, there are really 3 options. One is to do an augmentation to increase the size. The second is to do fat grafting to increase the size and the third is to do both perhaps. Each has its own merits and limitations. I hope you find the right solution for you.

Steven Wallach, MD New York, NY
10 months ago
SURGEON PROFILE PROFILE

You will have to wait and see how things will settle down. Give it 6 months and then if you feel that they are too small an implant might be able to be added.

Katerina Gallus, MD San Diego, CA
10 months ago
SURGEON PROFILE PROFILE

Hello and thank you for your question. I am sorry to hear you are unhappy with your results from a breast reduction. Your options include augmentation, fat grafting or a combination of both procedures. You are still early postoperatively and I would recommend that you wait 6 months before proceeding with a second procedure.

Stephen Chidyllo, MD, DDS, FACS West Long Branch, NJ
10 months ago
SURGEON PROFILE PROFILE

Breast reduction is a combination of art and anatomical geometry. Your surgeon needs to "fit the pieces" of the puzzle back together after reducing the breast components. The fact that you were 40 H/I pre-operatively makes the surgery even more challenging. The fact that your surgeon was able to create your new breasts into an E/F size is amazing, in that he/she was able to keep them that large. I realize that you want them still larger, and I appreciate your concerns. First I would wait one full year before making any further decisions. The simplest way to proceed, if you still want larger breasts, is with a small augmentation.

Rick Rosen, MD Norwalk, CT
10 months ago

I would agree with the other surgeons responses. I would wait and let everything heal first. Usually women may lose some weight from their abdomen's after the procedure and the breasts will seem larger on your torso. If things do not improve to what you want, you can consider fat grafting or an implant. Stay in touch with your surgeon.

When we perform breast reduction surgery, we do not have different sizing devices or molds that create a precise cup size for your postoperative breasts. The goal is removal of tissue, tightening of the breast skin, moving the nipple to the proper anatomic position, and ensuring as much size and shape symmetry as possible. No surgeon can guarantee you an EXACT cup size; however, I tell my patients that they should plan for a full D or DD cup after surgery. If some patients want a more aggressive reduction I can take a little more than usual, and vice versa. In your specific case, you are only 6 weeks out from surgery. Be patient and wait at least 6+ months. Now your breasts aren't going to get LARGER as you heal, but get acquainted with your new breasts. It is very possible that you will learn to love them and not want anything changed. If they are still too small after 6-12 months, then a breast augmentation or fat grafting may be options to help you increase their size.

Jon Ver Halen, MD Colleyville, TX
10 months ago
SURGEON PROFILE PROFILE

Dear Nicole,

Thank you for you excellent question. I agree with many of the comments on this thread. First, wait 3 months before making any decisions. If, after that time, you still want to be larger, then research an augmentation using an implant and/or fat grafting. Either option will likely suit your needs. Good luck!

Jon

Mariam Awada, MD, FACS Southfield, MI
10 months ago
SURGEON PROFILE PROFILE

Hello Ms Nicole,

I am sorry you are unhappy with your size. Focus positive energy on healing as best as possible and recovering from a major surgery. Give yourself time to live with your new breast size before convincing yourself you need to change anything. I recommend waiting a year to allow your scars to heal and breasts to settle . At that point you can determine where you want more volume if that is still the case. Breast implants and fat are the main options you have to add volume.

Sachin Shridharani, MD New York, NY
10 months ago

Dear Nicole,

It can always be concerning as a patient when you don't have the outcome you expected. Hopefully, you and your surgeon can work together and come up with a plan so you are pleased. Considering you are six weeks out from surgery, I would advise you to continue to follow-up for your routine appointments and surgical care. One should really wait at least 6 months prior to assess the final size and shape of the breasts after undergoing your procedure. At that time, if you are still displeased, you could have breast implants placed or fat transfer. Fat grafting/fat transfer is a process of liposuctioning one part of your body and using the healthy components of the fat and injecting it back into your breasts like a biologic "filler" to add volume.

Steve Vu, MD, FACS Huntington Beach, CA
10 months ago
SURGEON PROFILE PROFILE

I would definitely wait to allow your breasts to completely heal and settle (approximately 6 months). If you still feel that the breasts are too small then you have the option of breast augmentation with implants and/or autologous fat grafting. Waiting will also allow time to see if there are any other issues that may also need to be corrected: dog-ears, hypertrophic scars, asymmetry, pseudoptosis among other things.




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