Breast reduction questions
December 7, 2020 2:10 AM Subscribe
I am meeting with a well reviewed and recommended plastic surgeon later today about a breast reduction. I have questions and concerns - please help me sort them out!
I am currently a 38 DD and have hit my limit of back pain. I wear a bra pretty much 24/7 but I still find my upper body collapsing over the weight of my breasts. I am so done. I have known a handful of people who have had breast reductions and have some concerns based on their experiences. My biggest concern is that most reductions I have seen do not "reduce" enough. Even searching through before and afters on the internet I haven't found a single set of images that shows a reduction that I would be happy with. How do I make sure that the surgeon understands I do not want breasts that are proportional to my body that I would really like to be what would be considered small chested. That being said, I had gotten insurance approval in 2016 for a reduction but the doctor I was seeing moved out of state before the surgery could be done. From that consultation I remember the surgeon saying that if I used insurance she would have to remove most of my breasts. She asked to consider whether I would prefer what I currently have to having nothing and if nothing was preferable she felt I would be okay with the amount she had to remove. Nothing is certainly preferable to me but I would like my chest to still read female. Did you have an insurance covered reduction that you felt went too far because of the insurance requirements? I can pay out of pocket if I have to but I would rather not.
I feel a little like goldilocks here - what I have is far too much, I am concerned a surgeon won't remove enough because of aesthetics and I am concerned that insurance requirements will remove too much. How do I make sure I end up with the result I am hoping for? I've tried searching for pictures of breasts the size/shape I would like but can't figure out a way to weed out sex dolls and porn from my image searches and I would much rather have pictures of real breasts of average, everyday people.
Lastly, I know one person whose reduction resulted in their nipple unnaturally high (about 3 inches above her remaining breast tissue) and pretty much flattened completely. I have no reason to think this will happen with this surgeon but it is a fear I have. Any stories of personal experience will be helpful.
I am currently a 38 DD and have hit my limit of back pain. I wear a bra pretty much 24/7 but I still find my upper body collapsing over the weight of my breasts. I am so done. I have known a handful of people who have had breast reductions and have some concerns based on their experiences. My biggest concern is that most reductions I have seen do not "reduce" enough. Even searching through before and afters on the internet I haven't found a single set of images that shows a reduction that I would be happy with. How do I make sure that the surgeon understands I do not want breasts that are proportional to my body that I would really like to be what would be considered small chested. That being said, I had gotten insurance approval in 2016 for a reduction but the doctor I was seeing moved out of state before the surgery could be done. From that consultation I remember the surgeon saying that if I used insurance she would have to remove most of my breasts. She asked to consider whether I would prefer what I currently have to having nothing and if nothing was preferable she felt I would be okay with the amount she had to remove. Nothing is certainly preferable to me but I would like my chest to still read female. Did you have an insurance covered reduction that you felt went too far because of the insurance requirements? I can pay out of pocket if I have to but I would rather not.
I feel a little like goldilocks here - what I have is far too much, I am concerned a surgeon won't remove enough because of aesthetics and I am concerned that insurance requirements will remove too much. How do I make sure I end up with the result I am hoping for? I've tried searching for pictures of breasts the size/shape I would like but can't figure out a way to weed out sex dolls and porn from my image searches and I would much rather have pictures of real breasts of average, everyday people.
Lastly, I know one person whose reduction resulted in their nipple unnaturally high (about 3 inches above her remaining breast tissue) and pretty much flattened completely. I have no reason to think this will happen with this surgeon but it is a fear I have. Any stories of personal experience will be helpful.
For pictures of real, everyday breasts, the website bratabase has a gallery of user-submitted photos.
You can also see the bras that these people found fitted best if you click on a photo.
You may have heard this already - but I have often read that plastic surgeons have their own system for 'cup sizes' that does not align with the bras that actually fit people after surgery.
posted by tulipwool at 3:41 AM on December 7, 2020 [3 favorites]
You may have heard this already - but I have often read that plastic surgeons have their own system for 'cup sizes' that does not align with the bras that actually fit people after surgery.
posted by tulipwool at 3:41 AM on December 7, 2020 [3 favorites]
The /reduction reddit is actually pretty good. I'm not ready for a reduction yet, still in the learning phase.
posted by Ms Vegetable at 5:49 AM on December 7, 2020 [1 favorite]
posted by Ms Vegetable at 5:49 AM on December 7, 2020 [1 favorite]
I shadowed a plastic surgeon in high school (18 years ago) for a study program. Saw a LOT of consults for breast lift/reduction and stood in on a surgery. The conversations were nearly all about removing just enough breast tissue for insurance, while leaving the maximum amount of breast behind.
One thing I remember really clearly was how many consultations died in the water when the surgeon explained the realities of the lift part. Lift your boob and look at the attachment point. That cannot be changed by surgery. If you have low boobs, you will have smaller, perkier, but still low boobs after a lift. Turns out this was really useful information for me to hear at 17, there's nothing wrong with me I just have low set breasts, but this was a deal breaker for a lot of women who wanted the aesthetic of really high breasts.
The thing with the insurance was two-pronged. This was a while ago so things in our nightmare healthcare hellscape may have changed. But basically as I remember it was some percentage of breast mass that had to be removed, plus a medically documented history of failed treatment for the symptoms you suffer from your breast size.
In most of the insurance consultations the surgeon cupped both her hands together with fingers slightly overlapping to indicate the new breast size (approximately a B cup).
posted by phunniemee at 5:59 AM on December 7, 2020 [2 favorites]
One thing I remember really clearly was how many consultations died in the water when the surgeon explained the realities of the lift part. Lift your boob and look at the attachment point. That cannot be changed by surgery. If you have low boobs, you will have smaller, perkier, but still low boobs after a lift. Turns out this was really useful information for me to hear at 17, there's nothing wrong with me I just have low set breasts, but this was a deal breaker for a lot of women who wanted the aesthetic of really high breasts.
The thing with the insurance was two-pronged. This was a while ago so things in our nightmare healthcare hellscape may have changed. But basically as I remember it was some percentage of breast mass that had to be removed, plus a medically documented history of failed treatment for the symptoms you suffer from your breast size.
In most of the insurance consultations the surgeon cupped both her hands together with fingers slightly overlapping to indicate the new breast size (approximately a B cup).
posted by phunniemee at 5:59 AM on December 7, 2020 [2 favorites]
I had a reduction about a decade ago and it remains one of the best decisions I've ever made. Definitely push your surgeon to try to give you the size you want (I wish I had pushed mine a little harder), but also bear in mind that the size you get when you come out of surgery isn't necessarily the size they will be forever. Weight gain and general body changes as i've gone through my 30s have pushed my cup size up a bit from where it was immediately post surgery. I'm still super happy with how they look and feel though.
posted by fancypants at 6:36 AM on December 7, 2020 [1 favorite]
posted by fancypants at 6:36 AM on December 7, 2020 [1 favorite]
So, there is a limit to how much breast tissue can be removed and still maintain a normal breast shape. I think it’s really helpful to remember that the surgeon does not have a magic wand and that they will be working with your existing breast size and shape. If you haven’t seen a reduction that is small enough for your liking, it is unlikely you are going to receive one - this is not necessarily an indication that the surgeon has made an aesthetic choice or isn’t a good surgeon or isn’t listening to the patient, it’s just a function of anatomy. Ask your surgeon what the smallest size is that can be achieved with your anatomy so your expectations are manageable.
posted by tatiana wishbone at 6:39 AM on December 7, 2020 [5 favorites]
posted by tatiana wishbone at 6:39 AM on December 7, 2020 [5 favorites]
Also to echo fancypants, weight loss makes a HUGE difference in the size you will ultimately be at!
posted by tatiana wishbone at 6:41 AM on December 7, 2020
posted by tatiana wishbone at 6:41 AM on December 7, 2020
Mine was almost 13 years ago. I love my breasts now when I hated, hated, hated them before. I was developing a hump in my neck pre-surgery. I have mostly been overweight in my life, sometimes not, sometimes heavier than others, but my breasts are dense and have not changed much with my weight.
If you don't trust the surgeon you consult with, find another. That's the only way to make sure you are both well and happy afterwards - a surgeon you can talk to and work with.
posted by wellred at 6:42 AM on December 7, 2020
If you don't trust the surgeon you consult with, find another. That's the only way to make sure you are both well and happy afterwards - a surgeon you can talk to and work with.
posted by wellred at 6:42 AM on December 7, 2020
I also had a reduction 10 years ago, and wish I had done it 20 or 30 years ago. For me, one of the major differences is in comfort. I had boobs that hung/drooped low, and back pain from trying to hold them up with posture (and that is just insanely futile, but it wasn't voluntary), and tons of discomfort from bras trying to displace them 6" vertically digging into shoulders as a consequence of that futile task, and -constant- discomfort from the boobs falling out of bras. Never mind the chest binding and breathing restrictions.
Post op, I'm just so much more comfortable. They are maybe a C cup? But they stay in place largely on their own, they stay in any bra I put them in, it doesn't require a suitcase to try to hold them onto my chest. There's little to no flap or overlap from bottom of boob to chest below. They just -- stay. And I'm SO much more comfortable. So for me it was more about the translocation, probably through skin reduction as well as breast tissue, that resulted from the reduction.
Nth the recommendation to find pictures (and bring them to your surgeon), paying close attention to overall body type as well. Edit add: I see you're in W.Ma- I can recommend my surgeon at MGH.
posted by Dashy at 6:45 AM on December 7, 2020
Post op, I'm just so much more comfortable. They are maybe a C cup? But they stay in place largely on their own, they stay in any bra I put them in, it doesn't require a suitcase to try to hold them onto my chest. There's little to no flap or overlap from bottom of boob to chest below. They just -- stay. And I'm SO much more comfortable. So for me it was more about the translocation, probably through skin reduction as well as breast tissue, that resulted from the reduction.
Nth the recommendation to find pictures (and bring them to your surgeon), paying close attention to overall body type as well. Edit add: I see you're in W.Ma- I can recommend my surgeon at MGH.
posted by Dashy at 6:45 AM on December 7, 2020
Seconding the recommendation of MsVegetables to check out r/reduction. It's a great resource -- I've referred more than one person there from r/abrathatfits and they've said it's been really helpful.
What Bra Sizes Look Like, a blog started by the good people at ABTF, will show you images of people in bras that fit. It's a good place to get an idea of the size you're aiming for. (See my PS below, heh.)
And I'll echo the suggestion of tulipwool to look at the Breast Shapes Gallery at Bratabase. Also, I double second the observation about surgeons and cup sizes -- cup sizes correspond to band sizes, which they don't seem to know. A lot of people don't, but surgeons are getting paid $$$ and they should know!
PS Models in bra ads usually aren't wearing the right size bra unless it's a company like Ewa Michalak or Panache that makes a point out of good bra fitting.
Most of the time, they do one of two things:
1. Photoshop the hell out of the picture.
2. Put a bra with a 34-inch band on somebody whose ribcage, or underbust, measures 28 inches, then clip it in back so it fits well enough for the photo. (One thing I learned by hanging around ABTF is that it is not uncommon for adult AFAB people who are *not* models to wear a band size of 32, 30 or 28.)
posted by virago at 9:57 AM on December 7, 2020 [1 favorite]
What Bra Sizes Look Like, a blog started by the good people at ABTF, will show you images of people in bras that fit. It's a good place to get an idea of the size you're aiming for. (See my PS below, heh.)
And I'll echo the suggestion of tulipwool to look at the Breast Shapes Gallery at Bratabase. Also, I double second the observation about surgeons and cup sizes -- cup sizes correspond to band sizes, which they don't seem to know. A lot of people don't, but surgeons are getting paid $$$ and they should know!
PS Models in bra ads usually aren't wearing the right size bra unless it's a company like Ewa Michalak or Panache that makes a point out of good bra fitting.
Most of the time, they do one of two things:
1. Photoshop the hell out of the picture.
2. Put a bra with a 34-inch band on somebody whose ribcage, or underbust, measures 28 inches, then clip it in back so it fits well enough for the photo. (One thing I learned by hanging around ABTF is that it is not uncommon for adult AFAB people who are *not* models to wear a band size of 32, 30 or 28.)
posted by virago at 9:57 AM on December 7, 2020 [1 favorite]
Correcting myself so that my words correspond to the link:
It's not uncommon for adult AFAB people who are *not* models to wear a band size of 30, 28 or even 26.
While I'm here anyway, I'll add this: Bratabase explains how bra sizes work: Cup size is related to band size.
posted by virago at 10:10 AM on December 7, 2020 [2 favorites]
It's not uncommon for adult AFAB people who are *not* models to wear a band size of 30, 28 or even 26.
While I'm here anyway, I'll add this: Bratabase explains how bra sizes work: Cup size is related to band size.
posted by virago at 10:10 AM on December 7, 2020 [2 favorites]
This may not be a factor, but I met with many surgeons before settling on one and every old man surgeon I met with did not believe me that I wanted much smaller breasts. The one young woman surgeon listened to me, believed me, and gave me very close what I asked for and I am very happy with it. (I couldn't get it covered by insurance even though I met the criteria.) Finding a plastic surgery website-- I seem to remember Real Self had some reduction information not tied to any particular surgeon -- might help you find the images that you are looking for.
posted by *s at 10:27 AM on December 7, 2020
posted by *s at 10:27 AM on December 7, 2020
Here's the site that was super helpful to me. You have to register to access the forum (where people post pics), and to do that I remember you have to prove you're a real person, like using a drivers' license, for obvious reasons. But it really showed me the diversity of breast types (and reasons for reduction!) and helped me figure out realistic expectations, and how to talk & listen to the surgeon.
posted by Dashy at 12:03 PM on December 7, 2020
posted by Dashy at 12:03 PM on December 7, 2020
This thread is closed to new comments.
This may not be relevant for you for life reasons, but when I had my reduction done, I didn't think at all about breastfeeding (the way they shift the nipples I think) and two decades later I was very grateful the surgeon did and wish I'd pushed for more concern there.
posted by dorothyisunderwood at 3:39 AM on December 7, 2020