Thank you for sharing! Large breasts may not only interfere with your physical ability to function in daily activities but can be emotionally burdensome as well. From what you describe you are a candidate for a breast reduction. Breast reduction surgery removes excess breast tissue and reshapes the contour of the breasts so that they are smaller and perkier. It is possible to do a breast reduction with a minimal scar technique and can also be done as an outpatient procedure under twilight sedation. I commonly use a minimal incision technique (Le Jour), eliminating the need for large scars while providing a pleasing breast contour that is proportionate to the patient’s body. Your surgeon knows exactly how much tissue he or she is taking out, because it is weighed after removal. Additionally, breast reduction comes with an added bonus- the removed breast tissue can be sent to the lab and examined by a pathologist for signs of cysts or cancer. And having smaller breasts can take years off your appearance! Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine, which sounds like your situation. Recently, managed care has adopted stricter standards for coverage, so just make sure these problems are thoroughly documented in writing by your primary care physician and plastic surgeon. They may also have to submit photographs. Even then, you may be required to seek a second opinion from a chiropractor, physical therapist, or orthopedic surgeon. It's important to be sure expectations are realistic and you have an understanding of the commitment needed for the healing process. Make sure that you understand the nature of your surgery, the recovery process, and that you feel comfortable to make these changes to your body. I suggest making an appointment with a board certified plastic surgeon who will discuss your options in detail.

Gynecomastia is often an inherited condition that cannot be improved without surgery. Fortunately, today there are improved techniques that reduce the size if your breasts and give you an improved appearance to your chest. Small incision surgery with a liposuction approach can safely and effectively help without the need for general anesthesia. Boys going through puberty and even older men may develop gynecomastia as a result of changes in hormone levels. If you are considering male to female breast enlargement it may make sense to defer gynecomastia surgery since you will want to increase your breast size, not decrease it with gynecomastia surgery. While you could see enlargement with hormone therapy, removal of breast and fatty tissue might reduce the hormone receptors. I suggest making an appointment with a board certified endocrinologist and board certified plastic surgeon to discuss your options and what to expect.

Thank you for your question! Large breasts may not only interfere with your physical ability to function in daily activities but can be emotionally burdensome as well. Although it is difficult to determine post-operative cup sizes without an in-person examination, from what you describe you are a candidate for a breast reduction. Before the procedure, I usually have my patients bring in a bra of the size they want to be post-operatively. Breast reduction surgery removes excess breast tissue and reshapes the contour of the breasts so that they are smaller and perkier. I commonly use a minimal incision technique (Le Jour), eliminating the need for large scars while providing a pleasing breast contour and shape that is proportionate to the patient’s body. Your surgeon knows exactly how much tissue he or she is taking out, because it is weighed after removal. The good news is that this procedure can be performed under local anesthesia and twilight sedation as an outpatient procedure. Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine. Recently, managed care has adopted stricter standards for coverage, so just make sure these problems are thoroughly documented in writing by your primary care physician and plastic surgeon. They may also have to submit photographs. Even then, you may be required to seek a second opinion from a chiropractor, physical therapist, or orthopedic surgeon. It's important to be sure expectations are realistic and you have an understanding of the commitment needed for the healing process. Make sure that you understand the nature of your surgery, the recovery process, and that you feel comfortable and emotionally ready to make these changes to your body. I suggest you make an appointment with a board certified plastic surgeon who will examine you and go over your surgical options in detail.

Thank you for sharing your question! The volume removed from a patient’s breasts during a breast reduction procedure is difficult to correlate to a cup size. For example, a shorter and more petite patient receiving a breast reduction that removed around 200-300 g from each breast would have a more noticeable reduction in cup size than a patient who is larger and heavier in weight since the heavier patient may have more body fat, a wider back, and a different distribution of fat in the breasts giving the breasts a different appearance or contour. I suggest making an appointment with a board certified plastic surgeon to discuss the procedure in greater detail.