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How do you know when you are TOO big?

How do you know when you are TOO big?

Most men say never…. many women say that when their bra strap digs a permanent groove in their shoulder, that is too big. Of course there are some women who wish they could have some of their sister’s “endowment”. Those larger ladies know that when a brassier becomes a hoist that they are entering the “too big” zone. So what does insurance say? In general insurance companies recognize that being very large busted has a significant impact of quality of life and ability to function. They realize that the rashes, back pain, neck and shoulder pain and hand numbness are significantly improved after a breast reduction. To understand what some ladies deal with everyday, imagine that you take two full liters of Coke and tie one on each end of a rope that is about as long as your arm and then walk around all day long with that contraption around your neck! Now can you understand the neck, shoulder and back pain! Most women in this position have poor posture and also develop rashes. For young girls who develop breasts early, the embarrassment can be monumental. They will slump around and wear two bras and a teeshirt under their clothing to camouflage their size because of all the unwanted attention. No woman enjoys having all eye contact being addressed to her chest, never to herself. 

So you think that you may be a candidate for a breast reduction, the next step is to speak with your primary care physician to document your symptoms. They will then refer you to a plastic surgeon for an in depth evaluation. If you are due for a mammogram, it is important to have that done prior to any breast surgery. Your initial consultation will include a physical exam, measurements, and photos. This is part of the important process of documenting your symptoms to justify insurance coverage. Some insurance companies have very reasonable criteria which make the process straightforward. Other policies will not even cover breast reduction no matter how many symptoms a woman has. 

The surgery involves both resizing the breast and lifting the breast to a more perky, smaller size. This is done by lifting the skin back to reshape and resize the breast then re-draping the skin and removing the excess. This technique, done 95% of the time, does not involve removing the nipple and then replacing it like a postage stamp. Because the nipple remains attached, the lady is more likely re retain normal sensation and potentially even the ability to breast feed. Breast reduction even reduces the risk of breast cancer and in general improves the accuracy of future mammograms. While recovery is different for everyone, most ladies can return to most usual activities in 2-4 weeks. Of course, those ladies whose occupations require much vigorous physical activity should seek their surgeon’s advice about when to return those specific activities. Generally, this is an outpatient surgery. In the recovery period ultrasound massage helps to reduce swelling and bruising and speed recovery.

A breast lift is different from a breast reduction in that minimal to no tissue is removed. So how do you know if you need a breast lift or a breast reduction? If you like your size when you are in a nonpadded bra, then you just need lifting. If on the other hand, you feel too large in a bra, you may qualify for a breast reduction. In general a breast reduction removes at least two (2) measuring cups (500gms) of breast tissue. Both breast reduction and breast lift patients get the benefit of more lifted breasts which improves posture and neck pain from tight bra straps. OF course there are some ladies who are saggy and small, who benefit from a breast lift and augmentation, we’ll save that for a future article. 

Sometimes ladies who have had breast cancer opt to have a breast reduction or a breast lift on the other side to help reduce their unbalance and to improve symmetry. This would also be covered by insurance as they are required to cover any surgery required to optimize symmetry. 

Other special circumstances are ladies and men who have experienced massive weight loss. These people may have lost over 100 pounds and in the process have much hanging skin on their chest and breasts. The group of people often benefit from combination surgeries like arm and back lifts along with the recontouring of their chest and breast in order to have more normal appearing upper body contour. 

So if you feel any of the above situations is similar to yours, then consult your family doctor who can assist you in choosing a plastic surgeon. If you think that insurance will play a role in covering your surgery, then use that visit as an opportunity to document your symptoms. You can also make an appointment directly with a plastic surgeon, be prepared to have photos taken as those will be required by your insurance company.

Just remember that the alternative to being big and saggy draggy, is being a little smaller and perky!