Q: I had a breast reduction in October 2010, and I am thinking about getting pregnant again. I was a DDD before, and now am a B. Surgery went well, but if I gain roughly 20 lbs during pregnancy, how big do you think that the breasts will get? I had a free nipple graft, so no breast feeding. I just don’t want to go back to the “bigger” me. I love being smaller. Thanks so much!
A: The changes that will occur after pregancy from a breast reduction are fairly predictable for many patients. The breasts will, of course, enlarge during the course of your pregnancy. They will not likely become a DDD again but they will certainly get bigger than a B cup. After delivery, your breasts will almost certainly shrink back down. There are a few patients in which they do not shrink back down considerably but this is fairly rare. What will also happen in this shrinking process is that they may potentially end up even smaller than before, perhaps going all the way down to an A. This is known as breast involution (loss of breast tissue after pregnancy), and is common, but in the breast reduction patient may become more pronounced. I have seen more than one breast reduction patient who lost all of their remaining breast tissue after pregnancy and actually later went on to a have a breast augmentation to get back some breast volume and shape. What will actually happen to you, of course, can not be precisely predicted but I think the fear of ending up bigger again is unlikely.
Dr. Barry Eppley
Q: I am going to have breast reduction surgery and I was wanting to know if I have more children in the future will my breasts go back to the before size, or just bigger than the after size? My insurance will cover it now, not then, that is why I was curious.. Thanks for the help.
A: From a breast shape and size standpoint, the answer would be that one should wait until after having completed all the pregnancies that one desires then have a breast reduction. But life is rarely ideal and breast reduction followed by pregnancies are not rare. Teenagers and young women commonly have breast reduction followed by pregnancies. The back, neck and shoulder pain from large breasts make the appeal of such surgery very attractive to get relief now rather than years later. Also, if you have insurance now and may not later there is the obvious financial attraction to doing something while you have coverage.
That being said, breast reduction and secondary pregnancy are not mutually exclusive…provided one acknowledges that the breasts shape and size that is obtained from the surgery will be negatively affected by future pregnancies. Most likely they will get smaller, they will sag more (the bottom will fall out more) and they will become flatter in shape. Pregnancy stretches out the skin and shrinks away breast tissue causing a deflation effect. In rare cases, the reverse may actually happen where the breasts become bigger again.
There is nothing wrong with doing breast reduction before pregnancy as long as one realizes that the breasts will not stay the same size and shape afterwards.
Dr. Barry Eppley