There is no fixed limit. How much tissue comes out is decided by your anatomy and your symptoms, not by a number chosen in advance — and, importantly, Medicare item 45523 does not specify a weight. It asks only for macromastia causing neck or shoulder pain.
That matters because patients often arrive having read an overseas figure in grams. Those thresholds come from American insurance rules and have no standing here.
Why surgeons talk in grams, not cup sizes
Bra sizing is not standardised. A 14E in one brand is a 14DD in another, and the same woman can move two cup sizes by changing the band. Dr Kumar therefore plans and records the operation by weight of tissue removed from each side, and talks to you about proportion and symptoms rather than promising a letter.
If you want a rough translation: roughly 200 to 250 grams per side is often about one cup size for an average frame. It is a guide for conversation, not a measurement, and it shifts with chest width and breast base.
What actually decides the amount
| Factor | How it affects the amount |
|---|---|
| Your symptoms | The reduction is planned to take the load off the neck and shoulders, which sets a floor |
| Your frame | Chest width and height set what looks and feels proportionate, which sets a ceiling |
| Blood supply to the nipple | The further the nipple must travel, the more the tissue carrying it is stretched |
| Skin quality | Skin that has been stretched by weight loss or pregnancy behaves differently from skin that has not |
| Starting asymmetry | Most women differ side to side, so the two weights are rarely equal |
The limit that genuinely exists
The nipple stays attached to a column of breast tissue that carries its blood supply and nerves. In a very large reduction that column becomes long, and beyond a certain point the safer option is a different technique in which the nipple is taken off and replaced as a graft. That trades a more reliable outcome for the loss of nipple sensation and of any prospect of breastfeeding.
It is uncommon, it is discussed in advance rather than decided during surgery, and it is the one situation where the amount of tissue genuinely changes the operation.
Can I ask for a specific size?
You can tell Dr Kumar what you are aiming for, and it is a useful part of the conversation. What he will not do is commit to a cup size, because the finished size depends on how the remaining tissue settles over about three months, and because a reduction driven purely by a target number can leave too little tissue or take too little weight off your shoulders.
Patients who ask for a very large reduction usually want to be certain the symptoms go. Patients who ask for a small one are usually worried about looking flat. Both are worth saying out loud at the consultation.
Common questions
Is there a minimum for Medicare? Not a weight. Item 45523 requires macromastia with neck or shoulder pain. The criteria are set out here.
What is the Schnur scale? An American insurance tool relating body surface area to grams removed. Australian surgeons and Medicare do not use it.
Will both sides be the same weight? Usually not. The aim is symmetry of shape, which often needs different amounts taken from each side.
Can I go smaller later? A second reduction is possible but is a bigger undertaking than getting it right the first time, which is why the planning conversation matters.
Does more tissue removed mean worse scars? Not directly, but larger reductions more often need the anchor pattern rather than a vertical one. Where the scars sit.
Next step
Bring a GP referral to a consultation and Dr Kumar will examine, measure and photograph, then tell you what he can achieve for your frame and your symptoms. Call 1300 267 726 or request a call from his nursing team. More about breast reduction surgery, what it costs and recovery.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
