I have large breasts measuring approximately DDD. The weight of my breasts causes pain in my back and shoulders. I have severe arthritis already having 5 fusions in l-spine and c-spine and total shoulder replacement on right side. I consulted with a plastic surgeon to have breast reduction therapy. Evidently the surgeon decided on a size and submitted it to my insurance. I was very disappointed as I wanted to go smaller than average for my size and wasn’t given the chance to express this to the surgeon. The surgery was denied as not enough tissue would be removed. Is breast size automatically fixed according to body size of the patient? Is it possible to have breasts reduced to a smaller than average size?