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Breast Reduction from 36DD to an A?

My 29-yr-old daughter is a 36DD and wants to have reduction down to an A cup. Is that feasible? She would rather have a double mastectomy than have breasts larger than A. She has been planning on this surgery for many years.

Asked 33 months ago by WonderingMom in gainesville, FL

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Breast Reduction and Small Cup Size Result?

Thank you for the question. It is possible to reduce the breasts size very significantly. Sometimes when patients want “almost nothing left” the reduction should be done in 2 stages. The concern with the amount of tissue removed is related to blood flow to the remaining tissue; if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola) may be compromised. Part of the tissue that... more

Tom J. Pousti, MD

San Diego Plastic Surgeon

ASAPS ASPS

Large cup size change after breast reduction surgery

A large change in your cup size is possible after a breast reduction surgery you should proceed with a great deal of caution. When discussing your concerns and your post reduction goals with your plastic surgeon, keep in mind that you will want a balanced appearance after surgery. Make sure that the final cup size you select will be balanced with your hips and waist to create a pleasing figure. Also keep in mind that the larger reduction may require more extensive incisions... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Breast reduction

The goals to make an "A" cup from a D or DD cup size really is not realistic. You are basically asking for a mastectomy and the final result will doubftully look like a breast.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

It really couldn't be done

You really couldn't make a DD an A. Why? Because a DD breast has a very wide diameter. The base diameter of a breast gets narrowed somewhat in a reduction, but it can't be narrowed enough such that an A bra cup would fit, even if you reduced the volume enough so that there were almost no projection, it would still be so wide that pracdtically speaking it would require a larger bra. The best thing an augmentation patient can do for herself is to leave the concept of bra sizes at the door... more

Steven Teitelbaum, MD

Los Angeles Plastic Surgeon

ASAPS

I wouldn't try to go that small for breast reduction

Hello, Extreme breast reduction, like a mastectomy, is kind of a "one way street." I would recommend to preserve the sensation and the shape of the breast and reduce it within those parameters via a conventional breast reduction operation. The choice she is considering is not one she may be able to easily reverse later should she desire to do so.

John P. Di Saia, MD

Orange Plastic Surgeon

Extreme breast reduction

Thanks for your question - Such a dramatic change is possible but not without consequences that would make most plastic surgeons defer to treat her. A breast reduction from a DD to an A cup is unlikely to leave enough tissue to keep the nipple/areola complex alive. This means the nipple and areola would need to be removed and put on as a skin graft. This would mean that they would be insensate, the patient would not be able to breast feed and some patients can experience depigmentation... more

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

Not a Good Idea!

This magnitude of a change is drastic and would probably not be proportional to her body. She should consider being reduced to a size that is in proportion to her body and maybe slightly smaller. This will alleviate her symptoms and make her look much better. Pondering mastectomies instead of being larger than an A cup is alarming. There may be some issues here that need to be explored!

Michael S. Beckenstein, MD

Birmingham Plastic Surgeon

ASAPS ASPS

Breast reduction to an A cup is not likely

Many who seek breast reduction would like to be as small as possible and I frequently hear from patients who would like to be a B-cup, or perhaps a small C-cup. The key to reduction of the breast is preservation of the circulation and sensation within the nipple as the breast is reduced, and preserving the shape or aesthetics of the breast. Shape is very important and after reduction the breast should be pretty to look at. The skin remaining after reduction will only contract to a certain... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Drastic change

It isn't that women who have breast reductions are all by and large very happy with their change we try to keep some proportion. I would recommend that she pick a local board-certified plastic surgeon to have a consultation with to review her options. When a women comes in to see me basically stating that they want mastectomies, this is a concern and she may want to seek some counselling prior to any surgery. This doesn't mean that she could be a good candidate for breast reduction but... more

Michael C. Edwards, MD

Las Vegas Plastic Surgeon

ASAPS ASPS

Probably not in her best interests...

Hi there- One of the primary considerations in breast reduction surgery is maintenance of the blood flow to the remaining breast tissue and nipple. With greater tissue removal, there is a greater risk of losing blood supply and therefore losing the remaining breast tissue and nipple to necrosis. The alternative of removing the nipple and replacing it as a free skin graft at the conclusion of the procedure exists, but I would never recommend this to a young woman, as all nipple sensation and... more

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Armando Soto, MD

Orlando Plastic Surgeon

ASAPS ASPS

Breast Lift and Reduction in size

Dear Wondering Mom, Breast Lift and reduction in size is an excellent procedure and patients who have had symptoms for years do very well. A complete consult with the risks of the procedure is necessary and perhaps some photos of what shape/size your daughter would like would be helpful for the surgeon. With Warm Regards, Trevor M Born MD

Trevor M. Born, MD

Toronto Plastic Surgeon

ASAPS

Good shape and uplift is more important than size

I perform a large number of breast reductions and I would counsel the patient carefully into why trying to reduce her to an "A" cup would NOT BE RECOMMENDED. It is never good to go to extremes. Many patients that are quite large breasted can't wait to be smaller and they say things like "make them as small as you can". I agree the breast has to be properly proportioned to the patient's frame and chest wall and they are happy. I do not think it is possible to do this... more

James F. Boynton, MD

Houston Plastic Surgeon

ASAPS ASPS

It's All About Proportion

I hear this a lot from women with large breasts. They want to go completely in the opposite direction. But the reality is that the breasts should be in a natural proportion to the patients body. Most women should be a "C". This letter has limited real bearing but most women understand it as average. I think she should get an aesthetic procedure. She'll be happy with the lost volume.

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

A good plastic surgeon would turn down her request

There are many psychological problems she could get into after a surgery like you have described. Most good surgeons would counsel her to go down to a reasonable size, not lock in on a cup size, and keep her breasts in balance with her body.

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Careful consultation is required

First of all, your daughter should discuss careful what her expectations are. While some patients get fixated on a cup size, breasts are judged by proportional, shape, and symptoms. It is possible that she has been suffering from a fair amount of pain, discomfort, and perhaps embarrassment and self-image issues that she just wants the "damn things gone!" While that might be understandable, she might need gentle and realistic counseling about what would be reasonable and to perhaps... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Breast reduction surgery to reduce heavy breasts

Breast reduction is designed to reduce female breast volume while maintaining an aesthetic contour and form of the breast. The breast is an anatomic structure with glandular properties that should not be underestimated. Reduction of the breast from a DD to an A cup is very close to performing a mastectomy. A board certified plastic surgeon would be remiss in performing a surgery that would physically debilitate and deform a young female for life.

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

Small breasts after breast reduction

I guess you can say anything is possible, but unrealisttic. It would be hard for you to find a plastic surgeon that would do that surgery. You have to have some reasonable breast tissue after the surgery for the nipple and areola to live off of. If you reduce the breast that much, the chances of the nipple and areola dying off is very high. Most plastic surgeons would recommend going with a size that is reasonable and that fits her body well and does not compromise the blood supply to the... more