I Am 5'1" and a 34G. I Want to Be a C, but the Dr. Says D. Doesn't He Do What I Want? (photo)

There are a few issues for you to consider regarding reducing your breasts to a much smaller size. There are no accepted standards that dictate a particular breast volume translates to a specific cup size. That is why one company's "C" cup may fit identical to another company's "D" cup. As a consequence, it is possible that you and your doctor are thinking about the same/similar breast size but are attributing to it different cup sizes. Be clear with your plastic surgeon in regard to proportionality.

The next issue is that the outcome from surgery may not be entirely predictable. You may be in a range that could be "C" or "D" and your doctor is just making sure that you won't necessarily be disappointed if you end up slightly larger.

Finally, given your very large size, a greater reduction may translate to a greater risk of inadequate blood supply issues such as to the nipple where its viability can be compromised. Therefore, reducing slightly less may lower your risk for this problem which is definitely a worthy trade-off. 

I hear you. You would like to go as small as possible because you want more children. Cup sizes vary based on the bra manufacturer. To achieve a smaller reduction, you may need the inferior pedicle approach but this should not be a problem. Since you both may be thinking alike and expressing it differently, I recommend that you ask your plastic surgeon to show you a series of pre and post op photos so you can visualize possible results. Best of luck!