5'4", 215lb. Possible to Go From 42H to C or D Cup?

Thank you for the question. 

Congratulations on your decision to proceed with breast reduction surgery;  it is one of the most patient pleasing operations we perform.  Also, congratulations on your dieting and exercising program;  it is certainly in your best interest to reach a long-term stable weight ( if possible)  prior to proceeding with the breast reduction procedure.

Unfortunately, no plastic surgeon is able to predict exactly what cup size you will be after breast reduction surgery. As you know, cup sizes vary depending on who makes the bra; this makes discussing cup size an inaccurate way of communicating your goals.  Also, every patient's chest width varies;  if the patient has a wide chest wall it may not be possible to achieve a smaller width  or cup size.

Nevertheless, before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “D cup” or "fake looking" means different things to different people and therefore prove unhelpful.  

Best wishes.

Yes it is possible to be safely reduced from H cup to a C cup. Loosing weight first rather than after surgery will give you better cosmetic results.

Sincerely,

Martin Jugenburg, MD

Congratulations on your weight loss. Its impossible to give you any meaningful advice here.  Please see a board certified PS.