Breast Reduction from 36DD to an A?

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 when she sees her plastic surgeon. She should select an implant that optimally fills her breast envelope, neither overfilling and stretching it, nor underfilling it so that the breast is not proportionately augmented.

Similarly, a reduction patient should want the surgeon to reduce her to the size which creates the best shape for her body.

Hello and thank you for your question.
The best thing to do is to schedule a consultation with a board certified plastic surgeon to discuss the options. Best wishes!

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 is left in place is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue. If the pedicle is made too small (in the effort to reduce the breasts as much as possible)  then patient will likely have problems with tissue survival.  Doing the procedure in more than one stage allows the tissues to  acclimate to the surgically decreased blood flow before  further tissue removal (and potentially further decreased blood flow)  occurs ( with the 2nd stage operation).

The other concern with overly aggressive breast reduction surgery is patient dissatisfaction  afterwards.  It is not unusual for patients who have lived with very large breasts to want to have as much as possible removed. Care must be taken to be judicious in this removal to avoid an outcome where the breasts  are too small in relation (proportionately) to the patient's other body parts.  Again, it is not uncommon, for patients'  breasts to become smaller ( after the breast reduction procedure) with time and/or weight loss-  breast augmentation may become necessary to achieve the patient size goals.
 
 
I  hope this helps.