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!

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 (changes in color).

In addition, it would be very difficult to get a good cosmetic result from such a large reduction.

A careful discussion with a plastic surgeon regarding why she would like such a large reduction should take place. The most common reason for breast reductions are to improve neck and back pain, reduce shoulder grooving and intertrigo (rashes and infections in the folds) and to improve shape. All of these could be achieved with a more reasonable sized reduction.

I hope this helps.

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!

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 function would be lost.

I think that it would be much better to reduce her breasts to a size which provides both the symptomatic improvement she desires, while maintaining a feminine and natural appearance. The only thing worse than breasts which are too large, would be to end up with breasts which are too small and the need to place implants later (!).