Disproportionately Small Breasts During Reduction?

If I want a disproportionately small breasts, will a doctor be willing to do this type of Breast reduction procedure? Why or why not? I don't want just a form to suit what society thinks my body should look like; I want something around an A or small B cup. I am currently somewhere around a 44 F. I want to be as flat as possible without nipple grafting, but still be able to breastfeed.

Doctor Answers 10

Breast Reduction and Small Cup Size Result?

Thank you for the question.

Yes, breasts can be reduced to a very small cup size them may even look “disproportionate” to the remainder of your torso.

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.

Unfortunately,  the less breast tissue preserved,  the more risk that you will not be able to breast-feed successfully.

Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

As "flat as possible, but still be able to breastfeed"??

Your expectations do not sound reasonable to me.  Your current size of 44F indicates that you are not a small woman--that means an A or B cup would really not be proportionate for you.  Even if a surgeon could make you a B cup (not likely, due to breast width), nobody can ever guarantee that you can breastfeed after any breast surgery.  You may avoid a nipple graft, but you may or may not be able to breastfeed.  Your final cup size will be dictated by your breast width (the "number" in your bra size) and the amount of tissue that needs to remain to support the blood supply to your nipple complex.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 42 reviews

Final size is patient dependent

Ultimately, the final size that you would like your breasts to be is up to you. However, I think that it is important for you to be reasonable with yourself and with your surgeon. If you are really a 44F cup breast, then you have a significant amount of room for reduction in your operation.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 22 reviews

Achieving your size goals may be unrealistic

There are limits to how much a breast can safely be reduced especially when you eliminate free nipple grafting and stipulate the need to still be able to nurse. In the absence of free nipple grafting the surgeon must maintain sufficient breast tissue so as not to compromise the circulation to the nipple areola complex. Otherwise these structures could be lost.

As well, maintaining an adequate amount of glandular breast tissue is needed to insure the ability to produce sufficient quantities of milk for nursing. And finally, a certain amount of tissue must remain to fashion a nicely shaped breast. Therefore, you may have to modify your final desired size to satisfy your other goals. You must carefully discuss these points with your surgeon of choice prior to surgery.

David A. Ross, MD (retired)
Chicago Plastic Surgeon
4.6 out of 5 stars 89 reviews

Disproportionately small breast reduction


When discussing your breast reduction surgery with your doctor, be sure to be as specific as possible about your reduction goals. If you want breasts that are disproportionately smaller than the rest of your body, consider that this may cause you to have an unbalanced or pear-shaped appearance. Also remember that once the breast tissue is removed and can never be replaced. You may want to err on the side of caution and undergo a smaller breast reduction that will keep your body in shape and harmony. If you decide at a later date that you want even smaller breasts this is always possible.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Breast reduction

I think your goals are extremely unrealistic with the current size of your breasts. Do reduce an "F" cup to an "A" or "B" without basically performing a mastectomy or an amputative reduction with a free nipple graft will be impossible to sustain the blood supply and ductal tissue for breast feeding.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

You get what you need...

Remember the Stones' song: "You can't always get what you want?" Breast reduction is a combination of reconstructive surgery, which has cosmetic benefits. From the insurance company's perspective, the weight removed per side is specified. You and your doctor should agree in principle to your targeted size and how to get there, however there should also be some areas of negotiation. For example, if breast feeding is a priority, you must allow adequate preservation of the nipple-areolar complex. You shouldn't feel constrained to conform to a "societal norm" but you also need to understand and support the plastic surgeon's perspective, that there is an important trade-off between maintaining blood supply and resecting sufficient tissue. Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

You can't have all that you want

It would be possible to get you to a very small cup size, but almost certainly not without a free nipple graft if you are a size F right now. Even without a nipple graft, going down that far would likely eliminate breast feeding options. So be careful if you meet a doctor who says you can have all of these things without problems, either they aren't telling the truth or they are very inexperienced.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Small is possible

Breast reduction can accommodate a desire for different sizes, however, there is a limit as to how much tissue you can remove and still maintain a nipple that is supplied with adequate blood and enough breast tissue to breast feed. The greater the amount of breast tissue that is removed the smaller you will be, but you risk losing the nipple due to loss of blood supply. There is no guarantee that you will be able to breast feed after a breast reduction but if there is sufficient breast tissue still connected to the nipple it is reasonable to expect some milk production.

Discuss this issue with several plastic surgeons and choose the one that you think will get you the results you desire.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon
4.6 out of 5 stars 38 reviews

Multi-part question

You can reduce your breast to almost any size you want, it is just a matter of scars, shape, and risks. Mastectomy is the extreme of reduction. Nipple grafting is certainly an option since the more you reduce the breast tissue the more the blood supply to the nipple is in jeopardy. The other question of breast-feeding is a separate issue since ability to breast-feed is not dependent of size of breasts although nipple grafting would probably eliminate your ability to do so. Have a careful and extended discussion of your motivations, goals, and options with a reputable surgeon and perhaps get a second or third opinion.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.