Breast reduction from 32D/30DD - how small can I go? Discomfort and an athletic career

My large, heavy breasts are hindering my career as an adventure guide - backpacking, mountaineering, etc - by adding weight, unnecessary movement, and back, shoulder, and neck tension and pain (a problem even when I'm less active) I want a reduction as small as logically possible. I'm athletic and not super feminine so I'm not worried about 'not looking like a girl'. Any idea what cup size on a 32 band might be possible for me and/or how much mass/weight I could get removed? Thanks!

Doctor Answers 9

Breast reduction and size

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The good news is that a breast reduction procedure can result in a significant reduction in breast size. I do not like to use bra sizes as a measure, since they are so inaccurate and unreliable, but if you truly have a D cup size you can certainly go to a small C or large B cup and still retain a beautiful shape. I would estimate you can probably have 200-300 g of tissue removed safely. Remember, what makes a breast beautiful is not size but shape. A vertical, "short-scar" reduction with liposuction in certain areas will probably result in both a beautiful shape as well as achieve the reduction in size that you desire. Please consult with a board-certified plastic surgeon who has extensive experience in a vertical reduction technique - and best of luck!

Chicago Plastic Surgeon
4.7 out of 5 stars 38 reviews

What to do?

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You have a complex situation.  Right now you want much smaller breasts.  You need to establish a few goals: size, shape and the amount of scarring you will accept.  Most women want them to be smaller but maintain a good shape, preferably with the least amount of scarring. You may be into mountaineering now but that may change.  In your case you have full breasts with minimal sagging.  You still want to have good shape with minimal scarring.  My advice would be two options; 1. Specialized liposuction by itself to reduce the size.  2. Reduction with a vertical type scar- around the areola and down the middle.   I would only do the second if you were okay with the scar and you really really wanted to be as small as possible.  I recommend having specialized liposuction alone performed. It is always best not to look like you have had surgery. In both cases about a 1/4 breast size reduction.

Your situation is difficult because you are in great shape. Your breasts have great shape but are too large for your body.  The 32 and a large cup size make it difficult for clothing etc. Traditional breast reductions work best in women who have large and sagging breasts.  You only have the large and no sagging (minimal....)

George Orloff, MD, FACS
Burbank Plastic Surgeon

Breast reduction from 32D/30DD - how small can I go? Discomfort and an athletic career

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Thank you for the question.
Yes, it is possible to reduce the breasts size very significantly. 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.
With the goal of improving communication with my patients (determining their goals in regards to breast size after breast reduction surgery) I find the use of photographs of “goal” pictures (and breasts that are too big or too small) very helpful. I have found that the use of words such as “natural” or “B cup” etc. means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I hope this, and the attached link, helps.

Breast reduction

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Hello and thanks for your photos
It sounds like your breasts are getting in the way of your active lifestyle. Your shape is good to begin with, and it is very likely that your shape would remain good after a vertical (lollipop) reduction.

It's always hard to make a prediction of how much tissue can be removed and what the final bra size will be. The weight of the tissue may depend on how dense vs fatty your breasts are. You already know that bra sizes are not an exact science, from the fact that you wear a couple of different sizes.

There is good evidence in the plastic surgery literature showing that even small reductions like yours are very effective in relieving symptoms from large breasts. These studies suggest that decisions about whether breast reductions are medically appropriate should be based on patient symptoms, not on arbitrary numbers such as amount of tissue to be removed or bra size.

There are some limits to how small surgeons can go with breast reduction, since we need to maintain blood supply to the nipple and tissue, and ideally maintain a good shape, though smaller.

I do think, based on your photos, that you could go quite a bit smaller and still maintain good shape, while feeling better in your active pursuits. 

Schedule a consultation with an experienced plastic surgeon, and s/he will be able to help you further assess how breast reduction can achieve your goals.
Best wishes-

Breast reduction from 32D/30DD - how small can I go? Discomfort and an athletic career (photos)

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Thank you for your question and photos. Yes! You are a #candidate for #breast #reduction. You appear to be in good shape. Your desire to have smaller breasts is understandable with the activities in which you are involved. In my opinion, some #liposuction and possibly a #vertical #reduction would be good procedures for you. These procedures leave less #scarring and beautiful results. I recommend that you contact a few #board #certified #plastic #surgeons who specialize in vertical reduction. I will attach a link which leads you to the #American #Society of #plastic #surgeons. You can locate these specialists in your area. Best wishes to you!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews


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Thank you for the question and the photos and you can significantly reduce your breasts with a reduction but an examination is needed to show you and also learn how much should be safely removed so you would be happy with the result.Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

The endpoint for breast reduction can be a small is a patient wishes.

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Your final size is really up to you. It's important that your surgeon is aware of your expectations. This can be discussed with the benefit of photographs as well as pre-and postoperative examples.

Breast reduction from 32D/30DD

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It's possible to get pretty small but that is at the expense of a less attractive shape due to loss of the projection of the breast. You're not going to get any very good answers on this site as it takes an exam to determine anything relating to how much can be safely removed. See a consultant or two and be prepared to give a very clear idea of what your final goal is.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast Reduction

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Thank you for your question. A Breast Reduction procedure automatically includes a Breast Lift. The goal of breast reduction surgery is to reduce the size of your breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts. Therefore they are reduced in size and uplifted. You can also lift breasts without reducing their size.
You will get the best answer to your question by scheduling an in person consultation with a plastic surgeon certified by the American Board of Plastic Surgery and discuss your unique situation and concerns. The surgeon would meet with you, examine you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure in person and what to realistically expect. Then you can make an informed decision on which procedure(s) to start with according to your desires, recovery time necessary, your history and current health.

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.