I think that it is a good idea to lose the weight first, The breasts will likely get smaller and better to size them up when you reach your goal weight.
Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform. You are wise in achieving, as close as possible, to your long-term stable weight prior to proceeding.
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.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. This careful selection of plastic surgeon will be the most important decision you make.
Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon. Most patients wish to achieve a enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. I suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, a “A or B cup” may mean different things to different people and therefore may be a source of miscommunication. In my practice, I ask patients to communicate their goals with the help of goal photographs.
I hope this, and the attached link/video, helps. Best wishes.
Breast reduction surgery is like a geometric puzzle of removing a portion of the breast tissue (enough to have an effect on breast size-related back pain) while maintaining an aesthetic appearance postoperatively. The technical maneuvers involved in this to some degree dictate the amount that needs to be removed. This predetermined amount is also required by many insurance companies in order for the surgery to be considered reconstructive, and thus, have the cost be reimburseable. The surgeon can be more or less aggressive around this amount, but it's hard to offer a patient a guaranteed size, particularly since the fit of the same bra size can markedly vary between brands, and women (I've seen patients with similar breast sizes, although one fits a D and the other an F!). With that in mind I usually tell patients undergoing a breast reduction that approximately half of the breast tissue will be removed with around 20% wiggle room in either direction from that amount. Most importantly, be sure you are evaluated by a plastic surgeon certified by the American Board of Plastic Surgery in order to get a qualified, expert opinion on your surgical options and expectations.
Best of luck,
Keith M. Blechman, M.D.
New York, NY
Hello. Breast Reduction surgery is life changing! Your will feel better and have less shoulder and upper back/neck pain. The amount removed varies by patient and also their insurance company requirements. The goal of an A cup does sound a little " too far" and usually a B cup is a nice compromise. The deeper tissues have to supply the nipple with a blood supply so there really can be no guarantee, but all plastic surgeons would attempt to get you as small as you wish!
Losing a healthy amount of weight can help decrease the size of your breasts, and you might not need surgery. Your surgeon can help you reduce the size of your breasts proportionately, so it’s a good idea to pursue surgery once you’ve reached your ideal weight. How much the breasts can be reduced depends on your unique physiology, and generally the results should be proportionate and complimentary to your overall body contour.