Is a Reduction from 44F/44DDD/46DD to "Small" B Realistic?

Congratulations on your decision to proceed with breast reduction surgery; this operation is one of the most patient pleasing operations we perform.
 
There is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery.

Before undergoing the breast reduction procedure it will be very important to  COMMUNICATE your size goals with your surgeon.  Most patients wish to achieve  enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. 

With the goal of improving communication with my patients 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 “C 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.
 

Best wishes with your breast reduction procedure; again, to not hesitate to request more time spent communicating with your plastic surgeon prior to proceeding.

I would not generally recommend that much of a reduction.  Aside from aesthetic considerations, making the breast too small may impact the blood flow to the nipple and areola (many factors go into supporting the blood flow and no single one is necessarily the only one to consider).  Aesthetically, there is often a desire to leave the breast shaped well balanced with the res of the body.  Too much of a reduction may compromise that and, finally, if the breast is too small it may have too flat a shape.

For those reasons and others I would not recommend that a typical patient go from 46DD to a B.

I hope that this helps and good luck,

Dr. E