How many cup sizes can you go down safely with a reduction?

It is going to vary from patient to patient and requires an in person exam as it's dependent on any number of factors including your body type, breast tissue, and desired outcome. I would advise you to schedule a consultation with a board certified plastic surgeon in your area (link below) to discuss your options. Also, call you insurance company and see if they cover breast reductions. Best, Dr. Nazarian

I will say that there is not a specific cup size that is safe to reduce to, but in general, I can not make someone really small say to a A or B cup when they start out really large without compromising shape.

Congratulations on your decision to proceed with breast reduction surgery. It is one of the most patient pleasing operations we perform.  There are no universally accepted "rules of thumb" when it comes to how many cups sizes breasts can be reduced down to. Generally speaking, breasts can be reduced to a very small cup size. 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. There is also 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 is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful.   For example, I have found that the use of words such as “natural” or “C or D cup” 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.

A breast gland can be removed down to completely gone which would then be a mastectomy. The issues in reduction are retaining the blood supply, function, and sensation to the nipple-areola and solving the problems associated with breasts that are too large, too heavy, and too saggy. Normal breast size ranges from A to C cup in relation to the chest circumference. In other words, a female chest is built to handle breasts in the A-C cup range but sizes beyond a C cup are outside the normal range and can cause problems due to weight and position. The average breast size is a mid B cup. There is no physiologic reason to go smaller than average for a breast reduction as even a reduction to a C cup will solve the functional problems. 

Thank you for your question. The answer to this question varies from patient to patient due to many factors including the size desired, breast volume and risks that might be associated with the surgery itself. Breast reduction surgery most often achieves excellent results as most patients are relieved of the burden that leads them to surgery in the first place. Of course, there are concerns regarding going to small as this can potentially jeopardize sensation and also survivability of the breast. With the more current approaches,  improved shape and a reduction of scarring can often be achieved as opposed to more traditional anchor scar techniques. I would suggest that you seek out a consultation with a board certified plastic surgeon who is experienced in the procedures. I hope this helps and have a wonderful day. Dr Kayser - Detroit