Looking to get a breast reduction. I’m currently a size 40G. What’s the safest size I can be reduced to?

You need a formal evaluation by a licensed plastic surgeon and expert in breast reductions to determine what is best for you and your goals.Breast reduction is one of my favorite surgeries as it allows me to dramatically improve a woman’s breast appearance as well as alleviate many physical symptoms of large breasts, such as back, neck and shoulder pain, bra strap grooving, and rashes under the breasts. When I perform breast reduction surgery, I generally use a superomedial pedicle to provide blood supply to the nipple while maintaining fullness in the upper and inner breast. Excess lower and outer breast tissue are removed. Breasts are often asymmetrical, so I remove more tissue from the larger breast. The final scar pattern is a circle around the areola, down the breast, and possibly under the breast, depending on the degree of skin excess.
For me, breast reduction is not a one-size-fits-all surgery. The size and shape of the breasts are customized to each patient depending on her goals and desires. Some women want a significant amount of tissue removed while others prefer to have a more limited reduction. Regardless of the amount of tissue removal, I perform the maximum safe amount of lifting and tightening for each patient.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Reductions. - Dr. Cohen

The cup size measure has inherent variability.  Tissue density will always play a big role in the number of grams removed.  Going too small can sacrifice the shape of the breasts.  The nipple has to have a blood supply to survive from the underlying tissue.With a calculated BMI over 40, I would recommend that you discuss a weight reduction and exercise program with you PCP as weight loss can reduce the fatty weight of the breast.  Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

At 5’7 and 265 lbs, your BMI is about 42.  You are not a good candidate for surgery.  If you undergo surgery, you will most likely have fat necrosis or dehiscence.  You need to lose weight before having a breast reduction.  Best Wishes,Gary Horndeski, M.D.

A breast reduction is often a balance between the patient goals and the limits of anatomy. Your surgeon will know what is necessary with regards to weight resection. Anatomic limits are non-negotiable as a certain amount of tissue must be preserved in order to maintain vascular supply to the nipple areolar complex. Free nipple graft may be discussed in cases where the distance the nipple must be transposed is too great (commonly for sternal notch to nipple distance > 40 cm).
Ultimately, you do play a role in the decision making process. The anatomic restrictions are, on the other hand, more rigid. Technically speaking, the larger breast (and greater the ptosis) the more tissue that will need to be preserved in order to maintain vascular supply to the nipple areolar complex. 
With regards to your specific question, it is difficult to predict the size of safe reduction. However, as stated above, there will be limits based on anatomy. With a very large pre-op cup size (G) it is often unrealistic to expect a smaller "B cup" post op. I generally recommend that very large patients temper their expectations along these lines.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.  You will be best off, getting closer to your long-term stable weight (when it comes to safety considerations) prior to proceeding with breast reduction surgery.
  Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). 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 ask patients to communicate their goals with the help of  computer imaging and/or goal photographs.  Obviously, the outcome associated with the breast surgery will not necessarily match that of goal photographs perfectly, but they do serve as a better communication tool that subjective terms such as "natural", "proportionate", "voluptuous"… Evaluating goal photographs also allows for a plastic surgeon to determine the consistency of the patient's goals and allows for a discussion of realistic expectations as well.  
For example, I have found that the use of words such as “natural” or “C or D cup” or "still have boobs" 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. 
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you with an estimation of how much tissue will need to be removed (safely), in order to achieve your desired outcome.
Best wishes with your breast reduction procedure; hopefully you will be very pleased with the outcome of the procedure performed.

Hello and thank you for your excellent question. I agree with many comments on this thread -- once you lose weight and lower your BMI, you should be a good candidate for a breast reduction.  What size you reduce to really depends on your current versus desired breast shape and goals. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. Good luck!

Schedule a consultation with a board certified plastic surgeon. Upon examination your surgeon will be able to discuss specifics regarding your size following surgery. Breast reduction surgery is a balance. best wishes!