What is the smallest size and cup I can go down from 44DD?

Hi Maggie, I'm sorry to hear about how much discomfort and difficulty with your self-esteem that your breasts are causing you. This is very common in women with overly large breasts for their frame and you are not alone. Firstly, to talk about cup size. As I am sure you can appreciate cup sizes vary depending on the bra brand. Also, it's not uncommon for women to present wearing bras that are not fitted properly and which gives them the wrong impression of what starting cup size they actually are. I try not to talk about a specific cup size after breast reduction surgery but take considerable time to try to show my patient what I think they will look like after a breast reduction, so their expectations are appropriate for them. The size you can get down to is dependent, amongst other things, on your starting weight, the width of your breast as it attaches to your chest and, how far your breasts droop down from your chest. As a general rule you should be aiming for a body mass index of 30 or less before undergoing a breast reduction and be able to maintain this weight after surgery. Body Mass Index (BMI) is a person’s weight in kilograms divided by the square of their height in metres. A breast that is wide or attaches to the chest with a large diameter "footprint" is more difficult to reduce to the smaller cup sizes like a C or a small D and a breast that is very long and saggy also is more difficult to get to a smaller cup size. As a general rule women presenting for breast reductions will end up somewhere between a C and a D cup.

At size 44, each 400 grams removed corresponds to 1 cup size change. I reduce breasts to the size proportionate to your body. The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

The best way to determine what your breast size should be with respect to your anatomy and give true advice would be consultation with a board certified plastic surgeon. Not only does proportion depend upon the aesthetic balance of your breasts with your shoulders, waist, hips, and buttocks, but also upon your objectives, active lifestyle, soft tissue quality, muscular anatomy, and long-term concerns. A breast reduction also includes a breast lift.
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. A PS cannot guarantee that a breast will be a specific cup size after reduction. Very large breasts rarely are reduced by more than two or three "cup" sizes.