Can I get a breast reduction from a 40C to an A cup? (Photos)

The technique I recommend is a reduction using 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.

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. This amount tends to rise with the distance the nipple must travel from where it is to its planned destination. 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. Ultimately, you do play a role in the decision making process. The anatomic restrictions are, on the other hand, more rigid.
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 larger pre-op cup size it is often unrealistic to expect a significantly smaller cup post op. I generally recommend that very large patients temper their expectations along these lines.
It is also important to remember that we deal in weight and volume (which are standardized) whereas "cup size" goals can be extremely variable (depending upon the manufacturer). There is no correlation between cup and grams resected. Much like in augmentation, focus not on the cup but on the look and resolution of symptoms.That being said, an A cup is difficult to achieve regardless of pre-op size.
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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