Is It Possible to Have my Breasts Reduced from a 38DDD Down to a 38B?

Question

I have just turned 60 & I have had to buy larger bras 3xs in past 2-3 years. I am considering having a reduction done, but I want to go as small as possible.

Gary M. Horndeski, MD · Answer

To change your breast size from a 38 DDD to a 38 B would require removing 800 grams.  This can be done but you may not be satisfied by the result since it may not be proportional to your body size.  Many women request large reductions under the impression that it is the only technique to relieve their pain.  However, there is a new technique called The Ultimate Breast Reduction, which relieves pain by transferring the weight of the breast to the underlying muscle.  The breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Even though the breasts are reduced they are attractive and have good projection.  This technique maintains nipple sensation, the ability to breast feed and avoids the ugly vertical scars of the traditional Wise pattern, which was developed in 1956.  

	 

	Best Wishes,

	 

	Gary Horndeski, M.D.

Tom J. Pousti, MD · Answer

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform. 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 “B or C 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.

	It is possible to reduce the breasts size very significantly.  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.  
	The other concern with overly aggressive breast reduction surgery is patient dissatisfaction  afterwards.  It is not unusual for patients who have lived with very large breasts to want to have as much as possible removed. Care must be taken to be judicious in this removal to avoid an outcome where the breasts  are too small in relation (proportionately) to the patient's other body parts.  Again, it is not uncommon, for patients'  breasts to become smaller ( after the breast reduction procedure) with time and/or weight loss-  breast augmentation may become necessary to achieve the patient size goals.
	  
	I hope this, and the attached link, helps.

Patti A. Flint, MD · Answer

It is possible to perform dramatic reductions when certain techniques are used. When you consult with your plastic surgeon, be very direct that you want your breasts very dramatically reduced and ask about free-nipple grafting.

Karol A. Gutowski, MD, FACS · Answer

IN almost all cases, breast reduction offers dramatic relief of symptoms, even if the change is only 1 or 2 cup sizes. In most cases, going from 38DDD to 38B is not likely.

John Whitt, MD (retired) · Answer

The primary limitation on the amount of tissue which can be removed in a reduction is the need to leave a sufficient amount of tissue to heal remaining tissue, especially the nipple-areolar complex. A post-op C cup is probably attainable, but a B cup may not be.

Is It Possible to Have my Breasts Reduced from a 38DDD Down to a 38B?

Answers (5)

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