46 P - What is the smallest size I could achieve with a breast reduction?

Question

I’m a size 46 P. How much tissue can be removed? Smallest breast size after reduction?

Mert Demirel, MD · Answer

With a 46P breast size, a significant reduction is usually possible, but the smallest safe size depends on your anatomy, breast width, nipple position, blood supply, skin quality, body frame, and how much tissue must remain to keep a healthy breast shape.
There is no exact cup size that can be promised before an exam. Cup sizes are also very unreliable between bra brands. A surgeon can estimate grams to remove from each side, but the final cup size cannot be guaranteed.
For very large breasts, getting extremely small may require a free nipple graft. This allows more tissue removal in selected cases, but it has important trade-offs: loss of nipple sensation, loss of breastfeeding ability, possible pigment changes, and a flatter nipple/areola appearance.
If you want to stay with a pedicled reduction, where the nipple remains attached to tissue and blood supply, the surgeon may need to leave more breast volume for safety. That can still create a major improvement in weight, pain, rashes, posture, and clothing fit, but may not get you to the smallest possible size.
My advice would be to consult a plastic surgeon experienced in very large breast reductions. Ask what size range is realistic for you, how many grams may be removed, whether a free nipple graft is likely, and what balance they recommend between maximum reduction, nipple safety, shape, and long-term comfort.

Kelly Schultz, MD · Answer

The answer to your question really depends on your anatomy, which is why an in-person consultation is so important.
For patients with very large breasts, the primary factor limiting how small we can safely make the breasts is maintaining a healthy blood supply to the nipple-areolar complex. During a traditional breast reduction, the nipple remains attached to the underlying tissue, and reducing the breast too aggressively can compromise its blood supply.
In some patients with very large breasts who desire the smallest possible result, a free nipple graft may be recommended. This technique involves removing and grafting the nipple into its new position, allowing much greater flexibility in how much breast tissue can be removed. However, it also comes with important tradeoffs, including loss of nipple sensation and the inability to breastfeed.
The best technique depends on your anatomy, your goals, and your priorities. An experienced board-certified or board-eligible plastic surgeon can examine you, discuss these options, and help determine the safest way to achieve the size you're hoping for. 
I hope this information is helpful. Best of luck with your consultation and your breast reduction journey!

Jonathan Heistein, MD · Answer

It's difficult to tell you exactly how small you can be after a breast reduction, since there are so many variables to take into consideration.  In general terms, you can be a lot smaller than you are now no matter what technique is used.  But if you want to be even smaller than is possible with standard techniques to keep your nipple alive, then the procedure can be done with a free nipple graft which would allow you to be almost as small as you could request.  Best advice would be to ask your surgeon in-person because a physical exam is necessary to answer your question.  Hope that helps.

Gary M. Horndeski, MD · Answer

I have operated on a patient who was a 44 N but not anyone a size P. However, this is not much difference. Usually what I do is use the width of the chest wall to determine the radius for the breasts. I scan my patients pre-operatively using something comparable to Crisalix to determine the volume of the breasts and then I know the breasts I want to design and remove the difference. The breast reduction technique I recommend is the Bellesoma. 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 and long term stability. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

It's difficult to give an accurate answer to your question without photos or examining you.  This procedure will remove excess tissue and reshape the breast.  Enough tissue has to remain for good blood supply and to contour the breast.  You can expect multiple cup size reduction.  I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation.  I've included a video I hope you find helpful.

Manuel Diaz, MD · Answer

Helloo. The amount of breast tissue that can be removed depends on your anatomy, breast dimensions, skin quality, and blood supply to the nipple, so there is no fixed amount that applies to everyone. 
In most cases, it is possible to achieve a significant reduction, but there is a limit to how small the breasts can safely be made while maintaining a healthy blood supply and a natural appearance. During your consultation, the surgeon can help determine the smallest size that is both safe and proportional to your body.
A personalized evaluation is the best way to discuss your desired size and determine what result can realistically and safely be achieved.

46 P - What is the smallest size I could achieve with a breast reduction?

Answers (6)

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