I am a 38DDD, I would like to go to 34D. Would that be appropriate for me? I'm 5'4 152 pounds (Photo)

Thank you for your question and for sharing your photos. Congratulations on your weight loss!  It must be very gratifying.  You are a good candidate for a breast reduction which includes a lift.  A D cup is a reasonable end point for you.  My only concern at this point is that you may not be an actual DDD even though that is the bra size you wear.  Sometimes when you have a lot of skin laxity, it takes a larger cup size than you actually are to contain the breast tissue.  If your breasts are over-reduced you may end up much smaller than you would like.  You may only need a breast lift to get you to your desired end point.  Many weight loss patients feel that they need a breast reduction, but may be a better candidate for a breast lift.  An in person consultation is required to measure your true cup size and to get a better understanding of how much actual breast tissue you have to better predict your final cup size.  Hope this helps.  All the best!

Candidates for #BreastReduction surgery are women who wish to have smaller #breasts to achieve a more proportional appearance or to alleviate physical discomfort. Breast reduction can correct symptoms from excessively #largeheavybreasts that may cause the inability to do certain exercises, or create back, shoulder and neck pain, poor posture, bra-strap shoulder indentations and chafing or rashes under the breasts. Women experiencing these discomforts may benefit from Breast Reduction, also called #ReductionMammoplasty. Furthermore, large breasts may interfere with normal daily activities or exercise and will be more comfortable when reduced. Women who feel that their excessive breast size decreases a sense of attractiveness and self-confidence, or results in unwanted attention are also candidates.Large breasts (#macromastia) or #breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive #breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast depending on your individual insurance requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities.

You could achieve this reduction with a Wise pattern breast lift.  This results in an inverted T scar on your breast.  

Thank you for your question and photo.  If you clearly discuss your surgical goals with your operating surgeon, then reducing your breasts close to your desired size should be a realistic goal.All the best,Dr. ResultsMiami, FL

While the back size won't change, the breasts can be reduced and lifted. It is hard to predict cup size with volume removal. Good luck.

A real possibility for you. Post your discussions with the PS after being seen so we an have follow up with you. 

Congratulations first on your weight loss!. Based on the pictures you have provided, the breasts appear to be deflated with volume loss due to you weight loss. Therefore your breast reduction would consist of removing breast tissue as well as tightening the excess skin to give you a good result. I typically utilize special pedicle shaping sutures to reshape the breast to fill out the volume that you have lost at the top part of your breast to improve the breast shape.  As far the size being the right option for you, it is difficult to guarantee a specific cup size, however, it is possible to estimate your final cup size. I believe it is possible for you to be in that ballpark range however. At 5 ft 4 inches weighing 152 pounds , I believe that a 34 D cup is reasonable. Good luck. Hope this helps!