44H, 200lb - What Size Reduction Should I Get?

Congratulations on your decision to proceed with breast reduction surgery. It is one of the most patient pleasing operations we performed. It will likely be in your best interest to reach a long-term stable weight prior to proceeding with the surgery.

Unfortunately, there is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery.

Before undergoing the breast reduction procedure it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" 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.

Best wishes.

The "right" breast size after breast reduction surgery is hard to define. Enough breast tissue needs to be removed to allow for an improvement in breast symptoms but not so much that the breast does not have a good blood supple and retain a feminine appearance.

Starting from a 44H, it will be hard to make your breast a D cup or smaller. Since you are 200lbs and 5 ft tall, it is unlikely that you will look "too small"after surgery.

At 5 fot and 200 pounds, you are clearly overweight. If you could lose at least some of the extra weight before surgery, your results can be better.

What size would be right for you is a difficult question to specifically answer without a consultation and photos. You want to be small enough to make a difference but not too small that they would look ridiculous. Your input is important in terms of exactly what you are seeking afterwards.

You should consult with one or more board certified plastic surgeons who can evaluate you and then make recommendations based on your goals.