Breast reduction from 32F/G to 32 C/D?

Hi and thanks for your question.You sound like an ideal breast reduction candidate but the ideal "size" for your frame should be determined after consultation with a Specialist Plastic Surgeon. Sometimes such a large reduction, in the setting of naturally wide breasts, whilst being technically possible can occasionally put the blood supply to the nipple at higher risk AND sometimes predispose to a more square and flatter shape to the breast which isn't ideal. I wouldn't suggest delaying your surgery further if you are already symptomatic, and yes it is certainly possible to either slightly re-lift or re-reduce the breasts down the track if you decide to have more children (but often this is not necessary). Make sure you are seeing a Specialist Plastic Surgeon, you'll be in safe hands.RegardsPaul Quinn

I think it's very possible to get to you down to the smaller size and desire. The question of doing it now versus later is always an interesting one and no one can tell you a hundred percent what to do. But I would recommend if you're having a lot of back neck shoulder pain symptoms and difficulty exercising then I would recommend doing the surgery so you can enjoy your life while you're young.Best Regards,Dr Gartner 

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery.  Based on your question, I think that your goals are reasonable and realistic. Generally speaking, 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.    In my opinion, successful outcomes with breast reduction surgery depends on:
1.  Careful selection of plastic surgeon (and from the surgeon's  standpoint, careful selection of patient).   formal patients in the United States, I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. ***Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.
2.  Careful communication of goals ( which I will discuss further below).
3.  Skillful execution of procedure ( preoperative, intraopererative, and postoperative patient management).
In my practice, I would ask that you NOT communicate your goals, or evaluate the outcome of the procedure performed, based on cup sizes.  There is simply too much variability when it comes to bra sizes between bra manufacturers and even store employees doing the bra fitting measurements.
 Generally speaking,  for the benefit of patients undergoing breast reduction surgery:  it will be very important to communicate your size goals with your surgeon. Most patients wish to achieve a enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. Again, I suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, a “C or D cup” may mean different things to different people and therefore may be a source of miscommunication.
In my practice, I ask patients to communicate their goals with the help of  computer imaging and/or goal photographs.  Obviously, the outcome associated with the breast surgery will not necessarily match that of goal photographs perfectly, but they do serve as a better communication tool that subjective terms such as "natural", "proportionate"… Evaluating goal photographs also allows for a plastic surgeon to determine the consistency of the patient's goals and allows for a discussion of realistic expectations as well.  Timing of the operation will depend on the patient's life circumstances. In general, it is best to do this procedure ( like all other elective body contouring the stages,  when patients have reached their long-term stable weights.  In doing so, improve the safety of the procedure and minimizes the need for further surgery ( in the event of weight gain/loss after the breast reduction procedure).
There are patients who present with “juvenile” breast hypertrophy will benefit from breast reduction surgery ( for both physical and psychosocial reasons) at an early age ( even as teenagers). Patients should consider  carefully the pros and cons of the procedure as well as the potential need for further surgery if the breasts “regrow” in size.
If at all possible, it is best to wait until after completing pregnancies before undergoing breast reduction surgery. Again, doing so will minimize the chances that patients will require further surgery after pregnancy related breast changes.
On the other hand, it can be argued that,  patients with breast hypertrophy benefit from breast reduction surgery prior to pregnancy ( to prevent the symptoms that may occur as the breasts grow even larger during and after pregnancy/breast-feeding).  However, in the interests of avoiding additional surgery,  I feel that it is in most patients best interest,  to wait until pregnancies have been completed and a long-term stable weight has been reestablished.  If you choose to have breast reduction surgery now, it is certainly possible to have additional reduction or lifting done after pregnancies.
  Best wishes with your decision-making and for outcome that you will be very pleased with.