Can I go from a 32DD to a 32A in a breast reduction surgery?

Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform.
Yes, 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. 
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. This careful selection of plastic surgeon will be the most important decision you make.
Before undergoing the breast reduction procedure 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. I suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, an “A 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 goal photographs.
I hope this helps. Best wishes.

Yes, significantly reducing the volume of the breasts is possible during this type of surgery. However, I caution patients against getting too attached to a particular cup size. Cup sizes are not an exact science, and they can vary quite a bit between manufacturers. Instead, your surgeon will remove a portion of tissue that approximates the reduction in cup size.  I often suggest patients bring photos of the “ideal size” outcome them might desire, to help us understand each other. 

I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon

#RealSelf100Surgeon 

#RealSelfCORESurgeon