How small can my breast reduction be from a 34I?

Thank you for your question. 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. I recommend that you research board certified plastic surgeons in your area. Schedule two or three consultations and receive evaluations from each #BCPS. Discuss your desire and ultimate goal for breast size. Ensure that the #boardcertified #plasticsurgeon, is very experienced and is someone you trust. Best wishes to you!

Thank you for the question.
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.

The other concern with overly aggressive breast reduction surgery is patient dissatisfaction afterwards. It is not unusual for patients who have lived with very large breasts to want to have as much as possible removed. Care must be taken to be judicious in this removal to avoid an outcome where the breasts are too small in relation (proportionately) to the patient's other body parts. Again, it is not uncommon, for patients' breasts to become smaller ( after the breast reduction procedure) with time and/or weight loss- breast augmentation may become necessary to achieve the patient size goals.
It will behoove you to seek consultation in person with a well experienced board-certified plastic surgeons. So plastic surgeon very carefully and communicate your goals carefully as well. I would suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, a “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, and the attached link, helps.

Best wishes

Going from a 34I to an A cup probably can not be accomplished to leave a reasonable shape with a pedicle. You mentioned FTM top surgery. Are you transitioning?  In that case a mastectomy with a free nipple graft may be an option.  Best to be seen in person.