Problem with cup sizes is that a 34b is a completely different cup size from a 38b. So if you have a larger band size, the cup size is going to subsequently be larger and vice versa. Does anyone know if this comes into play? I would imagine it would, but I've never seen anyone talk about this.
I have heard of some people who were 100% set on peri who ended up doing it in a couple stages. So they'd have the first main reduction and then later they'd go and take some more skin off with a purse-string type thing-a-ma-bob I believe. I'm not sure all surgeons will do that, and I'm not sure how well they all come out. I've seen at least one that turned out nicely if memory serves me right. I'm thinking it's not the popular route to go because more surgeries, more possible complications.... also it might be harder to get things to look right. But I thought I'd mention that, at least.
But if it's really a no-go for you, just talk to your surgeon and see if they would be able to try out something else that's less common. Perhaps having only one "visible" incision next to the areola or on either side of the areola or something else entirely. Just mentioning that in case you weren't aware of other techniques besides the main 3 (T-anchor, DI, peri/keyhole). Some surgeons may have their own techniques that are either hard to find on the internet, or not on the internet at all.
Also wondering - I know ultimately it'll be up to the surgeon to say, but is there a way to get some idea on your skin elasticity?