Data are presented on small area vertical-cavity surface-emitting lasers with lateral sizes ranging from 5 to 1 μm that use both oxide confinement and a high-contrast distributed Bragg reflector as the upper mirror. Optical loss becomes appreciable for device sizes less than 3 μm in diameter, and is analyzed through measurements of threshold, differential output efficiency, and the far-field radiation patterns. The results suggest that loss of optical confinement occurs for thin apertures and small device sizes.