It's always best to be within 20 pounds of your ideal weight

Before considering having body contouring surgery, including a breast reduction, ideally you should be within 20 pounds of your goal weight. That way you won't develop loose skin if you were to lose weight after surgery.

In addition, in reviewing patients who have breast reductions and weigh over 200 pounds preop, there is a higher incidence of wound complications and delayed healing. Consequently, I personally won't operate on a patient wanting a breast reduction until their weight is less than 200 and closer to their ideal weight. This improves the safety of the surgery and the cosmetic result is also much better.

Many patients believe that their breast size is stopping them from exercising and losing weight and want to do surgery first and then lose weight. The reality of that plan unfortunately is that they usually don't lose weight afterward because there were other reasons that their weight was up that haven't changed from surgery. Regardless of exercise, if your daily caloric intake is less than the number of calories you burn, you will lose weight.

One of the most common complaints I hear is that "I can't loose this last 20-30 pounds"..."these breast are keeping me from exercising. They are heavy, painful ..." In response, I would include that the breast may or may not get smaller with weight loss.  It is important to understand that the breast is comprised of both glandular tissue and adipose (fat) tissue. The mix of the two is unpredictable and therefore makes it difficult to forecast a long-term result.

Ultimately, a revision procedure may be necessary once you have lost the remainder of your weight.  Either way, I have yet to hear any of my patients who had a reduction prior to their final weight loss say that they wish they had not done it. Breast Reduction patients are some of my happiest patients.  The result will enable you to get on with your life without the heavy, painful disruption of large pendulous breast.  The one thing that you can be assured of...If your breast size has not changed much over the past several years, it would be highly unlikely that they would get bigger with future weight gain, following a surgical Breast Reduction.  But, at the very least, If your weight is not stable...anything is possible.  A good diet, a good exercise program and a Breast Reduction could just change your life.

Best of luck to you,

Marshall T. Partington, MD FACS