Overweight and Breast Reduction Surgery: Worth Doing?

for a woman who is overweight...40+ pounds... is it a bad idea to get a breast reduction? will my weight cause them to enlargen again?

Doctor Answers 26

Overweight and Overcharged

Many patients who were considered clinically obese have come to me despondent, after being turned away by other surgeons who refused to perform breast reduction surgery on them until they lost the weight. I find taking that position ridiculous. Altough breasts are comprised partly of fat, even a drastic weight loss won't result in more than negligible shrinkage in that area (and even then, the breasts will still be saggy). Many doctors ignore a crucial dilemma: When your breasts are so large, exercise is a miserable, if not impossible option. How exactly are you supposed to drop pounds?

Being overweight doesn't exclude you frim having breast reduction surgery. In fact, it will motivate you to lose weight by improving your body image and freeing you to exercise with minimal bouncing and flopping.

New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

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Breast Reduction Surgery for Overweight Patients

It’s not unusual for women with breast enlargement to be overweight.  Breast enlargement is a disabling condition that often leads to inactivity.  Women with breast hypertrophy frequently give up activities that they have historically enjoyed because of disabling symptoms.  This often leads to inactivity and subsequent weight gain.
In our experience breast reduction surgery alleviates many of these disabling symptoms.  Following breast reduction, women often become more active.  This often leads to a more healthy life style and subsequent weight loss.
Unfortunately, insurance companies frequently require weight loss before approving payment for breast reduction surgery.  Significant symptoms associated with breast hypertrophy can make this a difficult proposition.
Breast reduction surgery in patients who are over weight can be the first step in a change in life style.  Not only can breast reduction alleviate many of the symptoms associated with this condition, but can result in weight loss because of increased exercise tolerance. In patients who are overweight breast reduction can significantly improve over all quality of life.  In most cases, breast size is stable following breast reduction, unless patients experience weight gain.
If you’re considering breast reduction surgery, consultation with a board certified plastic surgeon that has experience in this area would be appropriate.

Temporary fix, but it may be just what you need....

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

Do the best you can, then call your plastic surgeon

Most doctors will suggest that patients make lifestyle changes that can be sustained, i.e. starting to exercise regularly, stop snacking, cut down on carbs, etc.

However we live in a real world. If patients have truly done their best with respect to diet and exercise, it is simply unreasonable to insist they lose more weight.

Many patients find that after breast reduction, their ability to exercise, and their self esteem is greatly improved.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 103 reviews

Reducing your breasts may allow you to exercise more effectively

Breast reduction is a great surgery. Some of my happiest patients had breast reduction. As for when to have surgery (before or after weight loss) it is really up to you. In my view, once patients have breast reduction surgery, they are able to be more active and participate with their family and at work more effectively. Only if you gained even more weight would your weight cause your breast to enlarge. On the contrary, I think that you would actually loose more weight by having the breast reduction and then heading outside or to the gym or whatever you like to do.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 61 reviews

Breast Reduction and Weight

Do you tend to lose weight in your breast when dieting?  If there are little changes in your breast with weight gains and loses, you could be a good candidate for breast reduction surgery.  Consult with a Board Certified Plastic Surgeon ( ASPS) to determine if this is for you.  Best of luck!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 29 reviews

Breast Reduction - Overweight and Breast Reduction Surgery: Worth Doing?

Breast Reduction is normally recommended when the excess weight of the breast tissue is contributing to, or causing, neck, back and shoulder pain, bra strap grooving, intertrigo (rashes) underneath the breasts, or some combination of symptoms that can reasonably be expected to be relieved if the breasts are reduced in size (weight).  Whether or not it is covered by insurance is a separate (but important) question and, in general, insurance companies are reluctant to pay for procedures if a patient is overweight (according to any of a variety of scales, ratios, etc).   Their argument is that losing weight will also lessen the amount of tissue weighing on the neck, back and shoulders, etc.  My experience is that even with weight loss there is very little reduction of these symptoms.  But, depending on the situation you're in (self-pay vs insurance) this may be a significant issue.

With respect to weight gain and loss following surgery, my experience is that you will do so in a new distribution (ie, more will go to other areas after the breast reduction than did before - and this is typical of other procedures, too, such as liposuction and tummy tucks).  In other words you will not simply gain weight in your breasts again.

I hope that this helps, and good luck,

Being overweight is not always a contraindication to breast reduction surgery

In a perfect world, everyone would be at his or her ideal body weight before having surgery. It would reduce the potential complications or side effects of surgery and make the long-term result more predictable. Unfortunately not everyone is able to achieve their ideal body weight and therefore there are times when we have to compromise to treat conditions such as symptomatically large breasts. If patients are overweight, I ask patients to make a valid attempt at weight loss before surgery. At that point, if they are still overweight we can review any increased risks associated with their weight and decide whether the current symptoms such as back pain warrant the surgery. We can then make a joint decision to proceed with surgery.

There is always some risk that your breasts will enlarge in the future. There are many potential causes and weight gain is among them. Other potential causes include hormonal changes associated with pregnancy or menopause.

I hope this response is of some benefit to you. Good luck on your procedure.

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
5.0 out of 5 stars 21 reviews

For the most part yes....

For any procedure, it's best to be at (or at least close to) your ideal body weight for many reasons - like decreasing your anesthesia risks, getting a better result, decreasing wound healing complications, etc. Having said that, many women who suffer from symptoms due to large breasts find they have difficulty actually exercising and losing weight. While it's possible a large weight change after surgery may cause a slight change in your breasts, it's unlikely to have a significant impact. I would say if you have made a sincere sustained effort to lose weight, and have not had much success, proceed with your surgery.

Vishal Kapoor, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 8 reviews

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.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.