there is some hestitation on my part to get breast reduction. would a good candidate for breast reduction surgery be overweight?
Breast Reduction Recommended if Overweight?
Doctor Answers (31)
Breast reduction in patients overweight.
This is a very common question from women considering breast reduction surgery. Many times insurance companies use a scale to determine the minimum amount of breast tissue (per breast) to be removed in order for them to consider it medically indicated. This scale is based on Body Surface Area (this scale is called the Schnur sliding scale and can be found online). Obviously, if a patient looses weight then the BSA drops and therefore the minimum amount of breast tissue to be removed for insurance to cover will drop as well. Women who are close to their ideal body weight (BMI=25) or overweight will benefit from a breast reduction. The symptoms will improve dramatically. These symptoms include neck/back pain, shoulder pain, bra strap grooving, often times posture, skin maceration along the inframammary fold, and upper arm pain. Many patients report actually loosing weight after a breast reduction surgery. I'm not referring to the weight loss from the breast tissue removed, but women find that they have more energy and easier for them to live a more active lifestyle. Women find that they can go to the gym, exercise, jog, etc. If a patient is actually considering weight loss, then I would recommend waiting until a stable weight is achieved before undergoing the breast reduction surgery. This will most likely improve the long-term cosmetic results. The female breast is about 50-70% adipose tissue (fatty tissue). This obviously varies with age (the older a woman is the greater the percentage of breast fat). Therefore, weight loss will have an impact on the breast as well.
1) All patients with macromastia, irrespective of the pateint's overall weight will benefit from a breast reduction (if symptoms are appropriately attributed to the weight of the breasts)
2) Patients should have a stable weight (weight stable over the last 6-12 months) and are not planning major weight loss (in excess of 20lbs). Ideally, a patient should have a BMI<30, but this is not absolutely essential.
3) Insurance coverage of breast reduction is often linked to the BSA (BSA is linked to weight)
Overweight patients can have breast reductions
Both overweight people and those of normal weight may have breast reductions with good outcomes. A breast reduction is an option for anyone in good health whose breasts are larger than they'd like them to be or whose breasts cause them health issues such as back or neck pain, among other things.
If a patient's breast tissue has a major fatty content to it, then weight loss would decrease the breast size. In general, about 1/3 of women have breast tissue which doesn't have major fatty content and will not decrease much with weight loss. About 1/3 of women have all fatty tissue which does decrease with weight loss and 1/3 of women have breast tissue that's half and half which will decrease some with weight loss. A reputable surgeon in your area would be able to best work with you and help you determine what's right for you and your body/breast type.
Breast reduction if overweight
Not all breast reduction patients are overweight. In the patients who are, I advise them that if they have a breast reduction, then loose a significant amount of weight after surgery, their breasts may or may not get significantly smaller. Most people know if their breasts change much with weight loss or weight gain. If your breasts are large and do not get much smaller when you loose weight, then considering a breast reduction would benefit you in many ways. Good luck!
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Thanks for your question -
Breast reduction is a procedure that can be covered by insurance. It is designed to reduce the size of the breasts to help with back pain, intertrigo (severe rashes under the breasts), shoulder grooving from bra straps and appearance (though the insurance companies do not recognize this concern when evaluating coverage).
There have been several studies demonstrating that breast reduction surgery ranks very high in terms of patient satisfaction.
Breast reduction is a procedure that improves shape, reduces size and provides a breast lift. The trade-off is that breast reduction will leave visible scars.
The procedure is better if you're at your ideal bodyweight.
I hope this helps.
Thinking about a breast reduction?
The proper candidate for a breast reduction is simply one whose breasts are larger than they want. Reductions can come in large or small amounts. Enlarged breasts may also be causing symptoms and limiting exercise and clothing choices if they are large and heavy enough. These symptoms commonly include upper back pain, neck pain, shoulder grooves from the bra straps, and occasionally irritation between the breasts and the upper abdominal skin.
The candidate should be in good physical and psychological health. It is IMPERATIVE not to be a smoker or to be around second-hand smoke. Nicotine in any form constricts the blood vessels and can cause serious complications.
It is also critical not to be obese. Patients who weigh over 200 pounds have a much higher complication risk and don't get as nice looking results as they would want.
Finally, the patient must be able to accept the scars it takes to perform the procedure. This is a true sculpting operation and NO 2 SURGEONS are the same especially in this procedure. Select yours carefully because you will like the result and tolerate the scars if the shape and size are good for you.
Patients Who Are Overweight Will Benefit From Breast Reduction Surgery
For many patients breast reduction surgery is a life changing experience. Symptoms such as back, neck and shoulder pain seem to improve almost overnight. Patients note that clothes fit better and over time their self esteem and self image improve as well.
Patients who are overweight don’t differ from other patients in this regard. They note similar improvement in quality of life and significant improvement in symptoms.
When patients who are over weight undergo breast reduction surgery they often experience additional benefits. They often note increased exercise tolerance and subsequently become more physically active as they adopt a healthier life style. In many cases this results in significant amounts of weight loss.
Attempted weight loss prior to breast reduction surgery can be very difficult, because severe breast enlargement can make exercise almost impossible. This exercise intolerance becomes a major impediment to weight loss. In addition, even when patients experience weight loss, it often doesn’t affect the size of their breast.
For all these reasons, breast reduction can significantly benefit patients who are overweight. The procedure has multiple benefits which result in improved quality of life. One of these is improved exercise tolerance which has the added benefit of causing weight loss. It’s quite possible that breast reduction is more likely to result in weight loss; then weight loss is to lead reduced breast size. If your considering breast reduction, consultation with a board certified plastic surgeon who has experience in this area would be helpful.
For patients experiencing pain in the neck, back, and shoulders, bra strap grooving, rashes underneath breasts or some combination, breast reduction can help provide relief by reducing the side/weight of the breasts. Whether insurance will cover depends on the specifics of the case and the requirements of insurance.
Breast Reduction - Recommended if Overweight?
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.
I hope that this helps, and good luck,
Breast Reduction and Weight Loss?
Thank you for the question.
At some point you will be an excellent candidate for breast reduction surgery; it will be in your best interest to reach a long-term stable weight prior to proceeding with the surgery. This recommendation is based on safety of the procedure as well as predictability/long-term outcome of the surgery. Insurance company coverage likelihood will also be improved.
Breast reduction surgery in overweight patient
There are a number of factors to consider before deciding on breast reduction surgery. Is the patient contemplating weight loss, what is the patient's weight history, etc. Then of course there is insurance coverage consideration which is a separate topic in itself.
In my practice I see a number of overweight patients that request breast reduction. If I determine that their weight has been stable for some time and the likelihood of weight loss is small, I will proceed with breast reduction surgery. In this type of a patient the benefits of breast reduction, like the typical alleviation of macromastia symptoms, far outweigh any slight risk of healing in overweight patient.