I need a breast reduction. I weigh 220 lbs, breast size is 44F. Dr says I need to have a BMI of 30. Why? I have 35 BMI.

Patients with a high BMIs have a higher application. Your surgeon may feel that this is too much of a risk in your particular situation. You may want to get another opinion.

This is a requirement of your surgeon.  A BMI less than 30 is associated with less general complications and specific breast reduction complications.  

Thank you for the question.Breast reduction surgery is one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin  this operation reduces and lifts the breasts to a higher position on the chest wall. By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise.Timing of the operation will depend on the patient's life circumstances. In general, it is best to do this procedure ( like all other elective body contouring the stages,  when patients have reached their long-term stable weights.  In doing so, patients and their surgeons will  likely improve the safety of the procedure, decrease risks of complications, potentially improve aesthetic outcome and minimizes the need for further surgery (in the event of weight fluctuation after the breast reduction procedure).  Best wishes as you work toward your goals! 

Timing of breast reduction and a person's weight is sometimes a tough call.There is a lot of evidence that if obese the risks of infection,fat necrosis,various healing problems,DVT,PE increase ,so your doctor is right from a safety standpoint.On the other hand with shoulder neck and back pain from breast hypertrophy it is very difficult to lose the weight ahead of time.So some doctors and some patients forge ahead anyway with the understanding that the stakes are higher

The only reason I can think of why the plastic surgeon specifies a bmi of 30, is that your health insurance may have that requirement. I carry out breast reductions frequently on women in SC who have a higher bmi than you do.You may want to get a second opinion or check with your health insurance carrier.