42L, BMI 40. Too Obese for Breast Reduction?

Question

I Have a BMI of 40. Bra Size of 42L. Would I Be Considered Too Obese for a Medical Neccesary Reduction?

Sam Speron, MD, FACS · Answer

Based on the information that you have provided it is unclear on whether or not you would be a good candidate to undergo a breast reduction. There are many factors that one must look at in determining whether you are a good candidate. I recommend you schedule a consultation with a board certified plastic surgeon so that they can give you a physical examination and determine the best route for you and your body type.

Armando Soto, MD, FACS · Answer

Hi there-

	It would be in your best interests to lose as much weight safely as you can before proceeding- the operation and its recovery will be safer for you, and your outcome in the short and long term will be better.

	On the other hand, at some point, your large breasts may make it difficult for you to exercise- when and if you get to this point, that's when you should visit a surgeon certified by The American Board of Plastic Surgery for a consultation.

	Here's some advice on choosing one...

Otto Joseph Placik, MD · Answer

Your risks of infection, bleeding, wound healing problems, ckot firmation, etc are higher. You must make this informed risk.

David Shafer, MD, FACS · Answer

Without examining you and evaluating your medical record, it is impossible to tell if you are a good candidate for surgery. If you post pictures and give a more detailed medical history then we may be able to give you more specific advice. Good luck.

Scott C. Sattler, MD, FACS · Answer

There is a higher incidence of wound healing problems in obese patients after breast reduction surgery. This published clinical observation has certainly been my own experience in practice. This issue does not eliminate the possibility that a plastic surgeon would do your breast reduction. We accept this risk because the benefit patients derive from the breast reduction outweighs this relatively minor issue.

Scott C. Lindsay, DO · Answer

Thank you for your question.
In order to reduce the risk of infection and wound healing, your BMI should be no higher than 32. Reach out to your primary care physician for guidance on weight loss. Best wishes!

Tom J. Pousti, MD · Answer

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.

	Best wishes.

Peter A. Aldea, MD · Answer

Regarding: "Too Obese for Breast Reduction?
	I Have a BMI of 40. Bra Size of 42L. Would I Be Considered Too Obese for a Medical Neccesary Reduction?"

	You are touching simultaneously on 2 issues:
	- Risks of Breast Reduction in a morbidly obese woman (BMI of 40 and higher)
	- Would your insurance refuse to pay for it claiming you are "too obese"

	There is NO doubt that a BMI of 40 is associated with a higher risk for blood clots (VTE and PE) and other surgical complication. Moreover, the cosmetic outcomes of breast reduction done in obese patients are inferior to those of women who are in the below 30 BMI. If you could lose a lot of weight safely, you would reduce your risks and vastly improve the appearance of your breast reduction operation.

	As to the insurance issue, every insurance plan is different and has different requirements. Some post them in their insurance book, others do not. A Plastic surgeon in your area who works with your plan could best advise you on their requirements.

	Dr. Peter Aldea

Steven Schuster, MD, FACS · Answer

Dear BB, like evryone else says,without examining you it is hard to say. You do sound at the borderline obese level, but that does not preclude you having a breast reduction. Seeing photos and knowing your height and weight would be helpful. If you were my patient I would at the very least want you to be evaluated by your medical doctor and to start on an aggressive weight loss program. The results are better in a patient who is closer to their recommended body weight plud the recuperation is easier. Go on several consultations and don't jump into surgery without getting several opinions first. Good luck.

Steven Wallach, MD · Answer

To determine whether or not you are a candidate for breast reduction would require a physical exam an assessment of your  medical history.

42L, BMI 40. Too Obese for Breast Reduction?

Answers (13)

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