Can I get a breast reduction before weight loss? My breasts make it impossible to work out without immense pain.

Question

I'm a 5'5 woman, about 200lb, and I wear a 38HH bra. My breasts are very large + heavy, causing my back, shoulders, and shoulder blades to hurt to the point I become unable to work out. Is it an option to have my breasts reduced prior to weight loss? (Target weight of 140).

Jimmy S. Firouz, MD, FACS · Answer

Women with very large breasts often times are not able to work out at all to lose weight, and they end up being stuck overweight; it is unfortunately a vicious cycle. When this is the case, perhaps the patient can diet but exercise is mostly out of the question.  So I actually tell patients to get a breast reduction now so that they are able to exercise and lose weight. However, some patients may end up needing some kind of revision in the future if their breasts do become saggy and they aren’t happy with the shape anymore. But I can say that in my practice it is very rare that a patient seeks out or requires a second surgery. Hope that helps!

Miguel Delgado, MD · Answer

This is actually a very common problem. It is very difficult for many women to exercise when their breasts cause a lot of discomfort. It is possible to have surgery first, however if you are planning on having insurance cover your surgery they may require that you lose weight first. The best way to find out if insurance will cover your surgery is to see a Board Certified Plastic Surgeon who specializes in breast surgery. Good luck!

Sheila S. Nazarian, MD · Answer

It is a bit of a conundrum. The large breasts can interfere with exercise, yes, but losing the weight after your reduction could very well adversely affect your results (loose and sagging skin). I would suggest that you schedule a consultation with a board certified plastic surgeon in your area (link below) who can evaluate you in person. In the meantime, perhaps try a moderate weight loss plan such as weight watchers to get some of the extra weight off. Best, Dr. Nazarian

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question, Its really hard to workuot having this breast issues, yes it is possible to have the procedure done before weight loss but then your results can be different of what you really expect, so I recommend to visit a Board Certified Plastic Surgeon for and evaluation and to discuss your concerns. Good luck and bes wishes :)

Steven Wallach, MD · Answer

Yes, it is certainly possible to perform a breast reduction before weight loss, but remember, your breasts may shrink a bit with weight loss after a reduction.  This may lead to some sagging as well.

Robert L. Kraft, MD, FACS · Answer

Many of my macromastia patients have tremendous difficulty in losing weight because their shoulder and back pain restricts the ability to exercise.  You could have surgery now to alleviate these issues. Some insurance companies use the Schneur scale to deny women who are overweight. Check your insurance criteria to ascertain whether this would be applicable to gigantomastia based on your cup size.  Do you think you can realistically loss the weight? That is certainly a bottom line question.

Tom J. Pousti, MD · Answer

Thank you for the question.Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform.Although the breast reduction surgery may help you at this point, if you are contemplating the weight loss then it would be in your best interest to have the breast surgery after you have  reached your long-term stable weight (If possible). This will improve your chances of achieving your goals and minimize the chances that revisionary breast surgery (to treat “sagging” for example) will be necessary afterwards. Having said that, there are occasional patients who (despite best efforts) are not able to achieve their exercise goals secondary to neck/back pain exasperated by larger breasts. These patients may benefit from breast reduction surgery prior to their weight loss with the understanding that additional surgery may be necessary once they have reached a long-term stable weight.You may find the attached link, dedicated to breast reduction surgery concerns, helpful to you as you learn more.Best wishes.

Robert Savage, MD (retired) · Answer

The short answer is yes.Many women who have reductions are overweight and it doesn't exclude you from having surgery.With that said it does somewhat increase your risks for complications and depending on your insurance company's rules may make it harder to get approved.Your doctor's office should review all your options and +\-'s

Can I get a breast reduction before weight loss? My breasts make it impossible to work out without immense pain.

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