What is your perspective on the use of BMI to refuse a breast reduction? (Photos)

Studies have shown that when your BMI is over 30, there are increased risks of infection, wound breakdown, and other complications with surgery. However, I see tons of women who are much larger in Chicago with very large and heavy breasts. It is much more the norm to see patients with BMIs from 30-40 in this region than those who are under 30 seeking out breast reduction. Simply put, larger patients have larger breasts and tend to have more symptoms of heaviness. Even though the complication risk is higher for larger patients, it does not mean these patients will not be HAPPY. You can look at my photos for examples of larger breast reduction patients that were very happy with results. I would get another consult with a couple other board certified plastic surgeons and I am sure you will find someone who is very comfortable working with your size and breasts. Good luck on your journey!Ramsen Azizi M.D.
Double Board Certified Plastic Surgeon
R.A.M. Plastic Surgery - Chicago

Dear littleorb,
Most plastic surgeons use BMI to calculate the risk of complications. BMI over 30 is a significant risk factor for surgical complications so most plastic surgeons refuse to do elective procedures on overweight patients. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

At 5'3" and 155 lbs your calculated BMI is 27.5, certainly low enough to have a breast reduction.  Having a BMI exceeding 30 increases your chances of complications during and after surgery and decreases the probability of optimal results. Consult with another board certified PS in your geographical area.

Hello and thank you for your question! Most plastic surgeons will not perform surgery with a BMI >30-35 due to the complications that can occur after surgery. With a BMI >35 you may not have optimal healing and could alter your results. I personally look at the whole picture. If you are overall healthy and exercise regularly, I would have considered you a good candidate for that particular procedure.

The optimal candidate for surgery is healthy and has reached a healthy stable weight with which they are content (preferably with a BMI < 30).Based upon your narrative, your BMI does not place you into a high risk category. While a BMI of 27 is technically overweight, from a surgical perspective you would seem to be a reasonable candidate.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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Usually, surgeons prefer a BMI of 30 or less in performing surgeries to decrease risks of complication. Weight loss should be prioritized first, and then have a stable weight before undergoing aesthetic surgery. However, this is a case to case basis, some surgeons, depending on the patient's condition, do perform surgery at BMI higher than 30. Schedule an appointment with a board certifed plastic surgeon for an in person examination and a detailed discussion of your options.

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.  I agree with you that specific calculations, including BMI,  are not always helpful when it comes to determining a specific patient's suitability to proceed with surgery.
Having said that, it is always best (or ideal) to achieve long-term stable weight prior to proceeding with  elective breast surgery. Doing so, will increase the safety of the operation, will likely improve the outcome of the operation, and will decrease chances that additional surgery will become necessary subsequently.  Best wishes.

None of us were in the consult room and you haven’t shown photos of your breasts. Perhaps the doctor was trying to say that if you lost weight, you would not need surgery. BMI is used by insurance carriers. If over 30, the procedure is denied. If you intended to submit for out of network coverage, a surgeon wouldn’t want you to have reimbursement expectations.  It’s not unsafe to tell you to lose weight. Obesity can result in surgical and post op complications which are serious concerns.

I have no idea why a physician would have refused to do your reduction with your present BMI.  I go as high as 39.9 as long as the patient is in otherwise good health.Good luck with your procedure.Dr Taranow

It is impossible to answer why for another doctor. I do breast reductions on overweight patients and have never had an issue. You are not morbidly obese so there would be no reason you cant have a reduction based on your current BMI