Can I have a breast reduction while overweight?

Your safety should be the priority of any qualified plastic surgeon and undergoing breast reduction at this point would pose an increased risk of serious complications. I understand that it's difficult to maintain an exercise program with overly large breasts, but you should consult with a physician to create a weight-reduction plan that safely helps you get down to a healthier weight. 
Best of LuckDr. Romanelli

To obtain maximal results from the breast reduction and minimize risks of complications during and after surgery, it is best to achieve a BMI approximating 30.  With a calculated BMI of 54.8, losing some 100 pounds would allow you to reach that BMI goal.  Suggest you participate in a physician-supervised nutrition and exercise program to assist with the weight loss.After you have lost a significant amount of weight, a breast reduction performed by liposuction can reduce the size of the breast a moderate amount depending upon the amount of fat, but the procedure will not lift the breasts nor improve the skin. 
Liposuction for breast reduction may cause bruising right away or may become more obvious in a few days to a week.   Recovery will depend upon the extensiveness of the liposuction, your overall health, and the healing involved.  Swelling can persist for 6 months and sometimes up to 1 year following liposuction.  If the liposuction is very conservative, there is not much downtime at all.   
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

At
5’1 and 290 lbs, your BMI is 55.  I
usually do not operate on patients with BMI’s over 32.  Instead, I recommend is liposuction of your
breasts.  This would take the weight off but
your skin will hang excessively and you will eventually need a breast
lift.  This would be a good temporary
measure for you to help with the neck, shoulder and back pain.  You can then become more active and lose
weight or consider weight loss surgery.Best Wishes,Gary Horndeski, M.D.

You are always best to try and get your BMI down to 30 before considering surgery. There are advantages not only for the result but also for your anaesthetic. 

It is not safe for you to undergo surgery at your current weight and you will need to get down to a healthy BMI before surgery. The way you describe your breasts you will still need a breast reduction, but you will significantly decrease your risk of surgery, improve the shape of your breasts and decrease the chances of having a healing problems at a healthy weight. You will need to lose over a hundred pounds and you might think about seeing a bariatric surgeon or a professional nutritionist to come up with a plan.

Thanks for your question, HazelGrace427.
It’s possible to get breast reduction surgery even if you’re overweight. However, with a BMI of 55, you’re at a very high health risk for complications, which is why it’s best to cut down your weight a little bit more before getting surgery. Your results may not also end up as good as you expect it to be.
For now, I would recommend hiring a dietician/nutritionist first to help you lose weight. Once you reach a BMI of about 40, consult a reputable and board-certified plastic surgeon to see if you can already undergo breast reduction.
Good luck!

It is possible to have a breast reduction while overweight. The most ideal situation would be if you could get down to your ideal weight and then have a breast reduction. If you have a breast reduction and then lose weight, you are taking the risk of seeing your breast size decrease further or become droopy. There are some insurance companies that will require a minimum trial of conservative treatments, including weight loss, and must be documented by a physician. Check with your insurance company to see what their policy requires prior to proceeding.