I'm 32, a nurse, and struggle with my weight. Can breast reduction be performed privately if you have a high BMI?

Question

My BMI is around 31. I struggle to exercise however as I have very large breasts and they cause me pain during 12.5 hour shifts. I struggle to exercise because they are so heavy. I live in the U.K. So went to my GP regarding a reduction and he said I would not be considered unless my BMI was less than 25. If I were to seek surgery self funded, would the BMI rule still apply?

Hayley Brown, MD, FACS · Answer

Heavy, large breasts can be painful in patients of all sizes. There is no blanket "BMI rule" as every patient is evaluated individually. If you are healthy otherwise, you may be a great candidate for a breast reduction. When you have larger breasts, it can be difficult to exercise and loose weight. I perform breast reduction on patients with higher BMIs regardless of how they are paying if they are nonsmokers and free from major medical problems.

Navid Jallali, MB ChB (Hons), MD, FRCS (Plast) · Answer

We generally find that patients with macromastia find it difficult to exercise and hence lowering the BMI to less than 30 may not always be possible. It is also not unusual for the BMI to fall within the normal range once the breast reduction has been carried out, as substantial amount of weight can be lost with this procedure. Your BMI is not over 35 and hence I would have no hesitation in performing your breast reduction. Best of luck with your treatment.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.
  
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  
  
Best of luck!    
  
Dr. Schwartz 
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon 
  
#RealSelfCORESurgeon

Charles Nduka, MD · Answer

The real question is whether you are healthy or not. Exercise would be a challenge with the current weight of your breasts, as they would cause limitations and could induce more pain and stress on your body. If you are healthy enough upon evaluation then you are a good candidate for breast reduction. You would need an in-person examination.

Reza Sadrian, MD · Answer

It's always best to try to be at a healthy weight prior to surgery.  With that said, you may have tried to exercise and eat right, but remain close to or at your current BMI.  As long as you are otherwise healthy, your BMI shouldn't stop you from having a reduction. Some women tend to gain breast tissue as they age and or gain weight.  Sometimes having this surgery can kick start a healthier lifestyle and help you with having more of a desire to exercise because it will become easier to physically do so.

Surjit S. Rai, MD · Answer

It is true that a BMI over 30 is associated with increased surgical risks but for breast reductions I think most plastic surgeons will perform reductions in patients over 30 BMI. There have been a lot of studies that show regardless of your BMI there is a lot of symptom relief from breast reduction procedures. I'm not sure how it works in Europe but in the US there will be plenty of plastic surgeons willing to perform breast reduction on a BMI of 31 provided you are a good surgical candidate.

Hope this helps,

Hope this helps,

Jared Troy, MD · Answer

BMI has not been shown to affect who benefits from breast reduction surgery, and weightloss has not been shown to significantly reduce symptoms. BMI's above 30 do correlate with increased complications like delayed wound healing, but not enough that most surgeons would defer surgery. Breast reduction patients are some of the happiest patients in a plastic surgery practice due to how much it improves the complaints you mentions. Get a consultation with a private plastic surgeon and discuss your options.

Michael L. Workman, MD (retired) · Answer

Having a high BMI (above 30) can increase your surgical risk which is why many doctors do not want to perform surgery on heavier women.  Many plastic surgeons, including myself, will still perform procedures on women with a higher BMI as long as they are otherwise healthy and the BMI is not too high (Generally above 40).  Know your risks going in and you should be fine.  Be sure to see a plastic surgeon that is Board Certified.

I'm 32, a nurse, and struggle with my weight. Can breast reduction be performed privately if you have a high BMI?

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