I need a breast reduction badly but the first doctor I went to just called me outright fat without listening to me.

I've had large breast my entire life (I'm talking bcup in the third grade and currently over spilling my H cup). I have RA(rheumatoid arthritis) and scoliosis. These make it extremely hard to workout(I'm only recommended to swim but can't find swimsuits that fit), but the first surgeon I went to said he wouldn't consider until I lost at least a 100pounds, when my drs recommend only 60-70. He just made feel like a cow. Should I go to another dr or weight it out, to see if I can ever lose the weight?

Doctor Answers 5

High BMI and breast surgery

Sorry to hear about your unpleasant experience. A high BMI can put you at an increased risk for a general anaesthetic for the surgery. Also, there are significant risks with wound breakdown and wound healing if operations are carried out in patients with a high BMI. If the large breasts are tipping you over into a high BMI and reducing them is goint to return you to a healthy BMI then you can have the surgery. But if your BMI is significantly high, then you do need to reduce weight before comteplating surgery. I can understand that it must he very hard for you with your RA, but you do need to ensure that surgery is safe for you. The medication that you are on for your RA would also increase risks with wound healing and this will also need to considered. 

The chosen one, some advices:

Thanks for sharing your concerns with us. First of all I recommend you to send your photos to us to tell you about your future procedure. 

I usually tell my patients that the first step for a safe plastic surgery is to choose a board certified aesthetic and reconstructive plastic surgeon.

This should have a personal website containing details of his professional biography and some photos of the procedures performed.

Your plastic surgeon should be  transparent and a honest person with you, with ethical and human values, and especially with good reputation and history. Also, it's much better if this doctor have special training and experience in procedures like the one you're interested.

Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 179 reviews

Scarless reduction

this may be a wonderful opportunity for the quick simple safer, liposuction only operation.  Can be extremely effective  even with the overweight situation. You'll have to seek out a board-certified plastic surgeon in your area who actually specializes in this operation. it's an outpatient procedure done under sedation not general anesthesia.  Hope this helps. 

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.7 out of 5 stars 24 reviews

Breast reduction and weight requirements

I am so sorry you had that experience.  RA is rough, and can make physical activity very difficult.  Patients with BMI over 30 can have increased complications following surgery.  For this reason, we typically try to work with patients to achieve a healthier weight prior to proceeding with surgery.  Depending on the circumstance, we do sometimes do elective surgical procedures on patients with a higher BMI.  I would recommend consulting with another surgeon to get another opinion.  Again I am sorry for your experience and hope you find a surgeon who makes you feel comfortable.  

Kelly Killeen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast reduction while overweight?

 I am sorry to hear about the disappointing consultation experience.
Based on your picture and description you may be an excellent candidate for breast reduction surgery at some point; it tends to be one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin this operation reduces and lifts the breasts to a higher position on the chest wall. By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise.

Timing of the operation will depend on the patient's life circumstances. In general (ideally), it is best to do this procedure ( like all other elective body contouring the stages, when patients have reached their long-term stable weights. Losing weight prior to the procedure will improve the safety of the procedure and minimize the need for further surgery ( in the event of weight gain/loss after the breast reduction procedure). Keep in mind, that some of the complications that may occur when patients undergo surgery while overweight, can be very serious.

On the other hand, as you mentioned, patients with very large breasts have a difficult time exercising to their full potential; for some of these patients, breast reduction surgery (after careful consideration of potential risks/compliations is an option.  In my practice, I individualize these types of decisions, "case-by-case".


  Best wishes as you work towards your goals and for an outcome that you will be very pleased with.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.