Too FAT for breast reduction? Is there a restriction on a person's BMI in order to have breast reduction done? (Photo)

Question

I weigh 240lbs, 5'8", 32 yr old. 40 DDD. Have been refused consultation based on BMI. Is there a restriction on a persons BMI in order to have breast reduction done? Does OHIP have a BMI rule for coverage? Severe and prolonged back pain, bra indents, rash under breasts. I do not feel obese and feel my ability to engage in physical activity will improve with a breast reduction, as i am often restricted by their size.

Steven Wallach, MD · Answer

Patients with higher BMI's are at risk for more complications.  However,  denying surgery really is dependent upon multiple factors and this is determined on a case by case scenario.  Go seek another consultation.

Jeffrey Ditesheim, MD, FACS · Answer

You do have a higher BMI, which does put you in a higher risk category for complications, but you would definitely benefit from a breast reduction procedure.  Your back pain and rashes will most definitely improve. I can only advise you on the surgical benefits of the procedure, not whether a third party will provide benefits/

Alan M. Engler, MD, FACS (retired) · Answer

In general, people with a significantly higher BMI are at a greater risk of some complications (including poor wound healing, breathing problems, blood clots in the legs) than people with lower BMIs.  However, it's very much a question of degree, and what the underlying medical condition is.  With your BMI and symptoms I would think that trying to lose a little weight would be helpful but that, at that point, you'd benefit enormously from a breast reduction.Convincing your insurance carrier to "cover" this procedure is, as is often the case, a different issue.  Each insurer has its own procedures and policies and you'll have to wade through whatever obstacles they have.  I'd advise that you find a plastic surgeon you're comfortable with and work with him or her to find out what's recommended from a surgical standpoint, and how to get that approved by your insurance company.  Careful documentation of your symptoms and the failure of conservative therapy to provide relief are good starting points.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100

Robert Kagan, MD - Account Suspended · Answer

Hello,I understand your situation, however every insurance plan is different with different guidelines for approval of any procedure.   We have experienced in the past, patients being declined due to weight.It is a possibility you could schedule a cosmetic consult and pay out of pocket.  Having a breast reduction would definitely help you become more active, and would be a life changingprocedure for you.  You would need to keep up an active lifestyle along with lifestyle changesHope this helps!

Too FAT for breast reduction? Is there a restriction on a person's BMI in order to have breast reduction done? (Photo)

Answers (4)

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