Breast reduction. Will my BMI affect whether or not I can have the surgery?

Thank you for your question. It is very smart of you to do your research! #BMI can play a roll in any type of surgical procedure requiring general anesthesia. Unfortunately, most insurance companies take this into consideration as a qualifying factor too. The best advice I could give you, would be be reduce your #weight before surgery.The best place to start is by determining a weight that you are convinced that you can maintain before and after your breast reduction surgery. Weight loss does assist in a #breast reduction because a stable weight allows for a more stable result. For example, if you get a breast reduction and then lose a lot of weight, you may find that your breasts are less perky. It is best to lose the majority of weight prior to reduction if you can. In addition, optimizing your weight before general anesthesia helps minimize postoperative complications. The next step would be to make an appointment with a Board Certified plastic surgeon. They can make suggestions and guide you through the process. Good Luck!

Thanks for your question. Breast reduction universally is a procedure that virtually everyone benefits from if their breasts are disproportionately large for their frame and they are experiencing symptoms of neck, shoulder, back pain, etc. Insurance companies have become much less likely to approve reductions over the last few years and many policies actually exclude the procedure as a covered benefit. If you consult with a surgeon and they believe that you are a good candidate then you should go forward. With specific reference to BMI. Statistically complications increase as BMI increases. As BMIs approach 30 and certainly above 35 the risk can be prohibitively high for an elective procedure. This often is seen as wound healing problems but can also be life threatening problems. In addition, those who have a higher BMI tend not to get as good a result because now their reduced and lifted breasts do not match the rest of their body. Find a plastic surgeon in your area that is Board Certified via the Smart Beauty Guide. Best of Luck!

In my own practice I've studied the subsequent benefits to patients after breast reduction. The vast majority of patients went on to lose substantial weight. When asked they said that the physical imposition of the large breasts restricted activity and after the reduction they became more physically active.

There may be two parts to answer your question and thank you for asking it:1)  It has been long recognized that patients with lower BMIs have fewer healing problems.  Higher BMIs (above 30 and particularly above 35) in breast reduction patients give you a much higher risk of having wound breakdown issues and possibly other healing issues such as a fluid collection.  Risk of these problems also seems to go up with very large volume breast reductions.  There are also higher risk of forming a blood clot in your leg around the time of surgery (also known as a DVT) or having a blood clot go to your lung (known as a PE or pulmonary embolus).  Higher BMI are also associated with higher rates of pulmonary issues such as sleep apnea that can complicate surgery and higher rates of other disease such as diabetes which can raise infection rates.  So, for the safety of the patient and lowering the overall risks associated with an elective surgery, it is preferable to lose weight and be at a lower BMI.  However, depending on your overall health, you may still be a candidate for such surgery (understanding your higher risk) after consultation with a plastic surgeon who can help assess risk for you.  Many of us will want you in a safer weight category prior to surgery.2)  From an insurance standpoint (when patients are trying to get insurance to preauthorize the procedure), attaining authorization for breast reduction becomes a bit harder when your BMI is higher.  Insurance wants to see documentation of symptoms related to large breasts and they also want to see that conservative measures have been tried to get relief before surgery.  They want to see measurements taken from the plastic surgeon and the estimated weight of breast tissue which would be removed during a breast reduction.  Most now have BMI charts which plot out the expected weight of breast tissue given a patient's BMI.  For a BMI of 40, many insurance plans want to see that over 1000 grams would likely be removed from each breast to give authorization.  That is indeed a large breast reduction and many women with large breasts fall short of that mark.  I also sometimes see patients that want to lose weight and plan to do so after a breast reduction.  The problem with that is you usually have optimal breast shape, skin tightness, and size after a breast reduction.  If you lose substantial weight after a reduction, you may notice droop and a loss of that tight look.  Also, your breast size could become smaller than you wish as a result of the weight loss/body fat loss.  The most predictable long term result is obtained when patients lose the weight they wish to lose before surgery.So, you certainly may be an excellent candidate to get relief from a breast reduction.  However, it may be in your best interest to lose a bit of weight preoperatively.  Even achieving a BMI of 35 or 36 may limit some of the risks I discussed above.  I know that that is no easy task but I believe that a selective diet is the key for adult weight loss (much more so than exercise that is made difficult by larger breasts).  Good luck to you! 

Insurance companies base their decision on whether to cover reduction mammoplasty based on several factors including BMI and amount of tissue that the surgeon expects to remove.  If you remove the insurance companies out of the picture, it is certainly true that plastic surgeons base their decision on height/weight/BMI as well as other factors such as symptoms, breast size, other medical problems, and whether we overall expect the patient to have a good result in light of their risk/benefit issues.  Personally, I perform breast reduction on a wide range of patients and I reject only the heaviest of patients.  I can almost always achieve their goal of smaller, better looking breasts, and a significant decrease in their pain symptoms.  Austin is not too far away if you want to make the trip and there are some good surgeons in Temple.

HelloWhile there is no doubt that even heavier women get improvement in symptoms after breast reduction, there is also evidence that healing problems and other complications can increase at higher BMIs, especially over 35. I have certainly seen more healing problems with my high BMI patients. Anesthesia can also present more risks, and some anesthesiologists in smaller hospitals or outpatient surgical centers may not feel that high BMI patients are good candidates for elective surgery.If you are hoping that your insurance will cover your reduction, your BMI can also be a barrier. Breast reduction is a high satisfaction procedure, regardless of the amount of tissue removed. There are studies that show that even small reductions are effective in improving symptoms. However, many insurance companies in the US are now using the Schuur scale, which relates body surface area (not BMI) to the amount of tissue that needs to be removed. For very high BSA and BMI, it can sometimes be difficult to remove as much as the Schuur scale suggests, but many insurance companies stick to this for their criteria. Therefore your insurance company may not approve reduction at your current BMI. Others may want you to be within 25% of ideal body weight. If you are able to lose weight, even to the BMI 35 range, your plastic surgeon may be able to present a better case to your insurance and you may be a safer candidate.I hope that helps- 

Thank you for the question.At some point you will be an excellent candidate for breast reduction surgery; it will be in your best interest to reach a long-term stable weight prior to proceeding with the surgery. This recommendation is based on safety of the procedure as well as predictability/long-term outcome of the surgery. Insurance company coverage likelihood will also be improved.Best wishes.