Can I get a breast reduction if I’m overweight?
How much weight is needed for breast reduction?
What qualifies for a breast reduction?
Do I need to lose weight to get a breast reduction?
Breast Reduction Surgery Procedure
Reduction mammoplasty is a plastic surgery aimed at reducing the size and, correspondingly, the weight of the mammary glands, which helps create a more aesthetic contour of the breast, more proportional to the patient's body. Removing excess tissue, fat and stretched skin, the plastic surgeon not only reduces the chest, makes it lighter and elastic, but also corrects the symmetry and eliminates the sagging of the mammary glands.
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Your Consultation About Breast Reduction Surgery
Before breast reduction surgery, you will consult your surgeon. During your consultation, you'll talk about your medical history, including whether or not you've had a lump removed from your breast or have any other medical conditions that affect your breasts. Your surgeon will also ask you about your family's medical history.
Be completely open with the surgeon about your medical history and why you're seeking a breast reduction. Be prepared to discuss any emotional issues you've dealt with regarding your breasts, how your breasts have physically felt to you, and any physical conditions you've had.
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Breast reduction and health insurance
It is universally believed by patients that if a surgery is considered reconstructive, it is medically indicated and covered by health insurance. Conversely, many patients believe if a procedure is considered cosmetic, it is not a medically indicated and covered procedure.
In the case of breast reduction, however, for insurance purposes, it will typically be considered a cosmetic procedure until the patient can prove an adequate number of health issues and attempted remediations of those issues prior to undergoing corrective surgery. Once the threshold has been reached, the insurance company may then consider breast reduction a reconstructive procedure for that patient and cover it. The problem is that the threshold can be different for every insurance company or insurance company reviewer. It is my opinion that breast reduction surgery has long been thought of as a "hybrid" procedure. It is considered reconstructive in attempts to obtain insurance coverage for the surgery, but it is also considered cosmetic in that patients expect meticulous aesthetic expertise in their surgery and results.
How much weight is needed for breast reduction?
Some insurance companies will deny breast reduction surgery unless the BMI is <30, others <35, while others need to see documentation that the patient has attempted to lose weight in the past through diet, exercise or weight loss surgery. This is because breast size may decrease with weight loss.
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Can I get a breast reduction if I'm overweight?
Being overweight is a relative contraindication to (an important reason to be cautious or to avoid) having breast reduction. If you are a few kilos above your ideal body weight there is no issue at all.
If you are significantly overweight then the reasons to defer a decision about having a breast reduction start to mount up. Once you get beyond 10%- 15% over your ideal body weight you would be much better off to delay any proposed breast reduction procedure.
There are technical and common-sense reasons for this.
First the technical reasons. Once you are significantly overweight your risk of having a complication after any procedure increase. Complications like infection, wound healing problems and damage to the blood supply of the nipple related to surgery are relatively uncommon in breast reduction but once your weight starts rising so does the risks of surgery,
Secondly most women who are overweight realize some of the fullness they are seeing and which is causing symptoms is not actually breast tissue at all. For example, women often identify the fullness and fatty tissue on the chest wall under where your arms sit when they are by your sides as a particular problem. This tissue is beyond the breast tissue. It is not breast tissue in most cases it is fatty tissue. Whilst we can try and decrease the fullness in this area with liposuction at the time of breast reduction surgery it is much better to reduce this area by weight loss prior to surgery.
The other common sense reason to lose any excess weight prior to any planned procedure is so that you get the best outcome in terms of breast shape that we can achieve.
If you are carrying a lot of extra weight it is very hard to you the best possible shape. Because your chest tends to look broader if you are carrying major excess weight so your breasts tend to look broad and flattened out after reduction. Whereas if you lose weight prior to surgery you are more likely to get a more pleasing breast shape following surgery.
What qualifies for a breast reduction?
Generally speaking, you might be considered for breast reduction if you have problems caused by having very large breasts, such as:
- backache
- shoulder or neck pain
- skin irritation
- rashes and skin infections under the breasts
- grooves on the shoulders from bra straps
- psychological distress, such as low self-esteem or depression
- an inability to exercise or take part in sports
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Do I need to lose weight to get a breast reduction?
Very large breasts can be extremely uncomfortable and prevent women from wearing clothes that make them feel confident. Many women with heavy breasts also find that they avoid certain physical activities because of their breasts, leading to weight gain and more discomfort.
The best results from breast reduction come when patients lose weight first, according to a new study in the September edition of Plastic and Reconstructive Surgery, the official journal of the ASPS.
The study analyzed a group of women who (except for one) chose bariatric surgery to achieve major weight loss. Fifteen of the patients had a breast reduction before weight loss surgery, while 14 of them did not. Outcomes from breast reduction were good: they reported good aesthetic outcomes and felt better able to exercise. However, after bariatric surgery, they experienced a subsequent reduction in breast size.
Many women believe that a breast reduction can help them lose weight—both because it’s extra motivation and because some breast weight is removed during the surgery. But if you have breast reduction before losing weight, you should consider how that extra weight loss in your breasts will affect your surgically reduced breasts. Because of the changes in the skin after major weight loss, the cosmetic outcome of a previous breast reduction can change.
In some cases, women who lose their excess weight first find that they simply need a breast lift instead of a reduction.
After significant weight loss, 86% of the women who had undergone a previous breast reduction thought their breasts looked worse. “If giving advice to a friend, they said they would recommend losing weight before undergoing breast reduction surgery,” the ASPS reports. Interestingly, the benefits of breast reduction seemed to outweigh this cosmetic concern, as most of the patients “did not regret their decision to have reduction mammaplasty first.”
Among the group that did not have breast reduction (but did achieve major weight loss), about half said they were planning a breast reduction, while many others said they would if they could afford to pay for it.
What this study suggests is that women planning weight loss, whether through bariatric surgery or traditional methods, should expect changes in the appearance of their breasts. If these changes could potentially cause significant dissatisfaction, the patient may want to plan for breast surgery after weight loss is complete.
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Breast Reduction Surgery Procedure
Depending on your case, you might have breast reduction surgery in an outpatient facility, or you may have to stay at least one night in the hospital. In either case, you’ll get general anesthesia, which means you will be put to " sleep" during the procedure.
Breast reduction surgery will take about 2 to 5 hours, sometimes longer.
Your surgeon could use one of a few surgery methods, depending on the shape and size of your breasts, how much tissue they need to remove, and how you want to look after surgery:
- The surgeon will make small cuts in your skin and insert a thin tube connected to a vacuum that suctions fat and fluids from your breast. This option is best for small reductions and for people whose skin will “snap back” into place.
- Vertical or “lollipop.” This method is for moderate breast reductions and visible sagging. The surgeon will make cuts around your areola and down to the crease beneath your breast, remove extra tissue and fat, reshape the breast, and lift it.
- Inverted-T or “anchor.” The surgeon will make cuts around the edge of the areola, from the areola to the breast crease, and along the crease underneath the breast. This type of surgery is best for large reductions and for people who have a lot of sagging or unevenness.
Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in a special gauze. You may also need to wear a surgical bra.
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