Breast Reduction: Info, Prices, Photos, Reviews, Q&A

You should be at your ideal weight before you get a reduction. That said, I know it is hard to exercise and lose weight when you have large breasts.

Many women know insurance mandates we remove a certain amount to get the surgery covered. It is true. But insurance will make us take out more tissue the more overweight you are.

Why try to lose weight before breast reduction?

1. Breasts are about proportion to your body. If you are going to make your body smaller, do so before I reduce the breasts. Then I know what I am matching.

2. A breast reduction lifts the breast. If you lose weight after your surgery, your skin will loosen and you will droop.

3. If I make your breasts your ideal size and you lose weight in the future, then your breasts will be too small.

4. There are higher complication rates in obese patients. (Lauren Greenberg, MD, Palo Alto Plastic Surgeon)

Losing weight will make your breast reduction operation easier

Losing weight prior to surgery will make the entire process easier for you. In particular, the anesthetic-related co-morbidities (i.e. complications) are usually less frequent in patients you are closer to their ideal weight. When you lose weight, you will also lose volume in your breasts.

However, simply losing weight does not guarantee that your breasts will get smaller, so you will still likely need a breast reduction. (Kevin Brenner, MD, FACS, Beverly Hills Plastic Surgeon)

Being overweight can lead to large breasts

Since the breast is composed of fat tissue as well as breast tissue, partients who are overweight often suffer from large breasts.

Weight loss can often reduce the problems associated with large breasts. However, even normal weight patients can have overly large breasts.

In either case, if the patient has significant symtpoms associated with large breasts and if attempts at weight loss are unsuccessful, breast reduction surgery can be very helpful. (Robert B. Pollack, MD, San Diego Plastic Surgeon)

Breast reduction for someone overweight

When patients are overweight and desire to have a breast reduction and also lose weight we discuss two issues. First, weight loss which I feel requires nutrition, eating healthy, and exercise. I like to get my patients into this routine prior to surgery, see them lose some weight and then address breast reduction.

Some patients will also say they cannot exercise due to the large size of their breasts. If we can initiate a routine of nutrition and exercise if we have to take a time out to perform surgery, we can then return to an existing routine to further support the breast reduction.

There is no question that the breast reduction further motivates the patient. I intentionally leave you larger than you ultimately want to be as your breasts will also get smaller as you lose weight. (Roger J. Friedman, MD, Bethesda Plastic Surgeon)

Breast reduction is a rewarding procedure

Breast reduction is done in general for symptoms of neck, shoulder pain and other skin manifestations. Breast reduction is one of the most rewarding procedures as the goal is clear. The presence of scars has to be properly discussed to avoid any miscommunication.

Insurance coverage is a different issue and depends on the specific policy. (Hisham Seify, MD, PhD, FACS, Orange County Plastic Surgeon)

In my experience, women experience a significant improvement in their symptoms of back pain, etc. after breast reduction surgery, no matter what their weight is. Being overweight at the the time of surgery has several issues.

First, your insurance company may not cover the procedure if you are overweight. Second, the risks of the surgery are increased if you are overweight. Third, if you lose weight after the surgery, it may affect the aesthetic result of the surgery if you lose weight from your breasts.

In my experience, most patients who have the surgery and are overweight

1. do not lose significant amount of weight from their breasts if they lose weight;
2. have a safe, uneventful procedure; and
3. are very happy with the results, the reduction of pain and often lose weight after the procedure because they are motivated to do so and also able to do so. (Tracy Pfeifer, MD, Manhattan Plastic Surgeon)

Breast reduction if you are overweight

Payment issues aside, what makes someone a good candidate for breast reduction is having large breasts and desiring a smaller size due to unwanted symptoms related to the large breast size.

Examples of symptoms include shoulder grooving from bra straps, neck and back pain related to the breasts (not attributed to other causes), rashes, skin breakdown, and infections on the skin below the breast, inability to find clothing that fits, feeling self-conscious and limited by the breast size, etc.

Whether or not your reduction is covered by insurance is another matter. Each insurance company has criteria that must be met in order for the breast reduction to be covered. You can often find your insurance companies criteria listed on their website.

In addition to requiring symptoms such as those listed above, there is generally an additional criteria specifying the weight of breast tissue that the surgeon must remove in order for your surgery to be covered.

The specific weight that must be removed is usually determined based on your height and weight. I have had patients ask if they should have their breast reduction now while they are heavier, so that they have a higher chance of meeting the “magic number” for the amount of breast tissue removed.

This is not a good idea for a number of reasons. First, the more you weigh, the more breast tissue that must be removed to meet the criteria. More importantly, if you are not yet at a reasonably stable weight and have a reduction, once you lose more weight your breasts will change shape and volume, and you may be left with a breast that appears more flat or droopy.

The end result is not as predictable as when you remain at a stable weight. On the flip side, there are women who believe they are at their stable weight and have a breast reduction, only to find they can now exercise easier (and find exercise clothing that fits), that they go on to lose even more weight than they planned to.

All in all, there has to be a balance. Ideally you are at a stable healthy weight, and the breast reduction is done in proportion to your body and your needs. I would recommend consulting with a Board Certified Plastic Surgeon in person, and going from there. (Anita Patel, MD, FACS, Beverly Hills Plastic Surgeon)

You can have a reduction anytime you want as long as certain criteria are met to satisfy the insurance company. The insurance company will stipulate a minimum weight that must be removed and your doctor has to meet this (or get very close) for your procedure to be covered.

In the ideal world, you should be at a weight you can maintain easily because weight fluctations in the future will affect your overall appearances and weight loss almost invariably leads to smaller breasts than desired and often a breast augmentation.

So if you know you can lose weight and its easy to maintain, you should before your consultation and surgery. If you know you cannot and are satisfied with your current status and have the symptoms of macromastia and are accepting of the risks of surgery, then go for it… you will still be amazed at how you will feel after having the weight lifted off your shoulders. (Curtis Wong, MD, Redding Plastic Surgeon)

If you are planning on losing weight then Breast Reduction surgery is not highly recommended unless it is medically necessary. What I mean by medically necessary is if your breast size is causing serious problems with your back or harming anything else on your body.

The reason that it is not recommended is if you lose weight your breasts will become smaller than you previously had intended on them being. (Siamak Agha, MD, PhD, FACS, Orange County Plastic Surgeon)

Breast reduction is best when weight is stable

Your absolute weight is not the most important issue, it is your weight “change.” You want to consider breast reduction when you are at the weight you feel you can maintain. Losing or gaining much weight after the procedure risks changing the result. (John P. Di Saia, MD, Orange Plastic Surgeon)

A good candidate for a breast reduction is someone who is having symptoms of pain in the neck and upper back from excessively large breasts. Other issues such as skin irritation or infections under the breasts are also common indications.

Being overweight is often the case in women seeking a breast reduction. My recommendation for a woman who is overweight and consults for a breast reduction is to lose the weight first.

Reasons for this include:

• Being overweight puts you at greater risk for anesthesia related problems
• If you lose weight AFTER a breast reduction, you will lose volume in your breasts as well and may be unhappy with the resulting sagginess
• Many of the symptoms (neck pain/back pain) attributed to your breast size may improve with weight loss, avoiding an operation
• In order to be covered by insurance, most insurance companies require a documented weight loss effort (sometimes requiring a visit to a physical therapist)
• If, despite efforts at weight loss, the symptoms of large breasts remain, then a reduction can be a very satisfying operation.

A lot of patients become motivated after a breast reduction to exercise and improve their weight. Regardless, with all things being equal, plan to lose as much weight as possible prior to a breast reduction.

You will be happier for it and your results will be more likely to stand the test of time. (David Bogue, MD, Boca Raton Plastic Surgeon)

Breast Reduction in the Overweight Patient

Breast growth may or may not follow body size but in general, the heavier the person, the larger the breasts.

An individual usually knows how her body responds to changes in weight. For instance, someone who is moderately overweight may tell me that even when they weighed 40 pounds less, they still had large, heavy breasts.

Another person may tell me their breast size changes quite dramatically with weight gain or loss. Such a person may get insurance coverage for their reduction when they are heavier but be denied the operation if they lose weight.

From the standpoint of the surgery, the end result usually looks better the closer the person is to their ideal body weight before surgery and the operation is easier to do. However, many obese patients simply cannot exercise enough to lose weight if they have enormous breasts.

Every know and then I’ll do a breast reduction in an obese patient who just could not exercise then see them six months later and they’ve lost a significant amount of weight because they are now exercising. (Barry Stuart Handler, MD, San Diego Plastic Surgeon)

Breast reduction and weight loss

If you are overweight, it is best to get your weight down to within 15-20 pounds of your ideal (or at least realistic) weight before having a breast reduction. However, there is often a problem losing weight if your large breasts are impeding your ability to exercise.

Certainly do everything you can to lose as much weight as you can first. Consider a nutritionist or other professional if necessary.

Then after your breast reduction, you can refine your look with exercise and further weight reduction if necessary.

I sometimes see women come into my practice who have had breast reduction elsewhere when they were overweight, and then they went on to lose weight, and their breasts shrank significantly, needing implants! (Douglas J. Mackenzie, MD, Santa Barbara Plastic Surgeon)

It is always better to get down to your desired goal weight before undergoing breast surgery. However, I have seen some patients present who want the reduction to motivate them to lose weight. It is a delicate balance. (Steven Wallach, MD, New York Plastic Surgeon)

Breast reduction can be great for overweight women.

1) If your large breasts bother you, you should absolutely have a breast reduction, regardless of your weight. These are some of our happiest patients. 2) I have also noticed that in some women, having smaller perky breasts can be a real incentive to lose weight, which is so hard. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)

Many patients who have breast reduction loose additional weight after the procedure. I discovered this in a study I did on my patients for presentation at the Southeastern Society of Plastic Surgeons several years ago.

When we asked the patients (who lost on average about 14 pounds after the operation) why they were successful at weight loss, they stated that with the heavy breasts out of the way, they were able to be more active and exercise more.

Breast reduction can be a useful adjunct to weight loss. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

When I analyze a candidate for breast reduction surgery I look for tell tale signs of overly large breasts. Bra and cup size are a great place to start. Patients with a bra and cup size that are too big for their frame may be candidates for breast reduction surgery.

Problems associated with overly large breasts may include breast pain, bra strap grooving, rashes, back/neck pain, need for muscle relaxants/pain relievers, difficulty finding bras/clothes that fit, difficulty with engaging in exercise, social embarrassment, etc.

A good candidate meets many of the above criteria. My experience with breast reduction patients are that they are the most satisfied patients I have. Their quality of life is typically enhanced. In many cases, health insurance might cover the costs associated with breast reduction surgery.

When it comes to being overweight, some aspects of breast reduction surgery become more problematic. Very fatty breasts can heal a bit more slowly. Additionally, symptoms in the obese can’t always just be attributed to large breasts.

A large belly can also strain the back and neck. Finally, anesthesia is more risky in the obese. I prefer that patients be no more than 30% above ideal body weight to optimize for surgery. That doesn’t mean that you can’t have surgery if you are obese, it just means you have to seriously weigh the risks vs. benefits. (Manish H. Shah, MD, FACS, Denver Plastic Surgeon)

There are no absolutes here. This is somewhat of a subjective determination. Ultimately, you need to decide if your breasts are too large and cause you significant discomfort. If you are asking if the insurance company will agree, that is entirely a different matter.

Some companies, like Blue Cross, use reference guides such as the Schnur scale to determine elegibility for the procedure. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

For patients experiencing pain in the neck, back, and shoulders, bra strap grooving, rashes underneath breasts or some combination, breast reduction can help provide relief by reducing the side/weight of the breasts. Whether insurance will cover depends on the specifics of the case and the requirements of insurance. (Kris M. Reddy, MD, FACS, West Palm Beach Plastic Surgeon)

Breast reduction patients are the happiest plastic surgery patients. If you are bothered by breasts that are disproportionately larger than your body, back and neck pain and have difficulty exercising, then you may be a candidate for the surgery.

Seeking out a board certified plastic surgeon for a consultation is the best place to start. You always want to be near your ideal body weight before surgery as to avoid breast size changes with weight loss after surgery.

Some patients, however, do not have any changes to their breast size with weight loss. Sometimes it is difficult to exercise with heavier breasts. Discuss all your concerns with your surgeon and then you can decide which direction is best for you.

Sometimes having a breast reduction helps with weight loss as you can exercise easier. (Bahram Ghaderi, MD, Chicago Plastic Surgeon)

The breast reduction procedure is beneficial to women who suffer from problems related to their large and heavy breasts. If you experience back pain, shoulder pain, muscle spasms or rashes under your breasts, your insurance provider may cover this procedure.

In order to relieve pain and improve overall appearance, breast tissue is removed and the breasts are lifted to their appropriate position. (Jennifer L. Walden, MD, Austin Plastic Surgeon)