Q: Dr. Eppley, I’m 370 lbs with 52N size breasts, with severe ptosis and painful sagging breast tissue, I have severe back pain from supporting such pendulous heavy breasts for years, will you reject me as a candidate for the surgery?
A: As you have surmised, at your current weight you are not a good candidate for breast reduction surgery. While there is no doubt you would benefit by such surgery, your current weight increases your surgical risks and poses several logistical issues which I will enumerate for you.
1) Any patient over 300 lbs has to be done in a hospital setting. This is not only because of the more comprehensive medical setting and your increased risk of medical problems, but you also need to be conserved overnight after a 3 to 4 hours surgery done under general anesthesia.
2) The other reason a hospital setting is essential is that they have the operative beds that can handle any weight over 300 lbs, most outpatient surgery centers do not.
3) Due to the cost of surgery in a hospital, it is only economically feasible if the cost of surgery is done through insurance.
4) No health insurance will approve a breast reduction with one’s weight being over 300lbs. One of their criteria for coverage is that one’s weight should not be more than 30% of their ideal body weight. At the least they expect to see that the patient has a documented history of substantial weight loss efforts. While we know that weight loss is not going to be the cure for the symptoms of your large breasts, it is an insurance criteria they use.
For all of these reasons, you are not a good candidate for breast reduction surgery at this time. What you need to do kids get your weight under 300lbs which would help lower your medical and surgical risks and give you a better chance to have your surgery approved by insurance.
Dr. Barry Eppley