Breast Reduction Surgery
I am currently morbidly obese (313lbs) and have begun a diet and exercise regimen. The problem is that my breasts are extremely large, to the point where I am unable to find any place with a bra that fits. The biggest bra I own is a 42P and it does not fit. It is causing tremendous pain with my exercising and causes me to be unable to purchase clothes that look right. I currently do not own a fitting bra and have not had one for more years than I care to count. I am planning to have skin removal surgery and anything else necessary when my weight loss is complete, but my breasts are so large that it is becoming impossible to work with them in my weight loss journey as they are now. Should I have breast reduction surgery before I lose all the weight I want to lose?
I can certainly understand the problem that you face here. Your path to your weight loss goal seems obstructed by your heavy painful breasts, and it may seem like the answer is simply to have a breast reduction now. But I would caution you to try to be patient and hold off on this until you have lost enough weight to reduce some of the risks of surgery that can be associated with morbid obesity. Anesthetic risks, wound-healing risks, and risks of compromised nipple blood supply, are only a few of the many that could present themselves. A consultation with a plastic surgeon and anesthesiologist will allow a treatment timetable to be customized to your individual needs. Hang in there!
It is always better to lose the weight before any reduction surgery. This will help you get through surgery and recovery in a much better way.
Your problem is called as "gigantomastia" in medicine. The best treatment for this problem is breast reduction with free areola graft. Obesity is not an obstacle unless you have heart and lung insufficiency causing inability to give general anesthesia. A board certified plastic surgeon and anesthesiologist should decide whether you are operable or not. Good luck.
Ege Ozgentas M.D.
Technically the breast reduction surgery can be done now. As the others have noted there is increased risk, but this may be justified if this is a serious problem for you and if you understand the risks involved. It is better to do the surgery once you have lost your weights in terms of getting the best aesthetic result since further weight loss will cause the remaining breast tissue to shrink further and possibly resulting your breasts being droopy again when you reach your weight goal. This may then need further surgery in the future.
If you feel that this is of major importance to you right now I would suggest you consult an experienced plastic surgeon who can assist you and discuss the risks with you.
It depends. If you'd like the most stable result, losing weight first is best. It's always best to avoid operating on a moving target. On the other hand, if the size of your breasts is contributing to your difficulty losing weight, then the surgery may help you achieve your goals.
I would not recommend elective surgery such as breast reduction for patients with BMI above 40, as the complications are unacceptably high in likelihood.