Dr. John K. Long's Blog

I would like to write my first blog about the timing a woman must consider who desires a breast reduction and also is considering bariatric surgery or massive weight loss with a diet and exercise plan. The first consideration would be whether or not a woman has medical problems related to large, heavy and pendulous breasts. These problems would include shoulder grooving, pains in the neck, back, shoulders and breasts and chronic skin problems under the breasts. These medical problems are necessary to consider a breast reduction to be medically indicated and thus possibly covered by one’s medical insurance plan. The second consideration, unknown to many women, is the need to have a specific weight of breast tissue, in grams, to be removed at the time of the breast reduction surgery. At one time this weight was a standard fixed number somewhere around 500 grams. Now, the prospective breast reduction patient is often required to have a specific number of grams removed based upon their BMI. In summary, a prospective breast reduction patient must have medical problems related to the size and weight of her breasts, and a specific amount of breast tissue measured in grams must be removed to receive insurance coverage for the operation.

These important criteria, especially the required weight in grams of breast tissue to be removed, must be considered in the timing of the breast reduction operation. If one is losing weight by exercise and diet or by a bariatric operation such as a lap band or gastric bypass, you must consider the possibility that at some time in your weight loss, you will no longer qualify for insurance coverage for a breast reduction due to your breast becoming too small. Therefore, the scheduling of a breast reduction operation must be considered at the beginning of the weight loss.

In expectation of weight loss of a large amount in a patient considering a breast reduction, consideration is made at the time of surgery to remove the minimum amount of breast tissue to satisfy the insurance company and yet if at all possible leave enough breast tissue behind to provide the best result after the breast reduction operation and weight loss.

There is the possibility that after massive weight loss, most if not all of the breast tissue would be lost by some women even without a breast reduction. In this case, the breast reduction operation has been useful to give the woman after the massive weight loss breasts that are not sagging and breasts that have a nice shape. If one desires to have an augment, that is to make their breast larger to compensate for the massive weight loss and its affect upon their breast, then the breast lift one would desire has already been performed by the breast reduction operation and its cost can be covered by their insurance company. A breast lift, either before or after weight loss, is always considered a cosmetic procedure and is not covered by any insurance plans.

So Ladies, let me know what you think about this subject and tell me what experiences you have had relative to large breasts and massive weight loss.