Introduction: Breast reduction surgery is performed for symptomatic macromastia in overweight patients and in bariatric weight loss patients who continue to have severe macromastia. However, because quality and laxity of skin in bariatric weight loss patients are different, the tendency for pseudoptosis or “bottoming out” is greater.

Method: The control group consisted of 21 obese women (BMI 30 to 40) who underwent a Wise pattern reduction mammoplasty for severe macromastia. The study group consisted of 20 obese women who, after bariatric weight loss, had a similar type of reduction mammoplasty to treat persistant severe macromastia (Pittsburg rating scale of 1). Breast measurements were made at one month and again at one year after surgery.

Results: There was no significant difference between the control and the study groups regarding age (30±11 vs. 32±10), body mass index (35±4 vs. 36±4), and grams of tissue excised per breast (987±216 gm vs. 956±253 gm). However, one year after surgery the mean distance between the inframammary fold and the inferior areola was significantly longer in the study group (control group 9±2 cm vs. study group 14±2 cm).

Conclusion: Bariatric weight loss patients have greater pseudoptosis after breast reduction than overweight patients who maintain their weight.