I'm 19 yrs old, 5'4, 200 lbs. Am I a Good Candidate for a Breast Reduction?
Doctor Answers 6
Am I a good candidate for a breast reduction?
It would be in your best interest for weight loss to increase your safety for Surgery as well as have a mammogram prior to the procedure for screening prior to this procedure, as the architecture imaging of your breast will slightly change afterwards. Well known data exists that having a breast reduction will in fact lower your chance for developing breast cancer, simply because the amount of tissue will be less.
Consult with a board-certified plastic surgeon who will discuss the procedure with you, examine, and assist you in determining if this is the right procedure for you. Voice your complaints - your insurance will likely require a detailed description of your history and complaints as well as photo and an estimate of how much tissue will be removed. You should give a description of the therapies that you have done to ameliorate your complaints thus far. Any other notes from other physicians is helpful. It would also behoove you to discuss your issues yourself with your insurance carrier. Hope that this helps! Best wishes!
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Insurance coverage for reduction
Alternative technique to the traditional Wise pattern
Breast reductions are authorized by insurance companies based on 2 criteria. First, you must have symptoms related to the large breasts such as neck, back and shoulder pain or rashes. Second, you must have to amount removed that meets their criteria. The criteria is based on your height and weight. At 5'4 and 200 lbs your body surface area is 2.02 meters squared. If your insurance was Aetna, they would require 965 gram removal. At size 38 each 200 grams will correspond to 1 cup size change. 5 cup sizes would take you down to a size A or B. That size would be inappropriate for you. I recommend you consider an alternate procedure. There is a new technique called The Ultimate Breast Reduction. This technique is done without a vertical scar and avoids the boat anchor shaped incisions of the Wise pattern that was developed in 1956. This technqiue will allo you to select the size proportionate to your body so you will not be overly reduced. This technique provides immediate pain reliefe by transferring the weight of the breast to the undelying muscle and eliminating the strain on the skin. You are a good candidate for this technique.
Gary Horndeski, M.D.
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Breast reduction candidate?
Based on your symptoms it seems you would be a good candidate for breast reduction. A call to your insurance company will help determine if it's a covered benefit under your policy and any restrictions they have associated with the surgery. By visiting a Board Certified Plastic Surgeon you'll be able to learn more about the procedure including risks and benefits. Your surgeon can also assist you in exploring your benefit coverage. Good luck!
I am so sorry you are living with these large breasts.
- Yes, your symptoms make you a good candidate for breast reduction.
- Insurance usually will cover breast reduction - every policy is different. Call your insurer to find out what you need to do, if anything, to qualify for surgery.
- large breasts can make exercise impossible, making weight control difficult.
- Many breast reduction patients become more active after surgery and lose weight.
- if you qualify for insurance surgery, consult a plastic surgeon in your insurance plan.
- they file a pre-determination insurance report. Once approved, you can have surgery.
- In the meantime, try to lose some weight to lower surgical risks.
Hope this helps!
Good Candidate for Breast Reduction?
I'm sorry to hear about the problems you have experienced secondary to disproportionately large breasts since you were very young. Based on your description, it is clear that you have suffered both from the physical and psychosocial stamp point.
Also, based on your description it is clear that you may be an excellent candidate for breast reduction surgery at some point; it will be in your best interests to drop weight first. Doing so will help decrease the risks of surgery and help minimize the chances that additional surgery will be come necessary in the event of weight loss that occurs after the breast reduction procedure.
The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Make sure you are consulting with a well-trained/experienced board-certified plastic surgeons.
When dealing with health insurance companies, be prepared to be persistent. Keep in mind, that breast reduction surgery tends to be one of the most patient pleasing operations performed.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.