I have talked to my PCP several times about my situation. I had children (2 by 18 years old), and I've always had large breasts. Now I'm 31, 2 herniated discs, 1 bulging, and somewhere along my spinal issues, I have a pinched nerve. One of these discs sit on and irritate me all to hell everyday all day, so my PCP is dumb and acts like she can't recommend help for breast reduction, but my pain management doctor wrote on a script pad that he recommends it ... help.
Breast Reduction Due to Back Issues
Doctor Answers (8)
Breast Reduction Candidate?
Thank you for the question.
Breast reduction surgery has been shown to help alleviate neck, back, and shoulder discomfort that is exacerbated by the larger breasts.
I would suggest in person consultation with well experienced board-certified plastic surgeons.
Breast reduction and back pain
If you have large breasts and they are contributing to your back issues, a breast reduction may improve your symptoms. Criteria for approval are different for each insurance company.
Breast reduction for back pain relief
As mentioned, your options are to get a new PCP and try to convince them to support your cause or to go outside your netwrok and pay for this out of pocket.
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Breast Reduction is very effective in improving symptoms like yours
Breast reduction is very effective in improving the symptoms you describe.
Unfortunately, and for many reasons, it has become very, very difficult to get insurance coverage for this operation.
Your options are to visit a plastic surgeon, pay out of pocket, and have your breasts reduced, or to stomp your feet in continued frustration that your insurance company won't pay for your breast reduction.
In my experience the latter is of no benefit.
Breast reduction due to back issues
You are definitely a candidate for a breast reduction. You do not get IT!!! The PCP is capitated from the insurance company NOT to spend $'s. So if you were paying from your own pocket NO PROBLEM. But to get the HMO to pay is very hard.
Best of Luck From MIAMI DR. B
Breast reduction for back pain
While breast reduction may benefit back pain, neck pain and bra strap grooving, it will not correct herniated disks. There are many factors to consider in a breast reduction including how much breast tissue will be removed. Some insurance plans I have been in contact state point blank that breast reduction is not covered by insurance. Most plastic surgeons have stopped accepting insurance for breast reduction due to the dramatically reduced reimbursement. I would at least see a plastic surgeon - with or without your PCP recommendation- to see if you are a candidate.
Breast Reduction for Back Pain Relief
If you believe that your back pain could be improved by Breast Reduction Surgery, nothing is stopping you from seeing a Plastic surgeon, paying for and having the operation.
Based on your statement, it sounds like you want someone ELSE to pay for this operation ("my PCP is dumb and acts like she can't recommend help for breast reduction"). Implicit is that your PCP does not think your breasts are of a size that would be associated with the symptoms you are having.
Medicare/Medicaid are NOT medical insurance in the true sense of the word but there are THOUSANDS of different insurance policies and HMO's out there. Many specifically EXCLUDE Breast Reduction benefits no matter what your symptoms may be. Others have specific criteria of conservative care that need to be met before they will CONSIDER approving Breast Reduction surgery.
No letter or protests would work if your policy excludes Breast Reduction surgery. But it may be worth paying for a consultation with a Plastic surgeon who takes YOUR SPECIFIC insurance plan to see what criteria there may be and if you meet them.
Breast Reduction for Back Pain
Breast reductions are often indicated to improve chronic back pain, especially when other more conservative measures have failed. It sounds as if you should request a referral to a plastic surgeon from your pain specialist. He/she could then advise you if they think that you would benefit from a reudction.
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.