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Am I Eligible for a Breast Reduction?

asked 1 year ago by Kaley22121 in Wisconsin
Latest answer by Tom J. Pousti, MD
Question viewed 667 times
Tags: age 17 or under, 110-129 lbs, 5 ft 0 in to 5 ft 3 in, back pain, insurance

I am 17, 5'2, 120lbs, and 34D. Am i eligible for a reduction? And can i get it covered by insurance? My back and neck are always sore not to mention headaches all the time. I wear baggy cloths a lot to try and cover the size of my breasts and swim suit shopping always ends in tears because of them. All i want is to be physically and emotionally happy, but its hard with my unproportioned body. Insurance is the only way possible for the surgery to happen if eligible.

14 answers to Am I Eligible for a Breast Reduction?

Breast Reduction for Teenager

It sounds like you are dealing with juvenile breast hypertrophy along with the physical and psychosocial consequences of this diagnosis. In other words, the breasts are too large for the frame causing both physical and psychological distress. It sounds like you have done your homework and understand the potential risk and consultations associated with breast reduction surgery. You also understand that further surgery may be necessary in the future (for example if the breasts were... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Insurance and Breast Reduction

First find out if your insurance has an exclusion for breast reduction, unfortunately many do these days. Most that do cover the procedure require a minimum of 500 grams to be removed from each breast. In most cases that would be a DD. However you are small in relation to your breasts, so as long as you have parental approval, you need to have a consultation with a Board Certified Plastic Surgeon who can help you seek pre authorization for your surgery. If you get turned down,... more

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Breast Reduction and Insurance Coverage

Hi Kaley22121, Each insurance company is different and, not surprisingly, it is become harder and harder to get insurance companies to pay for this procedure. In general, though, they will cover the procedure if you can show that removing the indicated amount of tissue (more on that below) will be likely to alleviate certain specific symptoms. First, then, you have to have those symptoms. Typically they would include neck, back and shoulder pain, bra strap grooving and/or intertrigo... more

Alan Engler, MD
New York Plastic Surgeon

Questions regarding a breast reduction in a 17 year old

You have several very good questions and concerns that need to be sorted out. First of all, being a minor at 17 you would need permission from your parent(s)/guardian to proceed with surgery. You can be made smaller via a breast reduction. Whether it is "necessary" or will improve your appearance and self esteem is unclear. You must also consider the scars that would eventuate from the surgery and whether or not the trade off would be worth it. Insurance coverage varies... more

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Breast Reduction

Because you are a minor, discuss your concerns with your parents. A consultation with a Board Certified Plastic Surgeon would be the first step in determining if you are a candidate for this procedure. A letter from your Primary Care Physician will also be beneficial in obtaining approval. Insurance companies will also ask about conservative therapies such as losing weight (which you do not need to do), trying a wide strapped bra, etc. Your parents should also... more

Christine Sullivan, MD
Columbus Plastic Surgeon

Will insurance cover my breast reduction?

Kaley, you ask an excellent question. I perform several breast reductions a month and have become quite dismayed at how insurance companies completely control the process. The truth is that each insurance company has different criteria and some plas have exclusions. Without consulting with a plastic surgeon and submitting to insurance for pre-determination, you may never know. Good luck

Vishnu Rumalla, MD
Dallas Plastic Surgeon

Breast reduction may be covered by insurance.

This is a reasonable request. The minimum age for surgery without a parent or guardian is 18. Unless you are an emancipated minor. You can get a letter of predetermination from your insurance company to see if the procedure may be covered. In some cases and depending on the insurance company, they will cover it because it is causing you physical pain and distress. see video

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Eligible for breast reduction?

From what you describe, you may benefit from a breast reduction and it may be covered by insurance. The next step would be to see a Bard Certified plastic surgeon for a consultation.

Karol A. Gutowski, MD
Chicago Plastic Surgeon

Breast Reduction Surgery Requires Predetermination Letter For Potential Insurance Coverage

Insurance coverage for breast reduction requires a predetermination letter to be sent by your plastic surgeon with specific qualifying information. Your height, weight, breast cup size, history of medical symptoms associated with your large breasts, what non-surgical treatments have been attempted, and how much breast tissue in grams is to be removed is the needed information. This letter, complete with photographs of your breasts, will be submitted for their review. They will then... more

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

Breast Reduction in Teen

It sounds as if you would be a good candidate for a breast for a breast reduction with your breast size and symptoms. Although there i a good bit of variation among insurers and some policies have an outright exclusion for reductions, your reduction would likely be covered if you are willing to go to a B/C cup range. Discuss this with your parents and your physician.

John Whitt, MD
Louisville Plastic Surgeon

Eligibility for Insurance Covered Breast Reduction Depends on YOUR Individual Policy

Breast Reduction Surgery can be a true miracle surgery for women whose large breasts cause neck, shoulder and chest pain as well as impair normal activities. However, your insurance company will NOT pay for such surgery if you did not have it as a covered benefit. In other words, since you did not pay for such coverage in your insurance premiums they will not pay for it EVEN though you could benefit from it. In cases in which you DO have such benefits, some plans are better than others... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Medical necessity for breast reduction surgery.

Breast reduction surgery is an excellent means of eliminating symptoms caused by large breasts. Insurance carriers across the United States have different criteria for coverage. Most require a trial at conservative intervention(i.e. physical therapy or chiropractic care) to control the symptoms prior to considering surgical coverage. They require that a minimum amount of tissue is removed, sometimes leaving the patient smaller than desired. The tissue is actually... more

Beverly Friedlander, MD
Short Hills Plastic Surgeon

Insurance breast reduction

You will need to be examined by a plastic surgeon with your parents blessing and agreement. The insurance can then be explored. You might be on the low side for coverage though.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast reduction

If you want a breast reduction you have to check with your insurance company what their criteria are for approval. You will also need to go for a consultation ith your parent's approval.