I Am 18 Years Old, 5'3 and Weigh 130-135 Pounds and I Am a Size 34 Double D Might I Qualify?

I have been suffering with daily complications due to my large breasts. Headaches constantly, I cannot stay standing without my upper back in between my shoulder blades in excruciating pain. I am not able to wear regular bras or halter swimsuit tops due to how heavy my breasts are, they cause deal red indentions from the straps and it is extremely uncomfortable. My breasts also hurt constantly even without a bra. I live in Texas and have BC/BS I was wondering is a qualify for a reduction

Doctor Answers 6


Every insurance plan has their own unique criteria on whether they will cover a breast reduction.  More and more, we are seeing plans where a breast reduction is not a covered benefit.  If it is a covered benefit, some insurance plans set a minimum required amount of tissue to be remove in order to met their threshold for coverage.  Some set the amount in relation to your BMI (height and weight).  Others require extensive medical records documenting neck pain, back pain, and history of rashes.   The other alternative is to opt for a breast reduction as a self-pay option.   Start by visiting with a board certified plastic surgeon to learn more about your options.
Best wishes,

Dr. Basu
Houston, TX

Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

Younger patients can be good candidates for breast reduction.

From your description it sounds as though you would benefit from a breast reduction. There is a trade-off between the benefits of the operation in the aesthetic consequences namely the incisions. Whether insurance covers it or not will require some investigation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

I Am 18 Years Old, 5'3 and Weigh 130-135 Pounds and I Am a Size 34 Double D Might I Qualify?

Thank you for your question.  By most standards you do qualify for a breast reduction.  However, a couple of things need to be clarified.  First off, cup sizes are arbitrary and vary from one manufacturer to the other.  So please make certain that your symptoms are truly related to excessively large breasts.  Secondly, if your question in terms of qualifying relates to your insurance, the guidelines vary from one policy to the other.  Your plastic surgeon's office needs to contact your insurance company and see what their guidelines are.  Recently they have been requesting a documented 6-month period of "conservative" management (whatever that may be!).  Just make sure you are under the care of an experienced plastic surgeon certified by the American Board of Plastic Surgery.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breasts reduction best solution

yes you should practice  both breasts reduction by traditional way in a couple of  weeks you will be ready to develop any kind  of excersise.

Ramon Navarro, MD
Mexico Plastic Surgeon
5.0 out of 5 stars 2 reviews

Might I Qualify for a Breast Reduction?

You sound like a great candidate for a reduction. You would need to get a consultation from a plastic surgeon and then have his office contact the insurance company to see if you meet their requirements. You can usually expect a dramatic reduction of discomfort with the surgery. Make sure your breast size has not changed in at least 12 months and make sure you understand the possible risks which include loss of nipple sensitivity, inability to breast feed and unpredictable scarring.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast Reduction Candidate and Insurance Coverage?

I am sorry to hear about the problems your  disproportionately large breasts have caused. Based on your description, you may be an excellent candidate for breast reduction surgery.

It is probable that 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 your frame causing  both physical and psychosocial distress.

As you think  about  breast reduction surgery make sure you do your homework and understand the potential risks and complications associated with  the procedure.  Unsatisfactory scarring is  one of the potential complications. Make sure you  also understand that further surgery may be necessary in the future (for example if the breasts were to grow in size again).

On the other hand, breast reduction surgery is one of the most patient pleasing operations we perform and I think that for the right teenager (enough symptoms) it may be an excellent option (regardless of the age).

Sometimes breast  reduction surgery is covered through health insurance. 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.

When the time is right,  seek consultation with well-trained/experienced board-certified plastic surgeon.

I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

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.