Do you think Kaiser Permanent will cover the cost of my breast reduction surgery? (photos)

Question

I am 18 years old 5'3, 109 lbs. I danced ballet very seriously until I was 14 years old. I was also a runner in high school and it was during this time that my breasts became the size they are now. Exercise and dieting doesn't and will not help mitigate the size. I have also suffered from terrible back pain for the last 4ish years and I have tried everything except actually visiting a chiropractor, my parent's wouldn't let me. I would love to get some advice.

Ronald J. Edelson, MD · Answer

I know that Kaiser does a lot of breast reductions but don’t know if they would cover yours. Ask to get a referral to a plastic surgeon. The plastic surgeon can tell you more definitively. I think it deserves to be covered, but Kaiser doesn’t care what I think.

Kenneth Hughes, MD · Answer

BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered, but there are other criteria such as amount of breast tissue removed.
Read your Kaiser Permanent certificate of coverage. Determine what medical information is required for your medical provider to issue a pre-authorization or predetermination of benefits for BR surgery. Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, determine the amount of tissue to be removed, and help you in completing the paperwork required by your medical insurance company

Gary M. Horndeski, MD · Answer

Your breasts are very low on the chest wall and the nipples are pointing downward.  The technique I recommend is The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  This technique is not covered by insurance.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Sociable372248,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and the only way to find out is to be referred to a plastic surgeon at Kaiser after seeing your primary and see if you qualify

Dr Corbin

Do you think Kaiser Permanent will cover the cost of my breast reduction surgery? (photos)

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Do you think Kaiser Permanent will cover the cost of my breast reduction surgery? (photos)

Answers (5)

Answer: Breast reduction

Answer: Breast reduction

Answer: Reduction

Answer: Reduction

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Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.