Breast Reduction 15 Going on 16?

I'm 5' 4" 140lbs and a 34F/G size bust. I went for a consultation about a month ago and we sent an application to insurance and they turned it down. My mom is going to appeal the decision, I'm in serious pain I'm done growing my back neck and shoulders are in so much pain I don't want to go to school I can't wear certain clothing, I was just wondering what else I could do to make them approve it I don't know how much longer I can deal with this pain, I'm. 15 now I will be 16 in February

Doctor Answers 6

Breast reduction - 15 going on 16?

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Thank you for your question!  I hope that these answers help in making your decision.  You suffer from juvenile hypertrophy of the breasts, which is typically treated by breast reduction.  It is not uncommon to have the symptoms that you describe such as neck/back/shoulder pain as well as infections/rashes and shoulder grooving, especially in teenagers once her breasts begin to fully develop.  The decision of whether to proceed as well as the timing will ultimately be yours.

Once one begins to have the symptoms that you state above, consideration for a surgical procedure to ameliorate your symptoms, assist with self esteem, and allow you to get back to physical activities in your youth should be done.  Given your symptoms,  you would be an ideal candidate.  You must first discuss with your parents and pediatrician, and then consulting with a plastic surgeon for evaluation and examination to assist you in deciding if this would be the right thing for you.  Your surgeon will also go over what to expect as well as the risks and benefits of the procedure.  Overall, your symptoms should be ameliorated almost immediately and hopefully give you more self confidence and an increased activity level.  Your breasts may still continue to grow over the next several years, but it is certainly reasonable to consider this at this age with the issues that you are having.  I hope that this helps!  Good luck with your decision!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast Reduction 15 Going on 16?

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Your situation is totally understandable and unfortunately insurance companies are extremely unsympathetic and lack understanding when it comes to cases such as yours.  I don't know if you have had an orthopedist or chiropractor send you insurance company a report stating that you need the breast reduction in order to be relieved of your back and neck pain.  If you have not, please do so.  In addition, they would probably want to see reports and photos regarding the treatment of intertrigo and infection under your breasts which you probably have had.  Each insurance company has different guidelines, which you can obtain and follow their recommendations in order to obtain approval.  Hope this helps.

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

Teenage breast reduction is now more popular

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In the right individual teenage breast reduction can be life changing.  It sounds as if you do have juvenile breast hypertrophy and would benefit from the procedure.  Unfortunately, you and I have no control over health insurance plans and what they cover and what they don't cover.

It sounds like you are miserable and I would recommend you check into some type of financing or a loan to pay for the procedure, even if your insurance turns you down.  People obtain loans for plastic surgery all the time, in the long run for you it should be worth it!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

Appealing Insurance Decision for Breast Reduction

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You need to have your surgeon appeal the denial of your request for breast reduction surgery, not your Mom, but it is  good that she supports you! The insurance company will then have a medical doctor call your surgeon and they will discuss your case. I have gotten approval for many patients this way, good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Teen breast reduction

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The need for breast reduction is not dependent on age. You do need to be fairly certain that your breast size is stable for several months before you undergo a reduction. 

Insurance companies have their rules and the "fight" is with them regarding coverage.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

Breast Reduction 15 Going on 16?

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I'm sorry to hear about the physical and psychosocial problems your disproportionately large breasts are causing you. 
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 psychological distress.

In my practice, timing of breast reduction surgery is determined on a case-by-case basis. It is not too early to do your homework and learn as much as possible  about  breast reduction surgery and the potential risks and complications associated with  the procedure.  I am glad that you have your mother's support as you do your homework.

As you learn about breast reduction surgery, make sure you read about the potential risk/complications associated with the procedure. You may find the attached link helpful in this regard.  For example, 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 surgeons.

I hope this helps.

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.