5'4", 38D. Should I get a breast reduction? (photo)

Thank you for the question and pictures. Based on the photograph, I think you may be an excellent candidate for breast reduction surgery.  This operation for the appropriately selected patient, tends to be one of the most patient pleasing operations we perform. Reducing/raising your breasts on your chest wall will likely help alleviate neck/back/shoulder discomfort, although it may not necessarily improve discomfort caused by an anatomic problems such as the “spur”.  Of course, whether or not you choose to proceed with breast reduction surgery will be, a very personal decisions, best made after you have considered the pros/cons associated with the breast surgery carefully. You may find the attached link, helpful to you as you learn more. Best wishes.

Breast reductions are covered by insurance
companies if you meet 2 criteria. One,
you must have symptoms such as neck, back or shoulder pain attributed to large
breast. Second, you must meet a weight removal
criteria determined by the insurance company.
At size 38 D each 200 grams of tissue corresponds to 1 cup size
change. If they required 500 grams
removal, you would be smaller than a B and be dissatisfied with the
result. I recommend a new technique
called The Ultimate Breast ReductionTM. This technique reshapes your breast tissue
creating upper pole fullness, elevates them higher on the chest wall and more
medial to increase your cleavage. This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed. Pain is relieved by transferring the weight
of the breast to the underlying muscle, not by excessive reduction.Best Wishes,Gary Horndeski, M.D.

Insurance companies should pay for breast reduction based on symptoms of breast heaviness, breast pain, shoulder and neck pain, bra strap grooving. There is no arbitrary amount of breast tissue to be removed to achieve these results, and some women may not lose a lot of weight in their breasts if they are mostly glandular with less fat.  The picture shown would be an indication for a breast reduction if you felt symptoms mentioned above or if you just wanted smaller breasts.  However, getting insurance to pay is difficult because they sometimes make you jump through hoops to postpone or avoiding paying for the surgery. In my practice, I write a letter with photos to the insurance company, indicating the medical reasons why the procedure is indicated.  It can be helpful if you have some documentation from your regular doctor that you have been complaining about symptoms for some time, and that you did try to lose weight or lost weight with no improvement with you symptoms.Some insurance companies will then authorize the procedure, but some simply will not, and it seems arbitrary, based on current ASPS guidelines for breast reduction. Google   asps breast reduction insurance coverageand you will find a PDF position paper on this issue as well as sample appeal letters.