I want to know if I could be considered for a breast reduction?

I'm 5'3", I weigh 138 lbs. My bra size is a 34dd. No matter what brand of bra, I have bruises on my shoulders and under my breast from the bra. My breast are heavy and hurts my back. Would I be able to have an reduction under my insurance.

Doctor Answers 17

Breast reduction

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From your description it sounds like you would be happy with a reduction. Very satisfying operation for both patient and doctor. The tricky issue is the "covered" part. It's more and more difficult working with insurance companies on this issue. Even when it is covered it's usually only a relatively small percentage of the fee. And option is the Scarless reduction, liposuction only. It is not for everyone. 

Paramus Plastic Surgeon

Breast Reduction Candidate

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Your description fits the average patient who benefits from breast reduction surgery to reduce the size of your breasts as well as give them better support on your chest wall.  Appropriately selected   candidates experience rapid relief of their symptoms and regularly speak about the new life they enjoy.   Insurance coverage is dependent on your exact policy as each policy has a detailed list of requirements to be met prior to your surgery being considered medically necessary.   Go on line and see if you can find your policy's requirements.  Generally the insurer will want to see that you have tried "conservative" therapy which may include physical therapy, documentation of supportive garments or visits to a chiropractor.   Additionally they will want to see notes from a board certified plastic surgeon documenting your symptoms, history and providing pictures. It is best if you bring your documentation to your initial surgical consult as it will speed the process.  

Carlin Vickery, MD (retired)
New York Plastic Surgeon

Would I be considered for breast reduction?

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It sounds as if you have a rather small frame compared to your breast size. Women of all ages can have breast reduction surgery and you are an appropriate age to do so. Most women with larger breasts also experience a host of medical issues related to the size of their breasts. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Fortunately, when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast. Of course this is dependent on your individual insurance company requirements. By reducing the size of the breast tissue, you can eliminate some of the medical complications listed above, reduce sleeping difficulties, increase your likelihood of finding clothing that fits and improve self image. Some of the cons are that breast reduction surgery is still major surgery in which you greatly disturb the breast tissue. Complications can arise from the surgery and anesthesia, there is permanent scaring on the surface of the breasts and sensation and breastfeeding can be affected as well. Overall, it is an individual's choice and should start with a consultation with a Board Certified plastic surgeon. Good Luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Will insurance cover breast revision

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It is possible that your insurance may cover your breast reduction surgery, it will depend on your insurance. Some policies exclude breast reduction while other have many requirements you have to meet, such as; each breast will need a minimum of 500 grams removed not to be considered cosmetic, and that usually equates to a DD cup size. You may need to show what you have tried to alleviate your symptoms such as, physical therapy, special bras, analgesics, etc. Your best bet is to see a Board Certified Plastic Surgeon who specializes in breast surgery, your surgeon will know how to help you request authorization for your surgery. Good luck!

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

Breast reduction

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Thank you for your questions.  Based on your description it sounds that a breast reduction is a likely possibility for you.  To determine if it would be covered by insurance, please contact your provider.

All the best,

Dr. Results
Miami, FL

Candidate for Breast Reduction

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Insurance will consider the amount of breast tissue to be removed based on your height, weight, and body surface area. Any supportive documentation by an orthopedic surgeon or neurosurgeon would be helpful. Good luck!

Randolph Smith, MD
Augusta Plastic Surgeon
5.0 out of 5 stars 3 reviews

Breast reduction

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You sound like an excellent candidate for a breast reduction.  See a local Plastic Surgeon & they will be able to go through the procedure with you & whether insurance would cover it for you.  All the best

Kim Taylor, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 44 reviews

Insurance coverage for breast reduction.

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Not all insurance companies cover breast reduction under any circumstances. The provisions of your policy will determine whether or not be considerable functional benefit you would experience from breast reduction would be covered.

Breast reduction candidate, some advices:

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Thank you very much for sharing your concerns with us.
After having analyzed all the information provided to us, i can realize that you have very large breasts for your height and weight, and can be responsible for head, back, neck and shoulder pain.

In the future may cause permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts). For for this reasons, certainly you need a breast reduction surgery.

Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 369 reviews

Breast Reduction

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Large breasts can restrict your lifestyle and cause a variety of medical problems. Even drastic weight loss won't result in more than negligible shrinkage. Breast reduction surgery removes excess breast tissue and reshapes the contour of the breasts so that they are smaller and perkier. I commonly use a minimal incision technique (Le Jour), eliminating the need for large scars while providing a pleasing breast contour and shape that is proportionate to the patient’s body.

Breast reduction and lift surgery can be performed as an outpatient procedure and your surgeon knows exactly how much tissue he or she is taking out, because it is weighed after removal. And breast reduction comes with an added bonus: the extracted breast tissue is always sent to the lab and examined by a pathologist for signs of cysts or cancer. Having smaller breasts can take years off your appearance!

Sometimes breast reduction surgery is covered through health insurance. The best way to obtain insurance coverage for breast reduction surgery involves some steps. 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.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 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.