I am 55 years old; I've always had back discomfort from large and uneven breasts?

48ddd?e?, I've lost 60 lbs and just want them to look more normal in clothing. Is this usually covered by highmark? My camera is in the fritz but should be able to send some tomorrow. Laura

Doctor Answers 4

Insurance and breast reduction

You should check with your insurance company to determine if you quality under their criteria. THen you should see a plastic surgeon for evalaution.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

I am 55 years old; I've always had back discomfort from large and uneven breasts?

Congratulations on your significant weight loss. Based on your  description of symptoms and of breast size, it sounds like you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform. 

“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.

Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons.

Given that every insurance company is different, it will be best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, 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.  

I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Breast reduction

Hello and thank you for your question. Congratulations on the weight loss. That's not easy. 

Many women experience pain and discomfort with large heavy breasts. Some will often resort to using multiple bras,  Motrin,  pain medication and attempts at chiropractor or physical therapy. To date, there is no medical or scientific study proving that non-surgical options are of any value in treating this. 

The only treatment that is successful is surgery. All reductions are also lifts. Insurance coverage varies from plan to plan. I would start with calling your insurance carrier. They will be able to give you the basic coverage requirements. It can be difficult to get insurance companies to cover the procedure, however, if you read the details of your plan and follow through step by step it is manageable. 

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions.

As always it is best to be healthy, no smoking, and to make sure any health concerns you have are managed by your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Large and uneven breast?

It sure sounds like your breasts are large enough to be considered for insurance coverage but you would need an exam and more.  Your bra size does not tell all.  Most bra companies size patients larger than they actually are.  As far as back discomfort etc..this will need to be evaluated by your primary care first.  You need to start what I call the "insurance paper trail".  This might include X-rays, visits to back specialists and orthopedic doctors to rule out problems with your back etc.  Then submit paperwork to your insurance company for pre-certifications etc.  This whole process can take a couple of months, but you need to start it.  Hope this helps.  Good luck.

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 86 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.