Ehlers-Danlos Syndrome and Scheuermann's Kyphosis Patient Curious About Breast Reduction to Help Relieve Back Pain? (photo)

Question

I'm 47 years old with EDS type 3, Scheuermann's Kyphosis and profound back pain. I have a 75 degree kyphotic curve with the apex at T6-7. I recently lost 55 lbs (BMI=29 now) after gastric bypass. My breasts have always sagged profoundly, even as a teen. Current bra size is 38DDD and my breasts feel like they pull my whole chest down worsening the kyphosis. Do I have tuberous breast deformity? Would breast reconstruction/reduction help my back pain? Would insurance cover this procedure?

Kenneth Hughes, MD · Answer

Assuming medical fitness is perfect at 47, I would want to know about healing issues after previous trauma and surgeries. There are a lot of skin incisions made that need to heal after breast reduction. Although the breast reduction will likely benefit you from a pain perspective, it would be unfortunate to perform the surgery and have wound healing problems afterward with the EDS. Insurance may cover the cost as well.

Dhaval M. Patel, MD · Answer

Thank you for your question! You would have to prove that its medically necessary in order for your insurance to cover it.  I suggest you go see a board certified plastic surgeon and discuss your desired results with him.  Best of luck!Dr Dhaval PatelDouble Board CertifiedPlastic SurgeonChicagoHoffman EstatesOak Brook

Jourdan Gottlieb, MD · Answer

Thanks for your question and for the photo. Ehlers_Danlos  syndrome is a collection of 10 known variants (probably more to come), some of which are more severe that others.  Difficulties with wound healing are commonly quoted, and that does change the risk to benefit equation when decided about surgery.

	I cannot tell quite enough about breast size without a side view, but I did do some calculations based on your BMI, and the tables we use to determine how much tissue must be resected by insurers in my area, and it looks like about 650 grams. I fear that that would be about the weight  of your entire breast, and that the insurer would consider an appropriate operation to be a breast lift and therefore cosmetic in nature. Insurance stuff aside, the  lower the volume of tissue removed, the less likely will be the improvement in  back pain. 

	Better than our guesses based on incomplete info is an in person consultation with a plastic surgeon. When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Ehlers-Danlos Syndrome and Scheuermann's Kyphosis Patient Curious About Breast Reduction to Help Relieve Back Pain? (photo)

Answers (3)

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