Can I Go from a 34DD to 34C and Still Meet 500gram Insurance Requirement

I am a healthy 32 year old with a height of 4'10'' and a weight of 95lbs (I am very petite). I would like to have a breast reduction due to the stress on my small frame. Is it possible to reduce my breast size from a full 34DD to a 34C and meet the insurance requirement of 500grams per breast? Or would the 500gram requirement cause me to drop to a B?

Doctor Answers 8

Insurance Coverage

Every insurance plan has their own unique criteria on whether they will cover a breast reduction. More and more, we are seeing plans where a breast reduction is not a covered benefit. If it is a covered benefit, some insurance plans set a minimum required amount of tissue to be remove in order to met their threshold for coverage. Some set the amount in relation to your BMI (height and weight). Others require extensive medical records documenting neck pain, back pain, and history of rashes. The other alternative is to opt for a breast reduction as a self-pay option. Start by visiting with a board certified plastic surgeon to learn more about your options.
Best wishes,

Dr. Basu
Houston, TX

Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

500 gms in a 95 lbs woman

This is an excellent question and one that shows the problems of insurance requirements and a third party having control over breast reduction choices as well as using grams removed as the measured factor -- something similar to using cc's of an implant to figure results from an augmentation. 

There is no way to know or accurately measure the weight of the tissue to be removed before the procedure. 500 grams to a 95 lb woman is completely different proportionally than to a woman who is taller, bigger, and weighs 150 lbs for example. Thus the "weight removed" requirement discriminates against shorter, smaller women. Another way to look at it is that the surgeon can't go into the surgery and keep cutting out breast tissue until he or she reaches 500 grams and the patient will just have to accept whatever breast size is left. The goal is to solve the problem and achieve the breast size, position, and shape the patient is comfortable with, not remove an arbitrary weight of breast tissue. The best way to get around this is for the patient to decide on the result of the surgery as long as it's feasible and medically sound regardless of the weight of tissue removed but this means she will have to avoid the insurance or government control and bear the cost herself. 

By way of comparison, this is similar to choosing the size of a breast implant in cc's and forcing it to work for breast augmentation. The proper way is to measure the patient, choose an implant that fits, know what effect it will have in terms of size increase, and then find out the number of cc's. It doesn't make good sense to start from the number of grams or cc's and work backwards. 


Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Breast reduction and insurance requiremens

An exam would be necessary to answer your question. Bra sizes vary and a 32C is basically equivalent to a 34B. You should discuss your expectations with a board certified plastic surgeon. I have seen few companies which permit 350 gram reductions at this time and many have additional requirements. If you are truly seeking a reduction because of back pain, then at your height and weight, a slightly larger resection may be in your best interests in terms of alleviating your symptoms.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

DD to C with insurance coverage in petite woman

It would be difficult to say without examining you to see your relative size and how dense/heavy your breasts feel.    Different insurance companies have different requirements and you do not want to be in a situation where the surgeon must take too much just to meet the insurance criteria.  I would get the opinion of a board certified plastic surgeon who does a lot of breast reduction procedures and is familiar with working with your insurance company.  From your height/weight and bra size, It would be likely that 500 grams would make you smaller than you would like.

Marialyn Sardo, MD
La Jolla Plastic Surgeon
4.0 out of 5 stars 6 reviews

Breast reduction insurance requirements

The amount of weight that needs to be removed per cup varies by chest wall measurements as well as the density of the breast.  Based upon my personal experience, I would expect a 500gm reduction  would be more likely to result in a B cup breast.  When you mention the insurance requirement of 500gm, you should be advised that insurance company rules do vary - for example, for someone your height and weight, Aetna would require an approximately 300gm reduction (please note, this is not meant to endorse any specific insurance carrier, and they each have their own additional requirements).

I recommend that you consult with a board-certfied plastic surgeon experienced in breast reduction.  After performing a physical exam, the surgeon should be able to give you a better idea where you may end up after surgery (keeping in mind that bra sizes are not standardized across manufacturers).

Good luck.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast reduction

Without an exam it is difficult to say whether or not a 500 gm reduction can be performed to keep you at the volume you want.  Some breasts that are very dense are heavier and it is easier to achieve that goal.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Reduction and Insurance Requirements?

Thank you for the question.

Based on the description of your body type and breast size I think you may be an excellent candidate for breast reduction surgery;  It certainly sounds like your breasts are out of proportion  to  the remainder of your torso. For patients like yourself, breast reduction is one of the most patient pleasing operations we perform.

Unfortunately, there is no direct correlation between the amount of tissue removed and the ultimate cup size that a patient will wear after breast reduction surgery.

Before undergoing the breast reduction procedure it will very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.‚Ä®Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

After you review your goal pictures with your plastic surgeon he/she will be in a better position to predict as much as possible whether the insurance weight requirement will leave you with the results you wish to achieve.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Too small to meet insurance requirements

If you wear a size 34 bra then each 100 cc's is 1 cup size change.  To go down 500 cc's, you will be about a size B.  However, you described that the purpose of the breast reduction is to reduce the stress on your small frame.  You are a candidate for a new procedure that transfers weight to the underlying pectoral major muscle to relieve neck, back and shoulder pain.  From what you have described you will NOT meet insurance requirements and you will end up paying for it yourself.  If that is the situation, you would be better off getting what you want then getting too small of breasts just to meet the insurance criteria.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 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.