Would I be a likely client for a Breast Reduction?

Question

I have problems with chest pain underneath my breasts, arm pain, and back pain. Would I breast reduction improve my symptoms and appearance. Are my breast large or too large for my height and weight, or are my measurement within normal range or limits? Would I benefit from a Breast Reduction?

Donovan Rosas, MD · Answer

Candidates for breast reduction will typically have documented evidence of neck/back and shoulder pain as well as rashes and bra strap grooving attributable to the increased breast weight. They will often demonstrate that these symptoms have been resistant to more conservative measures like therapy, weight loss and pharmacologic intervention. This is needed for insurance coverage.
In addition to establishing a case for medical necessity, there are also requirements for resection weight (when covered by insurance). This may be a standard "500 gm per side" stipulation or a more variable standard based upon body surface area/Schnur scale. It is important to realize that these weight requirements can occasionally exceed your goals for size reduction. Insurance coverage is contingent on these requirements being met, thus cosmetic concerns become secondary(i.e. cup size goals).
Optimal candidates have reached a healthy stable weight (preferably with a BMI < 30). The best time to consider surgery is when you have reached your goal weight and stabilized for a 6 month period.Based on your narrative, you would likely benefit from a reduction. There is no normal or abnormal size per se. Symptomatic breasts are more important than a particular cup size.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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Gary M. Horndeski, MD · Answer

At 5’7 and 220 lbs, your BMI is 34.4.  Generally we like to have patients with a BMI of 30-32.  However, it is possible you could undergo a breast reduction.  The technique I recommend is The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear B4376,
it is hard to tell for sure without an examination. Based on your description, it sound like you might benefit from breast liposuction. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered by medical insurance.  If not, your medical insurance may try to deny you based upon a lot of things such as weight, lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. 
Read your medical insurance certificate of coverage. Determine what medical information is required for your medical insurance company to issue a pre-authorization or predetermination of benefits for BR surgery.  Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, determine the amount of tissue to be removed, and help you in completing the paperwork required by your medical insurance company.  (Take all documentation you have accumulated to your board certified PS's consultation appointment.)

Miguel Delgado, MD · Answer

You appear to be in need of a breast reduction which will help alleviate some of your issues. However you should probably lose some weight first. If you are looking to get insurance to cover your surgery, they may require it. Consult with a board certified plastic surgeon to learn what options are available to you. Good luck.

Joseph Franklin, MD · Answer

Judging from the photos, you appear to be a good candidate for bilateral breast reduction.  Attached are the guidelines for breast surgery from BCBS.  Pages 5 and 6 specifically refer to reduction mammaplasty coverage.

Robert L. Kraft, MD, FACS · Answer

You are a surgical candidate; the question is whether you will meet insurance criteria, particularly BMI standards. As Dr Hughes has articulated the full panoply of insurance delay/deny tactics, I will not repeat them. Surgery is always available on a fee for service basis but, if you want to go the insurance route, verify the criteria first. Best wishes.

Scott C. Lindsay, DO · Answer

Thanks for your question! Based on the photos and information you provided, I think you would definitely benefit from that procedure. However, I do agree with my colleague below that you should lose a bit of weight to ensure coverage. Also, it's best to be at your target weight prior to any surgery. Good luck!

Would I be a likely client for a Breast Reduction?

Answers (8)

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