I'm 5'3 and I wear a size 38D but interested in getting a Breast Reduction. Do you think insurance will cover me? (photos)

Your breasts are extremely ptotic but not that
large.Insurance will not cover your
reduction and you need a lift more than reduction.I recommend a new technique called The
Horndeski Method™.The breast tissue is
reshaped creating upper pole fullness, elevated higher on the chest wall and
more medial to increase your cleavage.The areolas can be reduced to the size proportionate for your
breasts.Your breasts can be reduced to
the size you desire.This technique
avoids the ugly vertical scars of the traditional technique, maintains nipple
sensation and the ability to breast feed.I do not recommend the anchor incision that was developed in 1956 and is
obsolete.Best Wishes,Gary Horndeski, M.D.

 Covers for breast reduction varies from policy to policy. Anytime it is covered the insurance company will want to know what functional advantage will come from the operation. There are other components such as the anticipated amount of tissue removal that goes into the formula for determining coverage.

Thanks for your question and photos.  From your photograph you appear to have large breasts that are very long and pendulous.  An in-person exam would be necessary, but if you have the typical complaints of pain (shoulder, back, and neck) you would likely be a very good candidate for a breast reduction.  With regards to insurance coverage, this will vary widely between different insurance companies.  Typically I will dictate a letter describing the symptoms and include photographs to demonstrate the problem.  There are formulas that some companies use to determine how much breast tissue mush be removed.   Please seek out a board certified plastic surgeon for a consultation to help determine if you meet criteria.  Out of pocket price will vary depending on where you live, but in Fort Worth I would estimate a total cost in the range of $6,000-8000.  Good lucik.  

Dear Goddess,Insurance coverage for breast reduction varies with the plan and policy that you carry.  Consultation with an American Board of Plastic Surgery board certified plastic surgeon can start the process going for you.  You may want to contact your insurance carrier directly first to see if the surgery is covered under your plan and what requirements they have if any.  Good luck!

Hi.  Thanks for your question.  Many patients wonder if their breast reduction can be covered by insurance.  The short answer is that it really depends on your insurance policy.  Some policies require clinical documentation of your symptoms for certain time period and may dictate how much breast tissue to be removed.  Some other policies may not cover breast reduction at all.  It would be best if you contact your insurance company and see whether 1) breast reduction is a covered procedure and 2) the criteria for the procedure to be covered by insurance.  Good luck!  - Dr. Kim

The best answer is call your insurance first and see if it is a covered option. If so, find a Board Certified Plastic Surgeon who does reductions. He / she will help you understand your breasts and discuss your options with you.Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Best to see a few boarded PSs in Texas and to call your health insurance to see if you are covered. If not than expect fee range from $5,000 to $10,000...

Thank you for the question and pictures.  If you feel that your breasts are disproportionately large for your torso, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform. Unfortunately, online consultants will not be very helpful when it comes to predicting whether a specific person's insurance company will provide coverage for the procedure. Ultimately, in person consultation with board-certified plastic surgeons will be your first/best step. Make sure that he/she can show you lots of examples of outcomes you would be pleased with.  It may also be helpful to talk to previous patients as well. Then, it will be important for you to communicate your goals carefully.  In my practice, I find the use of visual aids (goal photos and/or computer imaging), as opposed to the use of terms such as “the cup” or “natural”, most helpful.   I hope this, and the attached link, helps. Best wishes.