Do I meet the requirements to get a breast reduction? 19 years old, 5'0", 36 DDD, 165 lbs

Hi, thank you for your question. If you are experiencing neck/back pain with shoulder bra-strap grooving, you will likely qualify for a breast reduction. Insurance companies have various criteria that need to be met prior to approval. An in-person examination with a board certified plastic surgeon will help you know for certain if you are a candidate and what options are available to you. I hope this helps. Best of luck!

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.
Insurance coverage is contingent on the meeting the requirements (which will vary) for establishing a case for medical necessity.
Based on your narrative, you would seem to be a reasonable candidate for reduction. I would recommend reaching a stable weight before proceeding.
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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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 provider 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 provider 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 provider.

Thanks for your question! It really depends on your insurance company and their requirements. I would start by reaching out to them and seeing what they say. Then, they may be able to refer you to someone in network that can help you. Good luck!

There is evidence that complications of breast reduction are more common in women who weigh more trhan 80kg.  Your recent weight loss has brought you into this group.  It is important that you achieve a weight that you will maintain.  Some women lose weight after surgery and then the beneficial effects on breast shape may be lost - so lose any weight you are going to first.

For my patients, we recommend that they are at a stable and reasonable weight prior to breast reduction. But sometimes, patients lose weight but their breasts don't go down in size. This happens because women have different proportions of breast tissue and fat in their breasts. So if breasts don't go down with weight loss then there might be a lot of dense breast tissue. If they have the other symptoms of neck pain, back pain, bra strap grooving and meet the insurance requirements for gram removal then sometimes insurance will pay for it. It is best to meet with a board certified plastic surgeon for an evaluation. 

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.

Dear Fierce129573, 
Thank you for your question. Congratulations on your recent weight loss. At my practice, I do not operate on patients with a BMI of 30 or greater due to safety risks. At 5,0" and 165 pounds your BMI is currently about 32 so I would recommend a bit more weight loss before proceeding. Then I would suggest scheduling a consultation with a Board Certified Operating Surgeon so he or she can assess you in person. Best of luck to you!

Hi and thank you very much for your question. I believe you may be a great candidate for a breast reduction especially if you are experiencing back/ neck pain and having difficulty performing activity due to the size of the breasts. Insurance companies have certain criteria which they require if the surgery is to be approved therefore I recommend an in-person evaluation with a Board Certified Plastic Surgeon to discuss options and the best treatment plan for you. I hope this helped. Best wishes!

It sounds like you are a good candidate for a breast reduction but impossible to know without photos. It is worth seeing a plastic surgeon and seeing if insurance would cover the procedure.