Do insurance companies typically cover a second breast reduction? I was 17 when I had my first, I am 27 now (Photo)

Question

I had a breast reduction at the age of 17, I am 27 now. After my pregnancy my breast size increased drastically. Do insurances typically cover a second breast reduction? We have Tricare. I get routine injections in my lower back to help pain caused by Endometriosis but I am starting to wonder if my large breasts are contributing to my back pain as well. They are incredibly large for my 5'2 frame. What kind of documentation needs done in order to have the surgery approved for a second time?

Hampton A. Howell, MD · Answer

Hi.  It really depends on your current symptoms and your particular policy.  I would get the appropriate documentation from your primary medical provider and then see your plastic surgeon who can submit a letter to your insurance carrier to see if that would be a covered benefit.Good luck and take care,Dr. Howell

Jennifer Greer, MD · Answer

Thank you for your question! The insurance criteria for covering a secondary breast reduction are actually exactly the same as having them cover the intial procedure. You need to have documented symptoms due to large breasts (e.g. back, neck and shoulder pain) that aren't responding to medical therapy (e.g. physical therapy, pain medications, wearing a sports bra), and the surgeon needs to be able to remove the required amount of tissue- usually somewhere in the 500g range. I would recommend seeing a board-certified Plastic Surgeon in your area if you are interested in pursuing this.

Sheila S. Nazarian, MD · Answer

You will need to call your insurance company and ask them whether or not a second reduction would be covered and if so, what are the criteria. Then, schedule a consultation with a board certified plastic surgeon in your area (link below) to discuss. Best, Dr. Nazarian

Vincent N. Zubowicz, MD · Answer

If you have the coverage criteria for a second breast reduction meaning symptoms as well as anticipated weight of reduction then insurance will probably cover the procedure.

Edwin C. Pound, III, MD · Answer

As long as you meet the criteria for a breast reduction as put forth by your insurance company, it doesn't matter whether this is the first, second, or fifth time you are having a breast reduction.  I would suggest that you visit a board-certified plastic surgeon who can examine you and discuss your options with you.

Do insurance companies typically cover a second breast reduction? I was 17 when I had my first, I am 27 now (Photo)

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Answer: Insurance coverage and secondary breast reduction.

Answer: Insurance coverage and secondary breast reduction.

Answer: Second breast reduction

Answer: Second breast reduction

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Do insurance companies typically cover a second breast reduction? I was 17 when I had my first, I am 27 now (Photo)

Answers (10)

Answer: Insurance coverage and secondary breast reduction.

Answer: Insurance coverage and secondary breast reduction.

Answer: Second breast reduction

Answer: Second breast reduction

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Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.