I am 23, 5 foot 3, weigh 140lbs, and my bra size is 34G. Am I a good candidate for breast reduction? (Photos)

Question

I'm 23, 5 foot 3, 140lbs, and my bra size is 34G, I have constant neck and back pain, and headaches. I have also had a child she’ll be 2 in September. I do plan on having other kids. I have Tricare, through my husband and through the va. My breast have always been on the bigger side but ever since I had a baby 2 years ago my breast went from a 32D to a 34G and I didn’t breast feed. I also now have arthritis is my lower back. Do you think I’ll pass on tri care standards or is it a waste of time.

Miguel Delgado, MD · Answer

From your description it sounds like you are a good candidate for breast reduction surgery. You should have documentation of what you have tried to alleviate your symptoms, such as; special bras, physical therapy, analgesics, etc. get a referral to a board certified plastic surgeon that accepts your insurance. Good luck.

Robert Cohen, MD · Answer

You need a formal evaluation by a licensed plastic surgeon and expert in breast reductions to determine what is best for you and your goals.Breast reduction is one of my favorite surgeries as it allows me to dramatically improve a woman’s breast appearance as well as alleviate many physical symptoms of large breasts, such as back, neck and shoulder pain, bra strap grooving, and rashes under the breasts. When I perform breast reduction surgery, I generally use a superomedial pedicle to provide blood supply to the nipple while maintaining fullness in the upper and inner breast. Excess lower and outer breast tissue are removed. Breasts are often asymmetrical, so I remove more tissue from the larger breast. The final scar pattern is a circle around the areola, down the breast, and possibly under the breast, depending on the degree of skin excess.
For me, breast reduction is not a one-size-fits-all surgery. The size and shape of the breasts are customized to each patient depending on her goals and desires. Some women want a significant amount of tissue removed while others prefer to have a more limited reduction. Regardless of the amount of tissue removal, I perform the maximum safe amount of lifting and tightening for each patient.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Reductions. - Dr. Cohen

William Bruno, MD · Answer

You appear to be a good candidate for a breast reduction. Whether it will be covered by your insurance is unknown until you see a plastic surgeon and have your case submitted for approval. Most insurance companies require about 500gms of tissue to be removed per side. This can likely be accomplished through a vertical pattern breast reduction.  A consultation in person would confirm this and give you a more detailed recommendation. I feel you would have a very nice outcome and relief of you neck and back pain.Best wishes,Dr.Bruno

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 most medical insurance providers.  If not, they may try to deny you based upon a lot of things such as lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. The insurance companies will dictate the amount of tissue to be removed, not the PS.  
Read your TRICARE medical insurance certificate of coverage. Determine what medical information is required for TRICARE to issue a pre-authorization or predetermination of benefits for the BR and then work with a board certified PS who accepts TRICARE.
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Zoran Potparic, MD · Answer

Based on your photos and history you seem an appropriate candidate for breast reduction. We do this procedure in large breasts like yours using combination of liposuction followed with reduction of skin and breast tissue as needed. This significantly decreases blood loss and improves blood and nerve supply. You would need a referral from your PCP to a plastic surgeon who accepts your insurance. Good luck.

Jonathan Amspacher, MD · Answer

Luckily Tri Care is one of the best policies for getting coverage for a breast reduction.  You will need a referral to a plastic surgeon that accepts tricare and then a letter from them to tricare to obtain approval for the surgery.  I have found that they are easier to work with on breast reduction than many other insurance companies.  Best of luck on your journey.

Daniel Barrett, MD · Answer

Dear Polite9,
based on your photos and description, it looks like you might be a good candidate for a breast reduction surgery. Breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.
If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. 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

Donovan Rosas, MD · Answer

Candidates for 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.
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).
Based on your photos and narrative, you would seem to be a reasonable candidate. I am not familiar with the specific requirements of Tri Care (however, I would guess they fall within the spectrum of most providers). As long as you are large and have demonstrated medical necessity you have a reasonable case for coverage.
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
RealSelf Top 100
RealSelf Hall of Fame

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.
I suggest scheduling a consultation with a board certified plastic surgeon to discuss your options. At this appointment insurance benefits can be checked. Best wishes!

Matthew A. DelMauro, MD, FACS · Answer

Hello! Thank you for your question. Based on your photos, breast reduction surgery may be a good option to improve the shape, contour, and perkiness of your breasts. The surgery can be designed to minimize scar appearance. It may also help improve your neck and back pain. 
Breast reductions which
are medically necessary (e.g., if you have rashes under your breasts or if you suffer
from back, shoulder, and neck pain) are typically covered by most
medical insurance providers. Occasionally medical insurance providers
may try to deny you based upon a lack of symptoms, lack of previous
medical management, and/or lack of enough tissue to 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 the breast reduction surgery. Then, gather that information,
and schedule a consult with a plastic surgeon.
Keep in
mind that if you decide to pursue surgery it’s very important that you find a
surgeon whom you are comfortable with and trust and who evaluates you
in-person, addresses your concerns, and tailors an individualized treatment
plan for you and your aesthetic goals. Best of luck!
Matthew
A. DelMauro, M.D.

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