42H. Can large, beautiful, but hanging breasts remain beautiful after reduction? Does reduction automatically lift the breast?

Question

Back, neck, and shoulder pain plaques me. 50+ years old and desire smaller breast than 42H. Will HMO pay for reduction in this case? Does reduction automatically lift breast?

Gary M. Horndeski, MD · Answer

At size 42, each 300 grams removed corresponds to 1 cup size change.  Insurance companies use the Schuler's scale to determine the weight of breast to be removed.  After breast weight is removed, the breast does not lift significantly.  Instead, I recommend 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 and nipple sensation is maintained.Best Wishes,Gary Horndeski, M.D.

Kenneth Hughes, MD · Answer

Breast reduction reduces the size of your breasts and helps with the pain as well as lift the breasts.  None of us can predict what decisions insurance companies will make regarding coverage for BR surgery, what documentation will sway their decision, or the length of the approval process. 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 HMO medical insurance certificate of coverage. Determine what medical information is required for your insurance provider to issue a pre-authorization or predetermination of benefits for BR surgery. Seek consultation with a board certified PS who can evaluate your medical condition and history, discuss the pros and cons of this surgery as it applies to you, and help you in completing the paperwork required.  
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Urmen Desai, MD, MPH, FACS · Answer

Yes, when you reduce the size of the breasts, you end up lifting the breast.    I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear boobie64,it is hard to tell for sure without an examination. 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

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

Scott C. Lindsay, DO · Answer

Thanks for your question.
Some health insurance companies pay for breast reduction surgery. Contact your carrier to find out if this surgery is a covered benefit under you plan. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Susan Buenaventura, MD, FACS · Answer

Breast reduction does lift the breast but the surgeon can control how "much" it is lifted and this should be a thorough part of your pre operative discussion.   The breast size is reduced by removing breast tissue.  The lift is accomplished by removing skin.  I do these two components separately so that each can be controlled individually.  It should be possible to reduce your breast size but still leave you with a natural "hang" if that is what you desire.  All insurance companies are different when it comes to covering breast reduction; that would have to be addressed with your surgeon.   Many companies do not cover breast reduction, but it's worth it!  Best wishes to you.

Andrew T. Cohen, MD, FACS · Answer

Yes a breast reduction will lift  your breast to a higher  position.  A breast reduction involves removing breast tissue and reshaping your breasts and removing skin.   I perform a Wise Pattern Inferior Pedicle breast reduction which I have done now for over 20 years.  The new thing I have added is an internal mesh called Galaflex to maintain tissue support and keep them in good shape over time.  This has helped in paitients with loose skin and helps give me a better lift with a breast reduction.   Best to see a board certified plastic surgeon.   Good luck, Andrew Cohen, MD

Curtis Wong, MD · Answer

have to be done with care as an excessive reduction will create marked disproportion and unhappiness unless you are desiring to be as small as possible.  The procedure will lift your breasts and reposition your nipple to the front of the mound and you must be accepting of the scars.  See a board certified plastic surgeon for an evaluation for coverage by your HMO... and you will have to find a participating plastic surgeon in order to do this.

Matthew H. Steele, MD · Answer

Thank you for your question.  Yes, your large breasts will most likely appear beautiful after your reduction.  The goal of a reduction is to make the breast smaller to reduce your back, neck, and shoulder pain.  A breast reduction will reduce the size, lift the breast up, make the areola smaller, and place the nipple in the proper position.  This procedure has a very high satisfaction rate (almost 99%) with near complete symptom relief.  Best to check with a board certified plastic surgeon for optional advice.  Good luck.

Giovanna Ghafoori, MD · Answer

Good morning, Boobie64.  You ask a good question, that is hard to answer: There are many breast reduction techniques, some that have more potential to leave a pleasing breast appearance than others.  However, various physical exam and medical history factors may have an impact on the safety of each procedure, and a less "cosmetic" technique may be safer or more functional.  As such, I would encourage you to look at before/after photos of your plastic surgeon to determine whether you feel the results of prior patients is "beautiful," or not, after determining what technique is recommended for you.At a 42H, it is not at all surprising that you have neck, back, and shoulder pain!  A breast reduction generally provides instantaneous relief of these symptoms.  And, most women with that large of a breast, discover a myriad of symptoms that resolve following a breast reduction.  Each insurance company is different, and their policies change continuously, but most likely, with documented functional/medical issues and a 42H breast, insurance would coverage.  However, you do need to consider that the extra attention required in trying to produce a more cosmetically appealing breast, as well as the skill and artistry of the surgeon, may or may not be found within your insurance's physician list.I hope that you are able to achieve the cosmetic results and relief of symptoms that you are looking for, and I hope you have an uneventful recovery should you decide to have a breast reduction.  Best of luck!  Dr. Ghafoori

42H. Can large, beautiful, but hanging breasts remain beautiful after reduction? Does reduction automatically lift the breast?

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Answers (11)

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