Is a breast reduction from a 34DD to a 34B plausible with insurance? (photos)

Hi, I'm 4'11" and 19 years old. I'm a 34DD and I have extreme back pain, its impossible to even get through a full day of work and class without tylenol and ibuprofen on my side. I weigh 112 lbs; I'm quite petite but with very large breasts. Is it possible that if my surgery were covered by insurance that I can go down to a size as small as 34B?

Doctor Answers 8

Is a breast reduction from a 34DD to a 34B plausible

Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform.

Yes, it is possible to reduce the breasts size very significantly. The concern with the amount of tissue removed is related to blood flow to the remaining tissue; if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola) may be compromised. Part of the tissue that is left in place is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue. If the pedicle is made too small (in the effort to reduce the breasts as much as possible) then patient will likely have problems with tissue survival.  My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. This careful selection of plastic surgeon will be the most important decision you make.

Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon. Most patients wish to achieve a enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso. I suggest that you do not communicate your goals in terms of achieving a specific cup size. For example, a “B cup” may mean different things to different people and therefore may be a source of miscommunication. In my practice, I ask patients to communicate their goals with the help of goal photographs. I hope this, and the attached link/video, helps. Best wishes.

Insurance Coverage

Every insurance plan has their own unique criteria on whether they will cover a breast reduction. More and more, we are seeing plans where a breast reduction is not a covered benefit. If it is a covered benefit, some insurance plans set a minimum required amount of tissue to be remove in order to met their threshold for coverage. Some set the amount in relation to your BMI (height and weight). Others require extensive medical records documenting neck pain, back pain, and history of rashes. The other alternative is to opt for a breast reduction as a self-pay option. Start by visiting with a board certified plastic surgeon to learn more about your options.
Best wishes,

Dr. Basu
Houston, TX

Insurance coverage

Breast reduction may or may not be covered depending on your insurance carrier and your breast size. Please check your insurance policy to see whether breast reduction is a covered procedure. Often times, insurance company will dictate how much breast tissue to be removed. Please visit an experiences, board-certified plastic surgeon to learn about the procedure, its cons and pros, benefits, and alternatives. Please contact your insurance carrier to learn about inclusion and exclusion criteria. Best wishes.

Breast reduction from a DD to.B cup

Theoretically, it is possible to perform this operation. Some insurance companies have minimum requirements for the amount of breast tissue to be removed for coverage. There is also a limit of how much breast tissue may be removed to preserve blood a nerve supply to the nipple and areolar complex.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 84 reviews

#BreastReduction - Is a reduction from 34DD to 34B plausible with insurance?

Maybe, but it may not be advisable aesthetically.

There are two different issues:  (1) insurance coverage and (2) what should be done in your best overall interest.

Insurance coverage is a long and complicated topic.  Each insurance company is different, as are their requirements for obtaining coverage.  In general, the larger the breasts are RELATIVE to your overall size, the greater the likelihood you can get approval.   The same size breasts on someone who is 5' 2" and weighs 115 pounds would be likely to be covered while on someone who is 5' 2" and weights 165 pounds, or 5'6" and 150 pounds for example, might not.  Most companies require documentation of the failure of conservative methods of treatment (physical therapy, weight loss) and a low enough BMI (Body Mass Index) before authorizing payment for this surgey.

On the other hand, it may not be a good idea to have surgery based on the insurance company's mandate.  A real B cup may be too small for you (depending on what you like) and/or may have an unfavorable shape (sometimes the shape is more important than the absolute size).

You should have in-person consultations with several board-certified plastic surgeons in your area and go over what you'd like done.  Then listen to what their recommendations are and take it from there.  They can (normally) help you navigate the approval process.

I hope that this helps and good luck,

Dr. Alan Engler
Member of RealSelf100

Insurance coverage for breast reduction

Some insurance companies are more flexible in terms of the gram weight resection in petite patients than others.  The typical minimum is 500 grams per breast. You should be able to get down to a B cup. I will say that the breasts appear more ptotic than extremely large and I would expect the insurance company to mandate conservative medical management of the back pain which would include a 3-6 month trial of chiropractic or physical therapy as well as an orthopedic workup.

Insurance and Breast Reductions

You look and sound like a breast reduction would benefit you greatly. Whether or not an insurance company will cover your treatment may or may not be possible based on the type of insurance and or your extent of coverage. 
Call your insurance plan and find out the requirements to get approval for the procedure.
For more information, read my book " Cosmetic Breast Surgery - a complete guide from A to double D".

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 30 reviews

Insurance coverage of breast reduction

The size decrease sounds like something that an insurance company may cover. The symptoms they look for include neck or back pain, shoulder grooves from your bra strap or rashes under your breasts. However, some insurance plans will specifically exclude breast reduction procedures from you policy, so you can call your insurance company and see if it is a covered procedure.

Many insurance companies calculate a minimum that they require to remove in order to cover based on different formulas. Therefore it is best to see a plastic surgeon for a consultation. This way they can examine you, look into your benefits and discuss with you what your options are given where you are today, your goals and the requirements of your insurance company if they cover this specific procedure. Hope this helps and best of luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.