Am I a good candidate for a breast reduction?

Question

19 yo female, 5'2, currently 140 lbs (working on losing weight), 30I bra. I have been wanting to get a breast reduction for some time now but wasn't sure if I would qualify for insurance coverage. My large breast size causes me many physical issues, including poor posture, back and shoulder pain, shoulder grooves, and occasional skin rashes. I also find it very difficult to exercise and experience excruciating shoulder pain when I run. Not to mention detrimental psychological effects.

Cihan Sahin, MD · Answer

I do not perform inverted T or anchor scars. I have my own technique, lollipop scar breast reduction. With this technique, it is possible to obtain less scarring and a more natural breast shape compared to reverse T breast reduction mammaplasty techniques.A reduction proportional to your body is the most appropriate. The numbers are irrelevant. 
At the conclusion of your procedure, Prof. Dr. Cihan SAHIN will tell your companion how everything went, and he or she will have the opportunity to see you. You will be moderately bruised and swollen at this point. You will have dressings and drains. You will stay one night at the hospital (Florence Nightingale Hospital) prior to being discharged. You will be given Prof. Dr. Cihan SAHIN’s personal cellular phone number in case questions should arise after hours or on the weekends. Before your discharge your drains will be removed. Occasionally Prof.Dr. Cihan SAHIN may want to keep the drains for a few more days.You will be able to shower the first day after your drain removal. On the 3rd or 4th day after surgery, you will return to the office for a checkup. Take it easy for one week. Take short walks, move slowly, take care of yourself, eat healthy foods and drink plenty of water. Do not try to exercise, diet or do anything more than rest and recover.
At about three to four weeks you will notice almost all the bruising is gone and a lot of the swelling has subsided. Your incisions may look pink or brown and they might still feel tender and firm to touch. You can start doing more activities at this point.About three months after your surgery, you can measure yourself for new bras. While some residual swelling may still go away, you can buy new bras at this time.

James N. Romanelli, MD, FACS · Answer

Dear srh224

With an "I" cup bra it seems you should certainly be a candidate for breast reduction surgery as a medically necessary procedure.  Insurance companies vary in their coverage of reductions, and often have different criteria for approval.

Consult with a board certified plastic surgeon who does a large number of breast reductions.  In our practice, 80 % of patients are able to be qualified for insurance coverage.

Attached is some information on insurance.

Best of Luck
Dr. Romanelli

Caner Kacmaz, MD · Answer

Large breasts can cause health issues. In addition to self-image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue impairs your ability to live your daily life. I highly recommend a breast reduction surgery for anyone who is suffering physically and emotionally.

Afet Oncel Bozkurt, MD, FEBOPRAS · Answer

For an exact answer, we need to see your breasts. But if you feel back pain and if you are sure that this is because of your breasts, you can have your breast reduction operation.

Elizabeth Kiwanuka, MD, PhD · Answer

It's understandable that you're considering a breast reduction given the physical and psychological issues you're experiencing. Many insurance companies do cover breast reduction surgery when it is deemed medically necessary, and your symptoms could potentially qualify you for coverage. Here’s how you can improve your chances of obtaining insurance coverage:
Document Your Symptoms: Keep detailed records of your physical symptoms, including the severity of your pain, posture issues, and any skin rashes. Document how these issues impact your daily life and activities.
Medical Documentation: Obtain a letter from your primary care physician or a specialist detailing your symptoms, the impact on your quality of life, and any conservative treatments you have tried (such as physical therapy or pain management) without success.
Consult with a Board-Certified Surgeon: Schedule a consultation with a board-certified plastic surgeon who specializes in breast reduction. They can provide a thorough evaluation and help document the medical necessity of the procedure.
Insurance Criteria: Review your insurance policy to understand the specific criteria for coverage. Insurance companies often require evidence of physical symptoms and failed conservative treatments. Some policies have specific requirements regarding the amount of tissue that needs to be removed.
Submit a Pre-Authorization Request: Your surgeon's office can help you with the process of submitting a pre-authorization request to your insurance company. This request will include all necessary documentation to support the medical necessity of the breast reduction.
Follow Up: Stay in contact with your insurance company to track the status of your request and address any additional information or documentation they may require.
By carefully documenting your symptoms and working with your healthcare providers to submit a comprehensive insurance claim, you can improve your chances of obtaining coverage for your breast reduction surgery. If you have any specific questions about the process or need assistance, your surgeon's office can provide valuable guidance.

Daniel Barrett, MD · Answer

Dear srh224,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Irena Karanetz, MD · Answer

Hello,
 
And thank you for the question.

Based on what you are describing and the fact that your large/heavy breasts are causing you physical symptoms, breast reduction is a good option for you.  
 
During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller.  It is easiest to think of breast reduction as including the breast lift. 
 
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss  your options, specific techniques, concerns and expectations.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
 
I hope this helps.

Best, Dr. Karanetz
 
Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon
(516) 833 0309
Oakland Gardens, New York

Ajaya Kashyap, MD · Answer

Thank you for your query. Based on the bra cup size you have mentioned and also your symptoms, you are certainly a candidate for breast reduction. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Gary M. Horndeski, MD · Answer

At size 30 I, you may benefit from a breast reduction. Unfortunately, insurance companies have certain criteria that must be met, which are often times impossible to meet. You can have it done electively and 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. This technique is not covered by insurance.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Oliver Harley, FRCSEd(Plast) · Answer

Hi, I am sorry to hear you are having these difficulties; it is understandable and sadly a common problem with all of the physical and psychological issues that you describe here.  5'2 and 140lbs puts you at body mass 25 so this is a pretty healthy weight really and I doubt that reducing weight would have much impact on breast size.....indeed, but for breasts you would likely be body mass 24.

You would almost certainly benefit from breast reduction.  In view of your young age there is a possibility that breast could still be developing and growing so a consideration for operating in very young adults is that they could go on to increase breast size after reduction....however also your life is going by with the impediment of such large breasts and it may just be the case that you have to accept the possibility of requiring a further op some time if breasts continue to grow.

Whether insurance covers BR depends upon the terms of your insurance policy so the best thing to do is ask insurer about your cover and any criteria / terms or conditions that might apply to your situation....good luck for your treatment.  oliver harley plastic surgeon

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