Will the suggested amount my surgeon is removing be enough to yield satisfactory results?

Question

Hello. I am a 40-year-old woman who has been plagued with large breasts since I was a very young girl. I currently measure a 34” ribcage and a 44” bust: J cup. I would like to be a 39” bust: D or DD cup. My breasts are estimated to weigh 1200 grams each. Insurance is requiring 650 grams/breast to be removed for coverage. My surgeon says this is unsafe and estimates 450 grams/breast removal. Will this be enough? I have fatty breast tissue, not dense. I am desperate for relief. Thank you!

Justin Yovino, MD, FACS · Answer

It's impossible to say if you're going to be 100% satisfied but given my experience, it's likely that you will be, with almost 500 grams removed. I have found that the demands of the insurance companies can sometimes be excessive and risk too much removal and therefore put the cosmetic results in jeopardy. I always put the patient's cosmetic / size desires first and that helps me determine how much to remove. Removal of even 200-300 grams of tissue can help eliminate or at least reduce the symptoms of macromastia / breast hypertrophy. We don't work with insurance so we are not restricted to their requirements.

Scott C. Lindsay, DO · Answer

Thank you for your question.
I suggest contacting your surgeon with these concerns. Your insurance company may not cover your surgery cost if the required amount of breast tissue is not removed. Best wishes!

Dustin Christiansen, MD · Answer

The answer to your question depends on what you are really asking. Only you know what a “satisfactory result” is for you and your situation, so it is essentially impossible to give you a yes or a no without knowing what satisfactory looks like in your opinion. You would probably benefit from a discussion with your surgeon regarding your hope for an outcome and ask him/her to explain what you could reasonably expect from the procedure they are anticipating.

Gary M. Horndeski, MD · Answer

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.

Connie Hiers, MD, FACS · Answer

If you want insurance to cover this procedure, then 650 grams per breast will need to be removed, otherwise they will deny the claim.  If your surgeon is worried that the blood supply will be compromised removing that much tissue, then you can have less removed and pay for the procedure, or agree to have your areola-nipples removed and grafted back on for safety if needed. Please discuss this with your surgeon.  If your breasts are very fatty, you can have liposuction done to remove excess fat. This is not covered by insurance, but is cheaper.

Camille Cash, MD · Answer

When considering a breast reduction it's a good idea to visit with a few board certified plastic surgeons near you to listen to varying opinions.  Discuss your questions and goals for surgery.  Look at before/after photos of each surgeon's work.  This should help you make an informed decision.

Mats Hagstrom, MD (license on probation) · Answer

Everything you describe do you are a classic candidate for an insurance covered production. Recognize that the plastic surgeons receive very little compensation if they except medical insurance for doing procedures in comparison to how much they charge cash paying patients.
Insurance reimbursement for a breast reduction may be around $1600. Compare that to the price you were close for a cosmetic breast reduction.
The hospital fee, anesthesia fee and laboratory tissue processing well Adam to quite a bit of money. Over 200 g of tissue a difference.
From what you describe 450 g would be an extremely conservative option and I don’t think it’s a fission to get you the results you’re hoping for.
I don’t think you’ve found the right provider yet. Look for plastic surgeons in your community who do a lot of breast cancer reconstruction. They are usually willing to work with medical insurance.
I have a feeling temptation is swaying your providers decisions away from what it is in favor of patient advocacy to what is instead, self-serving, self promotion, and in plain language called greed. 
You can do better and deserve better.
Best,
Mats Hagstrom, MD.

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