I am sorry to hear about the problems your disproportionately large breasts may be causing; based on your description, you may be an excellent candidate for breast reduction surgery. “Official” recommendations of course would necessitate in-person consultation. Breast reduction surgery is one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin this operation reduces and lifts the breasts to a higher position on the chest wall. By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise. Of course, every operation carries risks that you should be aware of and should consider carefully as you make your decisions, whether or not to proceed. Some of the risks/potential complications associated with breast reduction surgery include: infection, bleeding, seroma, hematoma, wound healing problems, abnormal scarring ( hypertrophic or keloid), loss of sensation, inability to breast-feed, breast asymmetry, necrosis of tissue or skin, unsatisfactory cosmetic results, unpredictability of exact cup size postoperatively, recurrence of the breast hypertrophy, and the potential for further surgery. other risks related to surgery in general include deep venous thrombosis (clots), pulmonary embolism, pneumonia and even death. Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Again, your insurance company will be able to be more specific when it comes to what "hoops" they want you to jump through. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Also, prepare to be persistent when dealing with health insurance companies. My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals. Best wishes.