I have aetna insurance which has very strict rules of what needs to be removed to be approved. I am currently 5'7 and 185lbs and I I got a consultation and the prior auth was denied due to not removing enough. I needed about 1000 g per breast removed and the dr said that would be my entire breast...it's not adding up to me, according to "a bra that fits" I am a 38J (US) and that size fits, maybe 1 size down...
Answer: Bra size is not scientific Hi Stone,
Helpful 1 person found this helpful
Answer: Bra size is not scientific Hi Stone,
Helpful 1 person found this helpful
Answer: Insurance Your doctor knows how much volume he needs to keep the blood flow to your nipples and keep them alive. Since you are overweight, the amount of breast tissue that is required to be removed does go up. Try losing about 40 pounds and then see what is required by Aetna if you want insurance to cover your reduction. Most companies want about 500 grams per breasts when you are near your ideal weight. For you, that weight is around 135-145 pounds, with 135 pounds at "ideal".
Helpful
Answer: Insurance Your doctor knows how much volume he needs to keep the blood flow to your nipples and keep them alive. Since you are overweight, the amount of breast tissue that is required to be removed does go up. Try losing about 40 pounds and then see what is required by Aetna if you want insurance to cover your reduction. Most companies want about 500 grams per breasts when you are near your ideal weight. For you, that weight is around 135-145 pounds, with 135 pounds at "ideal".
Helpful
July 9, 2023
Answer: Breast reduction Photos or exam is needed for a specific recommendations. Breast reduction will decrease the volume and weight of the breasts as well as lift them. This often provides relief for the patient from concerns such as neck and back pain and rashes under the breasts. I encourage you to visit with a board certified plastic surgeon near you to determine if you are a good candidate and if the amount required to be removed by your insurance carrier is a realistic possibility for you.
Helpful
July 9, 2023
Answer: Breast reduction Photos or exam is needed for a specific recommendations. Breast reduction will decrease the volume and weight of the breasts as well as lift them. This often provides relief for the patient from concerns such as neck and back pain and rashes under the breasts. I encourage you to visit with a board certified plastic surgeon near you to determine if you are a good candidate and if the amount required to be removed by your insurance carrier is a realistic possibility for you.
Helpful
May 31, 2023
Answer: Breast reduction Dear stonel1994,
Helpful
May 31, 2023
Answer: Breast reduction Dear stonel1994,
Helpful
May 31, 2023
Answer: Bra sizes are not standardized According to the information you provided, your body surface area is 2.03 m2 (depending on which formula is used) and according to the BC/BS Schnur scale that would require your provider to remove a little less than 700 grams of tissue from each breast. That would roughly be about 2-3 cup sizes down. So starting from a J cup you would likely go down to a G cup. Please keep in mind that these are all just estimates. However, if your surgeon estimates that you are starting with only 1000grams, that would leave you with only an A cup or less AND might endanger the blood supply to your nipple. Remember that bra sizes are not standardized, so a "J" cup in one manufacturer may be a "DDD" cup or a "D" cup in another. Additionally, your surgeon may remove MORE than the estimate to give you the size you desire, but if he/she removes significantly less than the estimate, your insurer may not authorize the payment to the surgeon (after the fact) leaving you ultimately responsible. He/She must also leave enough tissue behind to keep your nipple and areola alive (unless you choose to have a free nipple graft) so the removal vs what is left behind is a balancing act when insurance companies are involved. If you have the option to pay out of pocket for your surgery, this may be the best option for you. Ask your surgeon if there are financing options available.
Helpful
May 31, 2023
Answer: Bra sizes are not standardized According to the information you provided, your body surface area is 2.03 m2 (depending on which formula is used) and according to the BC/BS Schnur scale that would require your provider to remove a little less than 700 grams of tissue from each breast. That would roughly be about 2-3 cup sizes down. So starting from a J cup you would likely go down to a G cup. Please keep in mind that these are all just estimates. However, if your surgeon estimates that you are starting with only 1000grams, that would leave you with only an A cup or less AND might endanger the blood supply to your nipple. Remember that bra sizes are not standardized, so a "J" cup in one manufacturer may be a "DDD" cup or a "D" cup in another. Additionally, your surgeon may remove MORE than the estimate to give you the size you desire, but if he/she removes significantly less than the estimate, your insurer may not authorize the payment to the surgeon (after the fact) leaving you ultimately responsible. He/She must also leave enough tissue behind to keep your nipple and areola alive (unless you choose to have a free nipple graft) so the removal vs what is left behind is a balancing act when insurance companies are involved. If you have the option to pay out of pocket for your surgery, this may be the best option for you. Ask your surgeon if there are financing options available.
Helpful
