Where Do I Start For Breast Reduction?

Question

I would like to get an evaluation for a breast reduction? How do I start the process? Do I start with my general physician for a referral?

Tom J. Pousti, MD · Answer

Thank you for the question.

	 If you are dealing with an HMO  insurance plan,  you will likely need to meet with your primary care physician for a referral to a plastic surgeon in the plan. If you are covered by a PPO insurance plan,  then this referral will not be necessary.  The same will hold true if you are paying for the breast reduction procedure out of pocket.

	Ultimately, it will be up to you to do your due diligence in the process of plastic surgeon selection. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. 

	Then, I would suggest you visit a few surgeons whose practices  concentrate on aesthetic surgery. Ask  to see lots of examples of their work and preferably speak/see patients who have had similar procedures done. 

	If you are having the procedure covered by an insurance company,  there will likely be some &ldquo;hoops&rdquo; to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance &ldquo;authorization&rdquo; for the procedure. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.

	I hope this helps.

Kelly Gallego, MD, FACS · Answer

I think it is typically best to start with your primary care provider.  You should have a frank discussion about all of your symptoms such as pain, rashes, shoulder grooves, headaches, etc.  They should clearly document your complaints.  They should also administer the appropriate conservative therapies.  In addition, they should be able to facilitate a referral to a respected board certified plastic surgeon in your area if the conservative therapies prove ineffective, as they generally do.

Susan Buenaventura, MD, FACS · Answer

The best first step is to consult with a board certified plastic surgeon.  Check with the American Society of Plastic Surgeons (ASPS) for a surgeon near you.   They will be able to tell you what is involved with the surgery and if you are a good candidate.  They can also help you find out if your insurance company covers breast reduction.  (Some do, some do not).  Good luck to you!  Breast reduction changes lives!!

Steven Wallach, MD · Answer

To get things moving quickly you should probably see a plastic surgeon first if you think you are a candidate for a breast reduction.  Different insurance companies will request different things, so you will have to find out what they require.

Kris M. Reddy, MD, FACS · Answer

The question starts whether this is a procedure that you would want to pay via your insurance plan.  If yes, then you should know the qualification criteria for your plan.  Second, the insurance company will pay more if the surgeon selected is in their network.  Review the list of surgeons that participate in the network.  Thirdly, choose 3 for consultion.  The one that best meets your needs through his/her expertise, experience, and understanding of your needs would be the one that you should opt for.

	 

	If you do not have insurance or do not qualify under the criteria of your plan, then skip to step 3 and consult with 3 surgeons in your area who have the experience and expertise to perform the surgery.

Where Do I Start For Breast Reduction?

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Where Do I Start For Breast Reduction?

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