Breast Reduction candidate? (photos)

I am scheduled to see the surgeon next month and I am a little nervous. Not just because of the surgeries that I have seen go bad, but I have wanted this for a long time and I hope my insurance covers it. Has anyone dealt with Tricare? I am a 34 DD 5'2" and 123lbs. My back tires easily which is not good with my job. Should I do this?

Doctor Answers 12

Breast Reduction Candidate

Thank you for your question.  You appear to be a good candidate for a breast reduction.  Tri-care does cover breast reduction surgery, however the surgeon will likely need pre authorization from the carrier prior to surgery. Since the insurance company will be paying for the surgery, they will dictate the amount of tissue to be removed.  While it is likely that the end result will be great there is some loss of control in choosing your final breast size.  Overall, if you choose an experienced surgeon you will likely have a very nice result.

Jackson Plastic Surgeon
5.0 out of 5 stars 11 reviews

Most of breast reduction patients are very satisfied with the results.

If you have done your homework properly you should now be in the hands of a skilled plastic surgeon that should give you a very good result. Call your insurance company to see if breast reduction is covered under any circumstances. If so, your surgeon will be able to determine whether they are criteria for coverage applies to your particular case.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Breast reduction

Insurances require surgeons to remove a minimum amount of tissue to ensure the procedure is reconstructive in nature and not cosmetic, like a lift.  In your case, your surgeon should remove at least 300 gm on each side.  This would put you in the range of a small C cup breast.  If you are interested in this, you should pursue the surgery through insurance.  Best wishes, Dr. T. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews

Best procedure for you, some advice:

Thank you very much for sharing your concerns with us. 
After having analyzed all the information provided to us, i can realize that you have very large breasts for your height and weight, and can be responsible for head, back, neck and shoulder pain.

In the future may cause  permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts). For for this reasons, certainly you need a breast reduction surgery.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 273 reviews

Breast Reduction Candidate


Thank you for pictures.  It appears that you a candidate for a breast reduction.  The best way to get a solid answer would be to schedule a consultation with a board certified plastic surgeon.  

Earl Stephenson, Jr, MD, DDS, FACS American Board Plastic Surgeon

Tricare breast reduction

A DD is probably the smallest that the insurance company will consider.  For most insurers, simply referencing back pain isn't enough; they may require proof of conservative treatment including medical records. You should address this with TriCare prior to seeing a surgeon.  The criteria may be posted on the Internet as well.  Coverage is a process and can take several months. Good luck!

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast reduction

Thank you for your question.

Every insurance if different on what their requirements are. It is based on height, weight, and body surface area. They may also ask for letters from a chiropractor, physical therapist, or primary care doctor. If you have ever had any rashes under the breasts, make sure that has been documented. The photos alone will not get an approval anymore when it comes to insurance. Good luck.

Francis Johns, MD
Greensburg Plastic Surgeon
4.8 out of 5 stars 73 reviews

Breast Reduction

Yes, I think that you will find much improvement of your symptoms after undergoing this procedure.  

I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery.

Best wishes!

Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Urmen Desai, MD, MPH, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 234 reviews

Breast reduction

You should check with your insurance company to determine what the criteria are for approval. Then go for a consultation. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Reduction candidate?

Thank you for the question. Based on your description, you may be a good candidate for breast reduction surgery; this operation tends to be 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 (in other words, the breasts are "automatically" lifted when a breast reduction is performed). 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.

 Sometimes breast  reduction surgery is covered through health insurance.. The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” 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 “authorization” for the procedure. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.

When the time is right,  seek consultation with well-trained/experienced board-certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly. Best NOT  to communicate your goals in terms of achieving a specific cup size; this type of communication can be a source of miscommunication. In my practice, I prefer the use of goal pictures during this communication phase;  many patients wish to remove enough breast tissue to improve/alleviate symptoms while maintaining upper/lower body proportionality. I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps.


Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,503 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.