Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD. I have had scoliosis curve of 32.9, am I a good candidate ?

Question

Could this surgery be covered under insurance? I am a dance and runner and my breasts have always gotten in the way and caused me pain.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your description, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations to perform.

“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.
Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.
Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons.

When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with.
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.

Once you have chosen your plastic surgeon carefully, it will be important for you to communicate her goals carefully as well. In my practice, I asked patients to use as many “visual aids”, such as goal photographs, during the communication process. Avoid the use of subjective terms;  for example, "C cup” and/or “proportionate"… these terms can be confusing, since they may mean different things to different people. Once you have communicated your goals, your chosen plastic surgeon will be able to give you an estimate of how much breast tissue will likely need to be removed to achieve your goals.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.
I hope this, and the attached link, helps.  Best wishes.

Sheila S. Nazarian, MD · Answer

Breast reduction, or
reduction mammaplasty patients are among the most satisfied of all plastic
surgery patients. Large breasts (macromastia) can often decrease quality of
life for a woman. With breast reduction, you can have smaller breasts that sit
higher on your chest wall. You will also find relief in your neck and back with
the decrease in weight and more ergonomic position of your breasts.

There are several
different variations of breast reduction, differing by size, and amount of
incisions; procedure; and the results. The different types of reduction
techniques include: The wise pattern breast lift, the anchor shaped incision,
and the donut mastopexy.

1. The wise pattern
breast lift involves an anchor-shaped incision around the natural contour of
the breast. To most patients surprise, this scar is mostly hidden under the
inferior aspect of the breast. However, the scar around the nipple/areola is
visible. Most patients heal this anchor type scar very well and are satisfied
with smaller areola in exchange for the scars. This surgery is used when there
is a lot of excess skin that needs to be removed in order to lift the breast
and give it a more aesthetic shape.

2. Often times, the
anchor shaped incision can me diminished to create a lollipop or J shaped
incision. This results in some excess skin at the inferior aspect of the breast
near the breast crease that will flatten out over a 6 month period. Some
patients are willing to tolerate this excess skin for 6 months in exchange for
a smaller scar. This is a personal decision that each patient can make.

3. The donut mastopexy
involves creating an incision around the areola and removing a doughnut-shaped
area of skin. This surgery can be used for patients that need a smaller amount
of lifting. This surgery results in a scrunched-up look to the breast skin
surrounding the areola for about 6 months before it flattens out. Patients need
to be understanding and tolerant of this in exchange for an areola-only scar.
These patients do run the risk of areola widening as well.

Insurance may cover
some of these cases when back pain, shoulder bra-notching, and rashes under the
breast are present.  Insurances vary
though and your doctor can submit a report and photos to see if your insurance approves
your procedure.

The risks of the
procedure include bleeding, infection, bruising, poor scarring, pain, swelling,
and changes to nipple and areola sensation. 
In general, however, breast reduction patients are some of the most
satisfied and grateful plastic surgery patients.  This is truly a life-changing procedure.  Best of luck!

Steven Wallach, MD · Answer

You might be able to have insurance cover your breast reduction, but you need to check with your insurance company to see what their criteria are for coverage.

R. Stewart Collins, MD · Answer

Breast reduction is usually covered by insurance.  You will need a history of bra strap grooving (groves in shoulders) and neck or back pain - related to the size of your breasts - documented by a primary care provider.   Some insurance companies require at least 1 months of documentation of the problems related to large breasts prior to approving the procedure.   Additionally, some insurers might recommend physical therapy consultation and a trial of weight loss.

Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD. I have had scoliosis curve of 32.9, am I a good candidate ?

Answers (4)

Answer: Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD.

Answer: Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD.

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.

Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD. I have had scoliosis curve of 32.9, am I a good candidate ?

Answers (4)

Answer: Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD.

Answer: Currently 18, 145lbs, 5'6" and wear a 34DD/34DDD.

Browse related questions

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.