Are these tuberous breasts?

Dealing with tuberous breast deformity and its associated discomfort can indeed be challenging. To address the pain and restriction in the areola region caused by the conical shape of the breast, several steps can be taken towards diagnosis, treatment, and potentially getting the procedure covered by insurance.
Diagnosis: The first step is to get a formal diagnosis from a qualified plastic surgeon or a breast specialist. They will examine your breast anatomy, discuss your symptoms, and confirm whether your condition fits the criteria for tuberous breast deformity.
Medical Necessity for Insurance Coverage: Once diagnosed, your surgeon can help document your symptoms and the necessity for surgery, which is crucial for insurance purposes. Chronic pain and physical restriction are key points that can help classify the surgery as medically necessary. It’s important to gather as much medical documentation as possible to support your claim.
Out-of-Network Provider Process: If you choose a specialist who is out-of-network, you’ll need to understand your insurance plan's benefits for out-of-network care. This might involve higher out-of-pocket costs, and pre-approval or a referral may be necessary. Contact your insurance provider to understand the specifics, including deductibles and co-pays.

Your breasts are not tuberous but are small and widely separated. You will need a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed if additional volume is desired. Insurance companies will not cover this procedure.

Best Wishes,

Gary Horndeski, M.D.

You have mild to moderate breast constriction, aka tuberous breasts. Although you may be feeling pain, it is not common among women with tuberous breasts. Treatment of tuberous breasts has always been cosmetic, and any procedure we could perform, including placement of implants, fat grafting, or breast lifts would not reliable alleviate pain. Further, insurance companies recognize the things I've said to be true, and will not pay for cosmetic surgeries for the purpose of pain reduction.