Is Visiting a Psychologist Necessary for Breast Reduction?

Question

I am mildly dysphoric about my breasts and rather want a breast reduction taking my large-C-cup breasts to a manageable A-cup. I am 18 and want to know if it is true that I need to go to a therapist for permission to get this procedure. I have talked to several friends, all saying that although I have no desire to have any other procedure other than reduction done, I will be recommended to see a therapist to be checked for mental disorders and then denied treatment based on the diagnosis.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Based on your description of your current age, breast size and goals  I think you should wait before having any breast surgery. I do not believe that your breasts currently cause symptoms typically seen with breast hypertrophy.

	Although it is not necessary to see a &ldquo;therapist for permission&rdquo; it may be in your best interests to see one anyway to discuss your &ldquo;mild dysphoria&rdquo;.

	If you decide to have surgery make sure you have done your homework and understand the potential risks, complications,  have scarring associated with breast reduction surgery. You  should also understand that further surgery may be necessary in the future (for example if the breasts were to grow in size again).

	Best wishes.

Jerry Lugger, MD · Answer

Hello Twig:

	       In my experience it is not necessary to obtain a psychological evaluation prior to breast reduction.  I frankly have not seen this as a prerequisite by an insurance carrier, although they seem to put so many "road-blocks" in the way of approval that I wouldn't be surprised that this would be mandated by some carriers.  Since you are only 18, your "body image" will be undergoing a number of changes in the years to come, so I would be very careful of changing it without a lot of thought and consultation with several board-certified plastic surgeons.  Going from a large "C" to an "A" cup is quite a difference, especially compared to something like an "E" to a "D". Sometimes, a good psychologist"s input is helpful, a I recall a patient younger than you who was quite large and was having severe problems with body image to the point of significant depression; with the psychologist's support, the breast reduction made quite a difference in this young lady's life ( and this probably helped with the insurance approval), but again I don't routinely obtain psych evaluations.  If you have a good relationship with your family, they may be another helpful resource to discuss this issue with. Good luck

Darryl J. Blinski, MD · Answer

Only if required by your health insurance plan in order to obtain a predetermination approval. Many health plans in order to cover breast reduction request a psych evaluation.

Rodger Wade Pielet, MD (in memoriam) · Answer

An elective procedure always has the potential for second guessing. If you are already questioning if a consult will be helpful to you, I think the answer is yes. The more secure and comfortable you are with a decision the better it will be for you and your outcome. Good luck

Robert E. Zaworski, MD (retired) · Answer

A qualified plastic surgeon should be able to advise you but generally a psychiatric evaluation is not indicated. Insurance companies usually require the patient to be 21 years old.

Charles Virden, MD (retired) · Answer

WOW, How insightful of you to know the warning signs. Many surgeons out there don't even have this insight. Doing an operation and needing an operation are 2 very different things. You state you are a C and only 18. I may understand this more if you were a double D. Get the therapy and let a few years go by.

Alan M. Engler, MD, FACS (retired) · Answer

Hi Twig,

	There is not normally an absolute requirement that you see a therapist before undergoing this procedure BUT each insurance company is different and has its own rules.  Your insurance company may have a range of requirements that will have to be met before the procedure is "covered."

	On the other hand, going from a C to an A is a very significant change.  You may read that people go down 2 or 3 cup sizes, but going from an H to a DD is very different from a C to an A.  That (C to A) is a dramatic change to your body and because you're 18, have presumably not finished any family plans, children, as well as any other life issues, there may be greater-than-average concern that you're truly in a position to make an informed decision.  At this time in your life.  So, from that standpoint, it may not be a bad idea to make sure you're completely comfortable with this decision.

	Whether or not it's required by your insurance company or anyone else is only part of the concern; the over-riding issue is that you do what's best for you in both the short-term and the long-term.

	I hope that this helps, and good luck,

	Dr. E

Mark B. Constantian, MD, FACS (retired) · Answer

Breasts cannot be reduced infinitely without creating new problems.  It would be possible to take you down one cup size, but experienced surgeons will tell you not to go farther.  Because the base diameter of your breasts cannot be changed, you would end up with broad, flat breasts.  You would then be faced with living with a different deformity and the only option of having implants.

	Get experienced, responsible advise and be careful.

Is Visiting a Psychologist Necessary for Breast Reduction?

Answers (8)

More Breast Reduction Questions

I Am 29 with a Size 40K Bra. I Am 189 Pounds. If I Lose 60 Pounds Will my Breast Sag?

How Soon After Breast Reduction Surgery Can I Go into my Swimming Pool (Salt Water)

How Soon Can I Swim After a Breast Reduction/lift?

While Healing After a Breast Reduction & Lift, Can I Sleep Without a Surgical Bra?

WE SEND PRETTY
EMAILS