Thank you for your question. Sometimes conservative measures like wide bra strap, physical therapy and may be chiropractor, Just need to say they tried and it did not work and will get benefit from reduction for symptoms. Good luck
I am very sorry for your dilemma. I would recommend that you see a primary care physician to document your back pain, shoulder grooving and large breasts. Additionally, there should be documentation that non-surgical treatments that were rendered were unsuccessful. At that point you can be referred to a board-certified plastic surgeon for evaluation for breast reduction and hopefully insurance coverage.
If you want your breast reduction paid for by insurance, simply call the office of a board certified plastic surgeon, and let them know your intentions. If they perform this type of work under insurance (which many do), they will walk you through the process of getting pre-approval. This usually involves an exam and breast measurements, a history of your syptoms and pictures taken to send to the insurance company. Then, if apporved, your surgery can be perfromed as medically necessary.
Than you for your question. Most board certified plastic surgeon's preform these procedures regularly for your symptoms, and most often the surgery is insured. We have little control over the way insurance policy's are written. Persistence, documentation, and patients, should yield prior approval from most carries.
The denial should have stated a reason. Most insurers are denying everyone under age 18 because of the likelihood of subsequent breast development, not to mention that any denial keeps money in their pockets. You have omitted your weight which could be a basis for denial and have not provided any information as to whether you have attempted conservative management. Review the insurance guidelines online. Also, I have treated many women who did not pass preauthorization because their surgeons did not advocate strongly in their behalfs. Good luck!
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 they are responsible for the back and shoulder pain that you has.
In the future may cause permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts).
For these reasons we should consider performing a breast reduction surgery on you.
Dr. Emmanuel Mallol Cotes.-