Will insurance likely cover my breast reduction?

I am 5'3, 120 pounds, and wear a 32DDD or 32E. I'm concerned that not enough CC's will be removed because in the grand scheme of breasts, mine are not that big, but they're too big for my frame, which is pretty slim. I would like to go down to a 32B or maybe 32C, but I am just not at the financial disposition ot get the surgery if it's not covered by insurance. I am just a little bit worried that not enough will be taken out because I know my breasts aren't that large compared to most people, they are just way too large for my frame, causing all the neck/back pain and headaches. Thanks!

Helllo, I’m sorry to hear that you are suffering with this issue. The majority of insurance companies should cover your breast reduction typically if the following can be documented:

1. Failed non surgical treatment such chiropractic care or physical therapy

2. Failure of prescribed medications such as muscle relaxants and/or NSAIDS (non steroidal anti inflammatory drugs)

3. Changes in your activities of daily living (ADL) such as the inability to care for your self or family due to pain, inability to participate in physical activities and/or use of specialty bras

4. Neck pain, back pain, shoulder grooving and/or skin changes by physical examination

Seeking out a primary physician first for a general exam to exclude other potential problems that could cause neck and back pain is the first step followed by referral to a board certified plastic surgeon for final evaluation and treatment.

I hope you find this helpful. Best wishes.

Earl Stephenson, Jr, MD, DDS

Earl Stephenson, Jr., MD, DDS, FACS
Earl Stephenson, Jr., MD, DDS, FACS
3096 Peachtree Industrial BlvdDuluthGA30097US

Earl Stephenson, Jr., MD, DDS, FACS

3096 Peachtree Industrial Blvd, Duluth, GA,
UNITED STATES, 30097

Thank you for your question! Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine, which sounds like your situation. Recently, managed care has adopted stricter standards for coverage, so make sure these problems are thoroughly documented in writing by your primary care physician and plastic surgeon. They may also have to submit photographs. Even then, you may be required to seek a second opinion from a chiropractor, physical therapist, or orthopedic surgeon. Large breasts may not only interfere with your physical ability to function in daily activities but can be emotionally burdensome as well. Breast reduction surgery removes excess breast tissue and reshapes the contour of the breasts so that they are smaller and perkier. I suggest you make an appointment with a board-certified plastic surgeon who can go over your options in detail.

Michelle Copeland, MD, FACS
Michelle Copeland, MD, FACS
1001 5th AveNew YorkNY10028US

Michelle Copeland, MD, FACS

1001 5th Ave, New York, NY, UNITED STATES,
10028

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