Will I be a good candidate for a breast reduction?

Most likely, yes you would be a good candidate for a breast reduction. The first thing you do is see a board certified plastic surgeon for a good exam. The medical office will then submit a letter to your insurance to ask for approval for the surgery. Keep an eye on your insurance company. They sometimes like to back out of things. Not all insurance companies cover breast reduction surgery. You can call your insurance company and ask.

At this time, it is unlikely that you could get in for a consultation. This is because of the Covid 19 situation. That is fine, The OR's aren't open for elective surgery anyhow.

Erin, as Dr. McCall stated, the process begins by consulting with a board-certified plastic surgeon. The surgeon’s office would then then submit to insurance on your behalf in order to obtain preauthorization. Insurance companies have different criteria for coverage, which can sometimes be frustrating, but my office would be happy to work with you. We offer virtual consultations to at least get the process started during the current COVID-19 crisis.

Thank you for sharing your question. Best to get in touch with your insurance company, and your specific plan, to determine if a breast reduction is a covered procedure, and if so what are the criteria you need to meet in order to qualify. Once done, schedule a series of in-person consultations with physicians in order to get the best treatment recommendation.

Different insurance companies have different criteria that must be met prior to authorizing breast reduction. Generally these requirements include shoulder grooving, neck pain, rashes under the breasts and ask if you have tried alternative therapies (these must be documented and submitted) such as massage, chiropractor, weight loss and exercise to alleviate your symptoms. You are also required to have documentation from your primary care doctor. During your consultation with your plastic surgeon, photos and measurements will be taken. Some insurance companies require a certain weight to be removed from each breast to qualify as a breast reduction. Others use the Schnur scale which is based on your body surface area to determine the minimum amount that needs to be removed to qualify. In some patients, these amounts would leave them very small breasted, something that much be taken into consideration before proceeding.