Hi, my name is Tiffany-Amber. I was speaking to an older relative about my breast recently and she told me to look into getting a reduction. My breast have been causing me pains recently, and I keep getting rashes under them too. I was complaining about a tingly feeling and heaviness causing back aches. I wanted to know what the qualifications are to get a breast reduction.
Hello,
Brest reduction can help symptoms such as back and shoulder pain, bra grooving, rashes under the breasts, interference with exercise, among others. Some insurance companies ask patients to explore physical therapy and other modalities before they will cover surgery. This happens on a case by case basis. I would recommend setting up a virtual consultation with a board-certified plastic surgeon in your area to discuss this further. Thank you for your question.
Mark G. Albert, M.D.
New York, NY
hi Tiffany , your symptoms are ideal for u being a candidate for breast reduction. u can have an online virtual consultation with any of the board certified plastic surgeon who shall guide u regarding the entire process of the procedure. thanks for your question.
If you have large breasts and want them to be smaller than you don’t need any qualifications other than that to seek consultation. On the other hand, if you are looking to see if your insurance company wlll cover your surgery, then I suggest you contact your insurance company to see what kind of documentation or symptoms you need to display before getting approval. Good luck.
Hi Tiffany-Amber!
Insurance coverage for breast reductions typically take into account your height and weight and determine an amount of breast grams needed to be removed during a breast reduction in order for your surgery to be considered "medically necessary." This varies a bit depending on the type of health insurance you have. When you consult a board certified plastic surgeon, you'll find out if you are a good candidate for a breast reduction given the requirements and your body habitus. I would be happy to see you and help you with your decision making. Best of luck!
Hello Tiffany-Amber. If you are suffering from back pain, tingling and rashes beneath your breasts, and have large breasts then you are correct in thinking that a breast reduction may help those symptoms. I perform this surgery quite often and my patients tell me that after surgery these symptoms are either completely resolved or very much improved. Insurance often covers the surgery, if your insurance company deems it medically necessary. When you see a board certified plastic surgeon for consultation, she or he can review your symptoms, the workup that your underwent and what treatments you have tried already. She can then give you the best advice moving forward as to whether the surgery would be covered by insurance. Feel free to reach out if you have any further questions.
Dr. Samara Churgin
Manhattan, New York
Thank you for sharing your question. As each insurance plan and company has different qualifications for coverage, I would first reach out to them to see what criteria they use to approve a reduction. Once known you can work on collecting the relevant information so when you present to a plastic surgeon for consultation all your ducks are in a row and can be submitted on your behalf. Best wishes on your journey!