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Would I qualify for a breast reduction?

Q:

I am 35 with a 4 year old. I have always been big breasted but even more so after having my child. I am 5'1 and 115 lbs and I am currently in a 30 GG bra. I have a lot of back pain but haven't seen a doctor about it. I also like to run and haven't let this stop me but when I run over 4 miles it does get uncomfortable and I get bad rashes under my breasts. Do you think this enough to qualify for a breast reduction if I see my doctor?

A:

thank you for your question. I believe you are an excellent candidate for a breast reduction. I would recommend you check with your insurance company for their requirements. Some require 3-6 months of physical therapy to reduce symptoms before covering the procedure.Then I would recommend a consultation from a board certified plastic surgeon in your area that performs this procedure regularly.

A:

Provided you are healthy for surgery, you would be a good candidate for reduction mammoplasty. Have your medical doctor, write a letter to the insurance company documenting the rashes, the back pain, and physical limitations you are experiencing. That will help. Ask your insurance company about their requirements for them to cover the surgery. Consult a member of this society who can help you understand the surgery and what to expect, the scars, the potential risks and benefits of the surgery.

A:

Jennifer,

 

 From a Clinical standpoint you appear to qualify for a Breast Reduction. But, please remember that Doctors do not dictate/ determine Health Care coverage of services. Insurance company's do. If you have insurance start by calling your carrier representative to determine if Breast Reductions are a covered service. Next, ask what are the clinical determinates/ qualifiers that insurance carriers requires for it to be a covered service. Hope this is of assistance. 

 Best,

 

Gary R Culbertson, MD, FACS

A:

I absolutely think you would qualify for a breast reduction.  The criteria for many insurance companies are to be at least a DD and remove about 500 grams from each.  You would fit this criteria.  You are even a better candidate because you have normal thin weight to height ratio, meaning you are not over weight or obese.  You are a ideal candidate.  Your next step is to find a board certified plastic surgeon and he/her will take you through the process.  Good luck.

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