Curtis S. F. Wong, M.D.
I am 24 years old and my breasts are a size D, most likely larger. I want to have breast reduction surgery as my breasts are causing me neck, back and rib problems. I have insurance through the state and I'm not sure if they will approve the surgery. Do I need my primary care physician's recommendation to get approval from my insurance company for the breast reduction surgery? Since my breasts are causing me pain, do you believe that the state insurance will cover this surgery?
As my colleagues have already stated, reduction surgery is covered by insurance if deemed to be medically necessary. Criteria as to what constitutes "medically necessary" vary by insurance programs. I would suggest contacting some surgeon's offices and see if you can schedule an appointment without a referral. Most offices will let you know when they find out the details of your insurance. A consultation would then determine if you would meet the criteria for a medically necessary reduction.
A side note... if you're dead set on wanting to breast feed should you have children, I would advise waiting until you are done with childbearing. Reductions will diminish and can sometimes prevent you from breast feeding in the future.
I'm thirty-six years old. I have two wonderful boys, but in having my boys I had surgery. The two surgeries have left me with a hernia and a bit of a pouch. My question is, can I have my hernia removed at the same time as undergoing a tummy tuck/liposuction? Or is it best to have the hernia done first and then tummy tuck surgery?
It depends. If your hernia is very large and/or you have thinned out tissues (muscle/fascia), a tummy tuck may not be possible. Liposuction (lipoplasty) is contraindicated if you have a known hernia so that should be done after your hernia is repaired or after you've recovered from your hernia surgery.
If you have a small hernia that is easily fixable and good tissues, a concomitant tummy tuck is certainly a possibility if you're willing to accept the risks of surgery. Combining liposuction with a tummy tuck also increases risk for complications, and I would personally be hesitant to do both procedures at the same time as a hernia repair.
When I was 16 I had a benign tumor removed from my left breast. I now have two large benign tumors, one in each breast. Presently I am a size 36B. If I have them removed, I feel I will be left almost completely flat-chested. With my history of breast tumors, would a plastic surgeon consider me a candidate for breast implants?
Before specifically answering this, I need to know how old you are. If you are still a minor, I would not recommend augmentation/implants unless you had some obvious deformities.
Assuming you are older than 18, and that your breasts have essentially developed as much as they are, you will have to decide whether you want to have the procedure or not. Benign tumors alone are not a contraindication to breast implants. However, breast augmentation can make mammography and biopsies more difficult in the future. If you have a very strong history of breast cancer, it would seem more prudent not to have a procedure (augmentation) that will make screening exams (mammography) more difficult. Nevertheless, the ultimate decision rests with you.
If your tumors are so large as to be causing visible deformities, you will have to deal with them first. Also, if your tumors have a known history of continued growth, this will also have to be resolved before considering breast augmentation.