How to Know If Breast Reduction Is Medically Necessary?

Breast reduction is unique among plastic surgeries because it is one of the few that could be medically necessary. As a result, many health insurance policies offer coverage if breast reduction can relieve neck or back pain or resolve constant skin rashes due to friction from oversized breasts.

Of course, every health insurance company has criteria for what it will cover. Still, breast reduction outcomes commonly improve health concerns. Here are a few medical concerns breast reduction surgery addresses:

Suffering with Chronic Pain

Women who suffer from chronic neck, back, and shoulder pain because of overly large breasts are likely candidates for insurance coverage. Recurrent inflammatory conditions at the breast creases can also be considered an acceptable qualification.

These conditions must be documented by your primary care physician or medical professional who has cared for you. These physicians may need to submit a medical analysis to your insurance company recommending a breast reduction to relieve your symptoms. Insurance companies require documented proof that your chronic discomfort is due to significant breast tissue unrelated to skeletal or muscular problems.

Permanent Shoulder Indentations

Indentation on your shoulders from bra straps is a symptom of excessive breast weight. It is a common problem for women with oversized breasts to develop permanent shoulder grooves from their undergarment straps. This condition, especially combined with chronic pain, could qualify you for breast reduction coverage.

No Alternative Treatments Are Effective

Some health insurance policies require you to try alternative treatments. For example, they may expect you to prove that physical therapy, chiropractic sessions, and weight loss did not improve your symptoms. These options may help some women alleviate chronic discomfort caused by excessive breast volume, but with most, they prove unsuccessful. However, if proven unsuccessful, these alternatives can be used to help you qualify for a breast reduction.

Breast Tissue Must Be Removed

Most insurance policies require a specific amount of breast tissue removed to qualify for coverage. As a result, significant reductions are often covered, like a G cup to a C cup. Breast reductions that eliminate a minimum of 500 grams from each breast are often covered.

The amount of tissue varies between insurance companies, as some consider your height and weight for determining how much tissue should be removed. However, you should disregard limitations on volume removed to get coverage if you are unhappy with a smaller or larger breast size.

Getting Breast Reduction Covered

If you suffer from symptoms attributed to oversized breasts, schedule a consultation with Dr. David Dreyfuss and contact your insurance company. If your first request is denied, ask for an appeal. Women who undergo breast reduction for a medical necessity are typically delighted with the outcome. Breast reduction can solve many physical and cosmetic symptoms and improve your quality of life.

Are you a candidate for breast reduction to resolve medical issues? To learn about breast reduction surgery in Chicago and how to get relief from your overly large breasts, contact us today for a discreet consultation with Dr. Dreyfuss.