How to: breast reduction

nossmf · July 2021

Back in November of 2019, a drunk driver smashed into my wife's SUV while she idled at a red light. She avoided serious injury and need for surgery, but the last year and a half have been filled with several types of pain management for the herniated disc in her lower back, from medication to physical therapy to chiropractic sessions to laser ablation of the nerves. Yet while we're managing the pain, it never truly goes away completely, and we think the weight of her chest is at least partially to blame. My wife has always been well endowed, and after giving birth four times she's even more so now than when I met her. Twenty-five year old me thought this was a great thing; but after nineteen years of marriage, my concern is for her health and quality of life.

Before starting this thread, I did a search for previous threads discussing the topic of breast reduction surgery. While I was able to find multiple threads over the years on the subject, invariably the discussion was limited to WHY, but not HOW. I have several questions about HOW to get this ball started, including:

1. Whom do we talk with to get this process started... her primary care physician? OB/GYN? Plastic surgeon?
2. Since this is quality of life related, how do we get insurance involved to see if they can/will pay for part/all of the procedure?
3. We have a lawyer handling the paperwork for a potential lawsuit against the individual driving. Should we get him involved in making the other guy's auto insurance pay for the procedure?

Moderators, if this isn't the correct forum for this discussion, I apologize.

MaltedTea · July 2021

1. Her GP could be an option but I'd be ready to drop at least $500 in plastic surgeon consultation fees. Many of them tend to apply the consult fee to any surgery you end up getting with them. If she's comfortable with the tedium of the process, I'd suggest seeing three docs at a minimum. Which doc to chose? Try realself.com and have her browse away. NOTE: in some jurisdictions, breast reduction may be covered by your province/state because it can be deemed a medical issue (as opposed to an aesthetic one). There is criteria for this and some plastic surgeons specialize in this area...but wait times can be long as they tend to prioritize their private patients.
2. In my line of work (not cosmetic surgery but healthcare adjacent), I generally encourage people to grab their fav bevvie, and a copy of their insurance policy booklet, then to sit down for as long as it takes to read it. Line for line. As boring as it is, there are bound to be savings in there that you don't know about. Furthermore, there are usually criteria to access eligibility for coverage so you may as well find out what that is beforehand (yes, even before shelling out for those consulting fees)
3. That's a legal question and nowhere near my wheelhouse. Doesn't hurt to ask? 🤷🏿‍♀️

Best of health to your wife

Lady_ovthe_lakes · July 2021

I would discuss it with her primary care and a spinal surgeon to see if they think it would help.

musicfan68 · July 2021

I had reduction for medical reasons, I would start with her GP and get referred to a good, reputable plastic surgeon. Insurance will cover it if it is a medical necessity, and the plastic surgeon will deal with that. One of the requirements at the time I had mine was that they take 1lb off of each side for insurance to pay, but he couldn't quite make the 1 lb, so he asked me on follow up about pain, (I had had excruciating pain in one of my shoulders that was completely gone immediately after surgery). I am also very short, 5'0" and have scoliosis, so it wasn't hard for him to convince the insurance company that it was medically necessary.

deputy_randolph · July 2021

A friend of mine is going through this now. I don't know all of the specifics, but I do know that she has consulted her insurance provider. Her pre approval for surgery was recently rejected by the insurance company, b/c it was not deemed "medically necessary." Her breasts aren't "big enough." She does not have any other medical issues that I know of that might contribute to it being medically necessary.

If she wants the surgery regardless of the coverage or cost, I would suggest starting the surgeon hunt first. My sister consulted 3 plastic surgeons before settling on one for a body lift. It was definitely not an overnight process. She can work on the insurance while looking for a surgeon.

AnnPT77 · July 2021

I have a couple of casual friends who had reductions. One went through a process somewhat like the post I quoted below: She did multiple rounds, trying to convince her insurance company that her original breast weight/volume was causing health problems, i.e., musculoskeletal issues such as back pain. It required requesting approval, appealing denials, getting more doctor statements/evidence, etc., but she was finally successful.

The other had reduction consequent to lumpectomy for breast cancer - the major lumpectomy left her affected breast much smaller, and irregular in shape. Under those circumstances, in the US, insurance coverage is much simpler, because there are legal requirements to treat breast reconstruction as a part of the cancer treatment, from a health insurance perspective.

musicfan68 wrote: »

I had reduction for medical reasons, I would start with her GP and get referred to a good, reputable plastic surgeon. Insurance will cover it if it is a medical necessity, and the plastic surgeon will deal with that. One of the requirements at the time I had mine was that they take 1lb off of each side for insurance to pay, but he couldn't quite make the 1 lb, so he asked me on follow up about pain, (I had had excruciating pain in one of my shoulders that was completely gone immediately after surgery). I am also very short, 5'0" and have scoliosis, so it wasn't hard for him to convince the insurance company that it was medically necessary.

33gail33 · July 2021

nossmf wrote: »

Back in November of 2019, a drunk driver smashed into my wife's SUV while she idled at a red light. She avoided serious injury and need for surgery, but the last year and a half have been filled with several types of pain management for the herniated disc in her lower back, from medication to physical therapy to chiropractic sessions to laser ablation of the nerves. Yet while we're managing the pain, it never truly goes away completely, and we think the weight of her chest is at least partially to blame. My wife has always been well endowed, and after giving birth four times she's even more so now than when I met her. Twenty-five year old me thought this was a great thing; but after nineteen years of marriage, my concern is for her health and quality of life.

Before starting this thread, I did a search for previous threads discussing the topic of breast reduction surgery. While I was able to find multiple threads over the years on the subject, invariably the discussion was limited to WHY, but not HOW. I have several questions about HOW to get this ball started, including:

1. Whom do we talk with to get this process started... her primary care physician? OB/GYN? Plastic surgeon?
2. Since this is quality of life related, how do we get insurance involved to see if they can/will pay for part/all of the procedure?
3. We have a lawyer handling the paperwork for a potential lawsuit against the individual driving. Should we get him involved in making the other guy's auto insurance pay for the procedure?

Moderators, if this isn't the correct forum for this discussion, I apologize.

From an insurance perspective, if she never had a consult for back pain or any other issue regarding quality of life prior to being in the car accident, I think you will have a hard time convincing a medical insurance company that breast size is the reason for her pain, and not the trauma from the accident. Is there any reason to think that if her breasts were smaller that her herniated disc wouldn't be causing her significant pain? You might have better luck suing the driver directly - but honestly breast reduction surgery for pain from a documented traumatic injury that is probably irrelevant to breast size - is going to be hard sell.
I've known people who have had the surgery covered for medical reasons (due to pain), but they had ongoing issues for years, not a traumatic injury.
If she has consulted with a doctor prior to the car accident injury then you will probably have a better case for payment through medical insurance, but a worse case through suing the driver, as it would be preexisting to the accident. So you'd have to really think about that before deciding which route to pursue.
ETA: And also just want to say, what a horrible thing to happen. Same thing happened to my husband, stopped at a red light and nailed from behind full speed by a drunk driver, pushed him into the intersection, then tried to drive away in a wrecked car. Totalled both cars and damaged his shoulder. I hope you manage to get all you can out of them.

springlering62 · July 2021

I had a reduction about twelve years ago.

I was so large, I used to sing the Continental Soldier song to them in the mirror while dressing. Sing the whole verse to yourself, and you’ll understand.

My initial visit about a reduction was with my GP, who agreed I needed one.

She submitted it and my HMO, Kaiser Permanente, agree to pay for it if I lost a specific amount of weight. I did, but when I followed up, they said it was no longer necessary, despite deep indentations in my shoulders and stomach from years of carrying K cups (and we ain’t talking coffee, either), and Kaiser denied coverage.

My husband told me we could afford it and to do it if I wanted.

In retrospect, I would have interviewed several doctors but I was pleased with the first one I spoke to, and anxious to get it done.

Some of what follows was very much my own fault, but the same plastic surgeon did a nose job on my daughter and made an utter hash of it, so I now question the competency.

I now know- didn’t earlier- that many of these doctors who are named “Best Of” in various local publications apparently pay for the privilege. Ignore that chatter.

My doctor removed over six pounds. I wanted him to remove more, but he refused. I’m still a DD. After a lifetime of people staring at my chest, I honestly wouldn’t have cared if I were flat chested.

My strongest recommendation would be to follow the doctor’s recovery instructions to the T. Breast and under-breast tissue is like stitching together wet Kleenex. It’s unfathomably delicate and easy to tear or split. I burst many of my stitches doing the gentlest of stretches after four weeks, after being specifically told it was too early. Yes, that was totally my fault.

I had a very very painful prolonged healing for many more months as a result, and was left with extensive scarring.

I was obese at the time of surgery, and my doctor did an odd fold & tack stitching under my arms that, now, with substantial weight loss, looks really wierd. I have pointy extra skin under my armpits that I have to literally tuck into my bra if I’m wearing workout gear or something sleeveless.

Also, TMI but needful to know, your breasts may not be as …errrrr…sensitive as before.

Would I do it again? Yes! My back no longer hurts, the liver colored “bang” spots where they rested on my belly finally disappeared after about ten years, the doc did give me a lift at the same time, so for my age I have lovely perky boobs if I do say so, and most of all, I no longer have to hunch to hide them. So much of my life was all about hiding boobs and “headlights” and being conscious of being stared at all the time. It’s was a running joke in my office that several male customers came to visit my boobs regularly. Mortifying beyond imagination if you haven’t been there. Yes, people DO talk to your chest and not your face.

Would I do it differently? Yes, I’d investigate more doctors, ignore what I thought were reputable publications (a popular magazine named after and devoted to my city), and above all, I’d follow the doctors advice. (Duh!)

I would also, if possible, lost weight prior to having the reduction so I’d have had a fighting chance to avoid the rather odd shape that came losing it after surgery. While everything else has rebounded with weight loss, the “artificial” shape of the side of my breasts has not.

But all in all, absolutely life changing. Being able to go out in public, fat or thin, and be looked at as a person rather than a pair of tits with a face coincidentally attached…..priceless.

nossmf · July 2021

Thanks for your sympathy. Yeah, my wife was sitting at a red light when a small truck driving 45+ slammed into her from behind. Our suburban was virtually unscathed...the impact was centered on our tow hitch, all we needed was a new bumper. My daughter in the middle seat had minor whiplash; my wife in the driver's seat was twisted around at the moment of impact, leading to torque related injuries to her hip and shoulder, and a herniated disc in her back. The drunk tried at first to convince my wife not to call the police; when she began to dial, he got back in his totaled truck and took off. However, a Good Samaritan witness followed the guy, calling the police to help guide them in. Word has it once the cops managed to force this guy off the road, he took a swing at the first officer to come within reach. When my wife got a court summons to testify at this guy's trial, the list of offenses he was facing was almost an entire page long. (Court hasn't happened yet.)

My wife is tall (5'10") and has scoliosis, which has only compounded the issue. We'd spoken a couple times about getting reduction prior to the accident, citing some back and shoulder pain, but we never had a doctor's consult prior to the accident.

We hired a lawyer, initially not with the idea of suing for damages but just to handle all the paperwork and interact with the other guy's insurance to handle our expenses. To date most of our bills have been paid for by the insurance (only a couple smaller ones by us), but there's apparently a two year statute of limitations to file against the company, so our lawyer is finalizing a complete package which will include documentation of injuries, future care required, expenses to be paid as well as (potentially) some unknown amount for "pain and suffering." No idea if we'll actually end up with anything in pocket after this is all said and done....as long as all the medical bills are paid, anything extra will be gratefully accepted.

I read one entry on a previous thread where somebody mentioned a loan they were able to take out to pay for their reduction over time. If all else fails we can look into something along those lines.

How to: breast reduction

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