What makes you qualified for a breast reduction?

Author: Manley Hane  |  Last update: Wednesday, November 26, 2025

Breast reduction surgery is meant for people who have large breasts that cause the following: Chronic back, neck and shoulder pain. Shoulder grooves from bra straps. Chronic rash or skin irritation under the breasts.

What do you say to get a breast reduction?

Write a Personal Appeal Letter: Draft a letter describing your symptoms, how they have affected your quality of life, and why you believe breast reduction surgery is medically necessary. Focus on the physical problems rather than cosmetic concerns.

How do I get medically approved for a breast reduction?

You'll generally have to provide records showing that:
  1. You have chronic health symptoms caused by having large breasts.
  2. You have tried nonsurgical treatments for your symptoms.
  3. Nonsurgical treatments have not helped.

What justifies a breast reduction?

Breast reduction may be recommended if you have very large breasts (macromastia) and: Chronic pain that affects your quality of life. You may be having headaches, neck pain, or shoulder pain. Chronic nerve problems caused by poor posture, which result in numbness or tingling in your arms or hands.

Who is not a good candidate for breast reduction?

However, if your Body Mass Index (BMI) is over 35, breast reduction surgery will not be covered by insurance, and it is not safe to perform.

Requirements for a breast reduction? Dr. Pane Explains

What size breasts qualify for reduction?

There is no specific minimum breast size for reduction, as it depends on the individual's body proportions and preferences. However, surgeons typically recommend that patients have at least a C cup or larger to be considered good candidates for breast reduction surgery.

What would disqualify you from getting plastic surgery?

Plastic surgery has gained immense popularity, but there are several factors that can disqualify individuals. Unrealistic expectations, psychological considerations, medical conditions, inadequate finances, poor physical health, and lack of commitment to aftercare are all crucial factors to consider.

How do you prove you need a breast reduction?

Breast reduction surgery is meant for people who have large breasts that cause the following:
  1. Chronic back, neck and shoulder pain.
  2. Shoulder grooves from bra straps.
  3. Chronic rash or skin irritation under the breasts.
  4. Nerve pain.
  5. Not being able to take part in some activities.
  6. Poor self-image due to large breasts.

Will insurance pay for breast reduction?

Can a breast reduction be covered by insurance? Yes. Breast reductions are covered by many health insurance plans. However, your surgeon may need to authorize the procedure with your health insurance company in order to get coverage.

Can I go down 4 cup sizes with a breast reduction?

The original size and shape of your breasts will also greatly affect the decision-making process, and your height and weight factor into deciding what size will be proportionate to your body shape. The lower limit on a breast reduction is an A cup. However, in general, patients will go down at least one or 2 cup sizes.

How much do DDD breasts weigh?

The average pair of DDD breasts weighs between 15 and 23 pounds. To put this into perspective, this is the equivalent of carrying around two small turkeys on your chest every day. . . . . .

What does no one tell you about breast reduction?

Breast tissue can be very heavy and the common complaint of breast reduction patience is back pain, shoulder divots from their bra straps, and the inability to participate in sports and other activities.

How to make your boobs smaller without surgery?

Eating a healthy diet

The breasts mostly consist of adipose tissue, or fat. Losing body fat can reduce a person's breast size. Maintaining a diet and lifestyle where energy expenditure is higher than calorie intake will cause a person to lose weight. This weight loss may lead to a reduction in breast size.

What do I wish I knew before getting a breast reduction?

10 Things You Need to Know Before Having Breast Reduction Surgery
  • You'll immediately feel lighter afterward. ...
  • Breast reduction surgery can improve your overall health. ...
  • You'll need to wait six weeks before wearing a traditional bra. ...
  • You might want to wait to have surgery until after breastfeeding.

What tests are done before a breast reduction?

Preparing for Breast Reduction Surgery
  • Once your surgeon has recommended cosmetic breast surgery for you, there are some preparations. ...
  • Lab Tests You May Need. ...
  • Pregnancy Test. ...
  • Mammogram. ...
  • Complete Blood Count (CBC) ...
  • Electrocardiogram (EKG or ECG) ...
  • Chest X-ray. ...
  • Other Preparations for Surgery.

What is the weight limit for breast reduction?

Body mass index (BMI).

Some insurance companies will deny breast reduction surgery unless the BMI is <30, others <35, while others need to see documentation that the patient has attempted to lose weight in the past through diet, exercise or weight loss surgery. This is because breast size may decrease with weight loss.

What documentation is needed for breast reduction?

Documentation: Documentation is key when supporting coverage for breast reduction. The Medical Record should document the symptoms associated with hypermastia the patient has experienced, as well as their duration. If required by the payer, conservative measures that failed to improve symptoms should be documented.

Will I be approved for a breast reduction?

Ideal candidates for breast reduction are:

Suffering from shoulder indentations caused by bra straps and/or have skin irritation beneath the breast crease. Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing. Nonsmokers/non-vapers.

What qualifies a breast reduction as medically necessary?

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.

How do you know if your breasts are too big?

You have back, shoulder or neck pain

Pain should never be ignored. If you have large breasts and experience pain around your upper back, shoulders or neck, then your breasts could be a contributing factor. While surgery could be an option, physiotherapy can also help with managing pain and posture.

What breast size is considered for reduction?

Most surgeons do not dictate or require a particular size to qualify you as a candidate for breast reduction. The most vital factor they consider is if the breast size causes you mental and physical health problems.

How do I get a medical clearance for plastic surgery?

In most cases, you'll receive your medical clearance from your primary care physician (PCP) leading up to surgery, although some ASCs have the ability to perform their own preoperative testing.

Who is not a good candidate for breast augmentation?

Generally speaking, anyone who is in reasonably good mental and physical health can be candidates for breast implants. However, you are likely not a good candidate for this surgery if: You're pregnant or breastfeeding. You have breast cancer or an abnormal mammogram.

What makes you ineligible for liposuction?

You Are Not Medically Cleared for Surgery

Even if you consider yourself healthy, some underlying conditions may disqualify you. Your doctor will go over these in your consultation. Conditions like asthma, diabetes, and high blood pressure are typical warning flags for plastic surgeons.

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