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How to get a breast reduction paid by my insurance? Breastfeeding after reduction?

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Old 06-15-2011, 03:53 PM   #1
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How to get a breast reduction paid by my insurance? Breastfeeding after reduction?

Hello! I am 27 years old, 5'2" and have size 36G breasts. I have ALWAYS been bigger busted than everyone my age. So my aches & pains started early. Anyway, I have read alot of posts on this site about how to get it done (complain, complain, complain...fill prescriptions...document, etc.). I have kaiser through my husband's work (he works for the state, so big company. great coverage...we barely pay for anything) and he has co-workers that said Kaiser DID pay for it. I am just curious if anyone has any insight or suggestions on Kaiser and how they deal with this and what their course of action usually is?

Also, everyone is telling me that I should start complaining now because it takes a long time. BUT, there's a couple things: I am breastfeeding and will be for 4 more months. Don't know if they will try to blame it on that or blame it on having a new baby and all the picking up, etc. Also, what I am more concerned about is that my husband might be getting another state job in a different state somtime this year. While I am sure they will also offer Kaiser, I do know that Kaiser is not linked from state to state. So, is it worth it to start this journey of documenting my complaints now? What if I move and have to start all over? I know that it is a HUGE pain to get records transfered cuz I had to do it once before. And even if they do get trasfered, will they count? Or do I need to stick with the same doctor that can verify everything? I just don't wanna waste my time and have to do it twice cuz I am not that good at complianing in the first place.

And lastly, I wanted to know if anyone out there has had a breast reduction surgery...what is it like? What are your breasts like afterwards? My main concern is that my breasts don't cause me pain anymore, but I have dealt w/a lifetime of struggle with clothes and just hating them and feeling that they were ugly. So I am hoping I can develop a healthier, more positive attitude towards them. I have heard that when you get a reduction, they also do a lift (like it is included in the reduction surgery)? If that's true, do they also do this if insurance is paying for it? Or will they only strictly do what is medically necessary? I am hoping they will look better as well as make me feel better. Breastfeeding has made me hate them more than ever...I don't even want my husband to see them. Speaking of breastfeeding...has anyone had trouble breastfeeding after reduction? I don't know if I wanna give up on breastfeeding for any future kids. I have read that it is really hard to breastfeed after reduction cuz of severed milk ducts. Has anyone run into this problem? I am just curious how common this is?

Thanks for all your help!

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Old 06-15-2011, 05:01 PM   #2
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Re: How to get a breast reduction paid by my insurance? Breastfeeding after reduction

I myself had that done in 2002.

Insurance will often require that you be sufficiently beyond breast feeding, have had doctor's visits over months prior to breast feeding regarding medical symptoms that are solely caused by breast tissue weight/size. This includes bra pain, rashes under, upper back and neck pain, etc. Some insurance will require that you first try things like physical therapy to see if pain can be alleviated.

So if you have been thinking of this for a long time and were just waiting until after your child was weaned, then the best thing to do is wait until fully weaned and you are no longer producing milk. Then talk to your primary care about the list of medical symptoms, what you do to alleviate the pain, how long this has been an issue, that you wanted this for a while but waited until after having your child, etc.

My SIL had a BR as well and has been able to do 2-3 wk of breast feeding for each of her children she had after the BR surgery. She produces more but it can't come out (which was a risk she knew going into surgery). If you plan on future kids you have to accept that you may or may not be able to breast feed at all. My SIL produces 1-2 oz per day and mixes it with formula (since colostrum has key health benefits for babies). She feels lucky to be able to do that much. After 3 wk the baby is on full formula only.
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