Breast Reduction Surgery - What to Expect/Recommendations
I'm seriously considering breast reduction surgery, but don't know what to expect. Can someone explain? Will insurance (Blue Shield) cover the costs? If so, what's the protocol?
I am looking for referrals for a doctor who can do a serious reduction. Preferred location- East Bay: Berkeley/Oakland/Albany but willing to go elsewhere for a good surgeon.
Thanks.
Sep 16, 2023
Parent Replies
Hi-
I had Kaiser when I had my reduction. I saw my primary care doctor regarding my back pain from large breasts, and she referred me to the reconstructive surgeon. Since my large breasts were causing other health issues, this was totally covered by insurance.
once I had my consult, we discussed preferred cup size. My surgeon said we had to wait for a little weight loss, as she wanted some of the fat on the side of my breasts to reduce. Surgery took a handful of hours and you’ll definitely need support post surgery. Recovery was pretty painful and you’ll need help with the drains. But despite recovery, I’m so happy I had the surgery done and I’d do it again.
sorry I can’t help with a referral since I had Kaiser. Good luck!
Insurance covers it if "medically necessary" - which tends to translate to a certain number of grams removed. Your surgeon will provide an estimate of grams that can be safely removed during your consultation. There is an incredible FB group called Breast Reduction Support Group which is a wealth of information about everything from approvals to procedures to real talk about recovery - strongly recommend you check them out!
I had breast reduction surgery in August. I live in Oakland but went to Dr. Christian Kirman in Walnut Creek because he was in my insurance network. A lot of doctors are in Walnut Creek so you probably want to include that area in your search. Anyway, Dr. Kirman did a great job and his staff are excellent. Here is the basic steps I took to get this done:
1. Talked to my primary care physician to get a referral. If you're insurance doesn't require a referral for a specialist this might not be necessary.
2. Made an appt with Dr. Kirman's office for a consultation about possible breast reduction. You don't meet with the doctor for this appointment, but like I said, the staff is excellent. The nurse will go over what they do, any symptoms/reasons you have for wanting one, answer all your questions, show you pictures, discuss possible complications, take pictures, etc. You can even schedule a surgery date (they book out pretty far) to get the ball rolling. A month or 2 before the surgery date you scheduled they submit a request to your insurance.
3. When a response comes from the insurance company they'll call you if there are issues. Mine was initially denied but only because the surgery center they usually use was out of network. They found another surgery center and resubmitted. Then the insurance sent me a letter saying it was approved and I called the office and had them find a date to reschedule the surgery. That part went surprisingly smoothly. Dr. Kirman's staff really is good at what they do and they do this all the time so they know all the ins and outs.
4. About a month before surgery you have a pre-op appointment. At this appointment you can ask to meet Dr. Kirman. They'll go over any remaining questions, discuss what to expect post op, you can discuss what size you want to be, etc.
5. Show up for surgery on your scheduled day. You'll meet with Dr. Kirman before the surgery and I showed him pictures of what size breasts I wanted post surgery. He does some markings on your breasts of where he's going to cut. I was very satisfied with the results and do think he followed my wishes of what I wanted to achieve.
6. Recovery has not been too bad for me. I'm now 5 weeks post op and back to normal activities. Still some swelling but that is expected to mostly resolve over the next month. The first week was the most difficult, as expected. But I stopped taking the narcotic pain relief after 2 days at home and switched over to just ibuprofen. 4 days post op I was able to drive.
All in all, I recommend. Check Reddit for a useful discussion board. https://www.reddit.com/r/Reduction/
Lots of info of what to expect, recovery recommendations, surgeon recommendations, insurance coverages vs not.
Hope this helps!
I am also in the same boat...following