Medically necessary breast reductions
By Dr. Kenneth Dickie
Mar 3, 2008 - 7:19:44 AM
What if you couldn’t perform daily activities, such as exercising or running with your children, because of overly large breasts that caused unending pain?
Despite existing scientific studies that outline the medical necessity for breast reduction, many insurance companies are denying thousand of woman the procedure each year because of rigid, unfounded conditions to secure coverage.
People often think breast reduction is an elective cosmetic procedure, but the majority of women seeking this surgery are legitimately debilitated by their breasts.
The criteria most insurance companies use is not supported by medical literature and eliminates a large number of women from coverage, forcing them to fend for themselves.
Most insurance companies require patients to exhibit specific signs of symptoms prior to approving breast reduction as medically necessary.
The amount of tissue removed to relieve symptoms associated with overly large breasts is the most controversial of all insurance criteria.
According to studies, although most patients have a one –and-a-half to two cup size reduction, the amount of tissue removed, body weight, level of obesity, or bra cup size do not affect the benefits that patients receive from breast reduction.
Many insurance companies require that patients exhibit all of the following symptoms to receive coverage for breast reduction: back, neck, shoulder, and arm pain; rashes; bra strap grooves; and numbness in the upper torso.
While most patients suffer from many of these symptoms, rarely do they exhibit all.
As I have found, most patients are women between 30 and 50 years old who have had upper skeletal pain for years.
Many of them have tried various treatments, including physical therapy and pain medications, to manage the pain before turning to breast reduction.
However, many of these women are still turned away by their insurance companies.
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Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.
He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery.
Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery.
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