My Experience of Having Breast Reduction Surgery

A personal account of the approval, procedure, and recovery processes

I was 14 years old when I went from being a flat-chested girl to a voluptuous woman—almost overnight. Every girl's dream, right? Not really. Having a D cup in your teens and a DD in your 20s is not so much fun.

Besides being uncomfortable naked and in a bathing suit, my neck and shoulders were killing me. And my belief that I looked OK in clothes was shot to pieces one day in my late 20s when I reviewed a taped segment of myself (I was an on-air TV reporter) and saw that I looked like I had two huge grapefruits under my sweater. I was horrified and never appeared on-screen again in anything but a business suit.

Life could have gone on like this—with me enduring the pain in my neck and rib cage; being tired of the sweat that accumulated at night between the two mounds of heavy skin while I tried to sleep; and strapping on several sports bras before every jog—if my mother hadn't met a woman who'd had breast reduction surgery.

I'd considered reduction mammoplasty, sure, but I really couldn't afford it. The average cost is approximately $6,000, according to the American Society of Plastic Surgeons (ASPS). But the woman my mother told me about had the surgery and loved it, and her insurance paid for it.

I had no idea my top-heaviness was a medical condition that might be covered. But I was about to find that out. Here's my journey and what you need to know.

The Approval Process

Insurance companies need to be convinced that breast reduction is medically necessary. And convincing them requires more than just a healthcare provider's recommendation: You need real proof.

To get it, I went to see an aesthetic-and-reconstructive plastic surgeon. After a quick examination, he told me what I already knew. My breasts were large for my frame, one was a good deal larger than the other, and I had the typical indentation marks on the top of each shoulder where bra straps had pressed into my skin for years. In his opinion, I was a good candidate.

The next step was harder. I had to be photographed from the neck down, and the pictures were sent to my insurer. A panel of healthcare providers would determine if a reduction was appropriate and, most importantly, if my bill would be paid.

Insurance companies typically make the call by relying on a set of charts that consider height, weight, and the amount of removable tissue in each breast, accord­ing to Amy S. Colwell, MD, a specialist in aesthetic-and-reconstructive breast surgery at Massachusetts General Hospital in Boston.

The surgery is covered 90 percent of the time when the tissue to be removed meets insurers standard criteria—between 400 grams to 2,000 grams, or about 1 to 4 pounds. Women with DD, DDD, and H cups usually qualify. But Dr. Colwell said the criteria of different insurers can be fuzzy.

Weeks passed as I waited to hear what a panel of strangers had decided about my body. When the call finally came, I was shocked and thrilled all at the same time: The insurance company had approved my surgery, and I would probably go from an overflowing DD to a B. At 5-foot-4 and 130 pounds, I thought that sounded a little bit small, but I knew I needed the surgery. And now, finally, at 30 years old, I could afford it. The cost? My small deductible of $150.

The Procedure

There are several ways to perform a breast reduction. In my case, tissue was removed from the bottom of each breast, and my nipples were moved up without disconnecting them from the blood flow, allowing me to quickly regain sensation.

The risks included infection, wound breakdown, scarring, and the need for re-operating. Studies have suggested that 2.4% to 14% of breast reduction cases resulted in major complications and 2.4% to 69% of cases resulted in minor complications, according to a September 2021 BMC Surgery review. But the healthier you are, experts have said, the more likely surgery will be a success. Dr. Colwell said most women are extremely satisfied.

The Recovery

With mild pain medication and a full week of rest, recovery was easier than I had anticipated. Early on, I had feeling in one breast but not the other. With time, sensation returned to both, just as the doctor said it would.

Two years after the surgery, the scars around my nipple and the lower-middle section of each breast were barely visible. The scars underneath each breast are light-colored and hidden. Because they're around and below the nipple, they don't show in bikini tops or plunging necklines. To be honest, I love the scars. They are a reminder that I took control of a part of my body that was out of control.

Although it takes months for breasts to take on their permanent shape after a reduction, I quickly looked and felt different. The weight on my neck and rib cage was gone, and, for the first time in a long time, I felt proportional. And my bra size? I turned out to be a perfect 34D. (Once in surgery, my doctor was able to meet the weight-removal requirements set by the insurance company and still leave me with breasts that felt right to me.)

Now that I'm out of the Big Bra Club and feel great, I'm on a mission to help other women whose large breasts are a health issue. They need to know that feeling top-heavy, uncomfortable, and embarrassed isn't just a part of life that they need put up with. They need to know it's not normal to have to search constantly for a bra that fits or to have backbreaking pain. And although a reduction can limit a woman's ability to breastfeed, it's unlikely to affect mammograms. Ultimately, these women need to know that big-breast problems can be fixed—for good.

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