Question:
My PS said there is a formula insurance co's use to approve breast reduction.

He said it has to do with your body mass index (BMI)and height and that gives the surgeon the amount of tissue that would need to be removed in order for the reduction to be covered by the insurance co. I need more of a lift then a reduction and so I am hoping this will pan out for me. He said he sees no problem. I have not heard of this "formula" before.    — crishsapig (posted on November 21, 2002)

November 21, 2002
yep, your PS is right. It is a funny little graph that you have to fall into. If you look at the AETNA website, and look under the medical determinations, under breast reduction is the whole thing explained. I do not knwo where they cam up with it, but hey, I got mine approved with this formula!!
   — Vicki L.

November 21, 2002
Thanks vicki! I used the graph and came up with between 500 and 600 grams from each side. That would be 1.3 to 1.5 pounds each! That sounds like so much and I am not that large (a D cup).
   — crishsapig

November 21, 2002
Hey I thought it was the pencil test! (Just kidding) Actually mine removed a total of 5 lbs. So that does sound correct (grams)... I wonder if people ever think of what it's like carrying around a five pound bag of flour just around your neck? Then to have it removed? So liberating! Good luck with yours!
   — Karen R.

November 22, 2002
Most insurance companies will pay for a breast reduction if they remove a certain number of grams (300 is a typical amount).
   — Patty H.