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Functional Breast Reduction

Breast reduction is cosmetic or plastic surgery that is usually not covered under health insurance. Most plastic surgery is not covered by insurance, as these procedures are considered cosmetic or elective. However, functional breast reduction is one of the few plastic surgeries that may be considered medically necessary. Our pain specialists at Caliber Pain™ in NYC can provide evidence for medical necessity justification for functional breast reduction.

Large breasts can put stress on the body. The weight of breasts on the upper chest can create an imbalance and extra pressure on the spine and musculoskeletal system. Women with overly large breasts compared to their frame can suffer from chronic pain in their neck, shoulders and back. Long-term effects include wear/tear on the spine that can lead to osteoarthritis and other degenerative conditions that cause pain and mobility issues.

Medically Necessary Breast Reduction

Insurance companies will usually require extensive evidence to prove that a functional breast reduction is medically necessary. Our pain specialists understand the effects large breasts can have on the spine and musculoskeletal system and why it can cause chronic pain. Our physicians work with patients to provide the evidence and documentation needed to prove a functional breast reduction is a medical necessity. This can include providing treatments to relieve neck, back and shoulder pain that may be required by the insurance provider before they will cover breast reduction for pain relief.

Large breasts can be a source of chronic pain for many women, especially those with a small frame. If you desire functional breast reduction but have been denied coverage by your insurance company, you may need to prove the procedure is medically necessary. Contact Caliber Pain™ in Midtown Manhattan to discuss obtaining the evidence needed to receive a medical necessity justification for a breast reduction.

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Caliber Pain™

737 Park Avenue 1C
New York, NY 10021

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