Breast Reduction Surgery: Eligibility and Health Concerns - Breast and Thyroid

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Breast reduction surgery issues?


Could you please clarify the criteria for determining if a condition is considered pathological in terms of size, according to Taiwan's health insurance standards? Where can one go for testing? Previously, I was informed that shoulder pain and difficulty breathing could warrant surgery.
I have a hunchback, experience shoulder pain, and occasionally have breathing difficulties.
The prices I found in New Taipei City are quite high, and the insurance representatives seem to be uninformed, so I have to do my own research.
Thank you, doctor.

Miss Huang, 30~39 year old female. Ask Date: 2021/10/04

Dr. Yuan Tianmin reply Breast and Thyroid


It is quite difficult to determine the exact size of breasts that qualifies for health insurance coverage; most cases are still handled as out-of-pocket surgeries.

Reply Date: 2021/10/04

More Info


Breast reduction surgery, also known as reduction mammoplasty, is a procedure designed to reduce the size of large breasts, which can cause physical discomfort and emotional distress. In many cases, this surgery is covered by health insurance if the patient meets specific medical criteria. In Taiwan, the eligibility for insurance coverage typically hinges on the degree of breast hypertrophy and the associated symptoms.

To qualify for insurance coverage, patients often need to demonstrate that their breast size is causing significant physical issues, such as chronic back, neck, or shoulder pain, skin irritation, or difficulty in breathing. The exact measurements that constitute "pathological" breast size can vary, but generally, a breast weight of over 500 grams per breast may be considered excessive, especially if it leads to the aforementioned symptoms.
Patients seeking breast reduction surgery should consult with a qualified healthcare provider, such as a plastic surgeon or a general surgeon experienced in this type of procedure. During the consultation, the surgeon will evaluate the patient's medical history, perform a physical examination, and discuss the patient's symptoms. This assessment may include imaging studies or other diagnostic tests to rule out any underlying health issues.
In terms of the process, if you are experiencing symptoms like shoulder pain, breathing difficulties, or postural issues (such as kyphosis), these can indeed be indicators for surgery. The surgeon will likely document these symptoms and may recommend physical therapy or other conservative treatments before proceeding with surgery. If conservative measures fail to alleviate the symptoms, surgery may be deemed necessary.

Regarding the costs of the procedure, prices can vary significantly based on the surgeon's experience, the complexity of the surgery, and the facility where the procedure is performed. In New Taipei City, as you mentioned, costs can be high, and it’s essential to inquire about the total expenses, including pre-operative assessments, the surgery itself, and post-operative care.
Insurance coverage can be complex, and it’s advisable to have a detailed discussion with your insurance provider. They may require specific documentation from your healthcare provider to approve the surgery. This documentation typically includes a letter outlining your symptoms, the impact on your daily life, and the recommendation for surgery.

Post-surgery, patients can expect a recovery period that varies from person to person. Most individuals can return to normal activities within a few weeks, but it’s crucial to follow the surgeon's post-operative care instructions to ensure proper healing and minimize complications.

In summary, if you believe your breast size is impacting your quality of life, it is worthwhile to pursue a consultation with a qualified surgeon. They can provide a thorough evaluation and guide you through the process of determining eligibility for surgery and insurance coverage. Remember, the goal of breast reduction surgery is not only to alleviate physical discomfort but also to improve overall well-being and self-esteem.

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