When Is A Breast Lift Medically Necessary? [Explained]

Dr.Edna Skopljak

Dr.Edna Skopljak

Edna Skopljak is a Doctor of Medicine. She has over 10 years of experience in the medical field. She is also a volunteer at several organizations, and is always looking for ways to improve the health of her community.

Women who experience difficulties due to their large breasts may question when is a breast lift medically necessary for their health. Determining this on your own can be challenging, but our guide outlines the criteria most commonly used by insurance companies to determine whether a breast lift is necessary.

When is a breast lift medically necessary?

Changes in the breasts can occur with weight gain, pregnancy, or aging. The changes result in large or heavy breasts that can cause discomfort and affect the way everyday tasks are performed.

Many of these issues are recognized by insurance companies as being ones that impact the quality of life and may provide coverage for breast lifts because of them. There must first be documentation on file from specialists such as doctors, chiropractors, or physical therapists showing that health issues are occurring due to breast size and volume. Some of these issues may include:

Neck, back & shoulder pain: The top health issue caused by large breasts is chronic pain that is caused by large breasts shifting the center of gravity in the body. This causes overcompensation in other areas of the body to stabilize and often results in tension and strain of other muscle groups over time.
Since heavy breasts also pull the shoulders forward and down, the back tends to hunch and, over time, alters the curvature of the spine.

Arm tingling & numbness: Many women do not realize that their large breasts can cause tingling in the hands and fingers as well as numbness throughout the arms. This is due to breast size creating strain throughout the torso and neck, which can cause nerve compression. By removing excess tissues and lifting the breasts, the pressure on the body and the nerves decreases, and blood flow to the arms normalizes.

Deep Shoulder Grooves: It is normal to have grooves after removing a bra, but large and heavy breasts can create deep, permanent grooves in the shoulders from carrying extra weight for years.
This can lead to permanent pain and disfigurement and is a genuine concern, especially if it worsens over time.

Rashes: Large breasts can rub on the skin below, and the crease can start to flare up with rashes and other infections. This is due to constant friction, moisture, heat, and lack of air circulation, which can result in irritation, wounds, and chronic skin conditions.

Physical Limitations: Many women are unable to participate in certain physical activities due to their breast size, making the process of exercising and playing sports an uncomfortable situation. A recent study shows that women with large breasts spend around 37% less time exercising than their small-breasted counterparts. Not only do they exercise less, but they also participate in activities that are lower-intensity

Will insurance cover my breast lift?

Insurance companies typically offer coverage for surgeries that they consider a medical necessity. While a breast lift is usually considered cosmetic surgery, there are some cases in which it would be covered if it was proven to be a medical necessity. It is best to discuss with a doctor and insurance company to see if a breast lift would help to improve issues that are occurring. They may recommend a breast reduction over a breast lift, which still has components of a lift included in the surgery.


The question of when is a breast lift medically necessary becomes more important over time as issues caused by large breasts take their toll on a person’s mental and physical well-being.

Seeking professional advice from a health care provider is the best first step in determining whether or not a breast lift will be required to alleviate these issues to live a pain-free, happy life.

Insurance company representatives will also be able to provide guidance on the steps an individual will have to take before coverage is an option.