A surgical treatment called breast reduction surgery, commonly referred to as reduction mammoplasty, is used to reduce the size of breasts that are unnaturally large. Breast reduction surgery is an option for both men and women with smaller breasts, while it is typically performed on women with particularly large breasts. Breast reduction can alleviate emotional misery brought on by having excessively large breasts as well as physical symptoms including back, neck, and shoulder pain. After giving birth, some women may discover that their breasts have grown too heavy to carry comfortably. A condition known as mastitis, which causes the breast tissue to expand, can occasionally be brought on by the weight of the breasts.
In order to generate smaller, firmer breasts that sit higher on your chest wall, breast reduction entails removing extra skin and fat from the breast area. When deciding whether or not to have this surgery done, it is crucial for you to understand what will happen. You should take all necessary precautions to ensure that everyone involved recovers from breast reduction surgery safely and without regrets if you decide to have it done on yourself or another person.
Read on to learn more about Best Insurance For Breast Reduction ,Breast Reduction Requirements
Best Insurance For Breast Reduction
Are you overwhelmed or self-conscious about large, heavy, and oversized breasts? Do you feel restricted or inhibited by your large breasts from doing everyday normal activities that other Long Island women can enjoy? Our board-certified plastic surgeons at Romanelli Cosmetic Surgery can help you improve your lifestyle with a cosmetic procedure called breast reduction surgery.
Many women think about having their breast size reduced, but simply do not know what their options are, or if they can afford it. We are happy to inform you that there are a number of options to create a normal, lighter breast appearance and many cases, this surgery can be covered by medical insurance. Read on for more information!
Am I A Candidate?
Breast reduction surgery, also known as reduction mammoplasty, is a procedure that is available to Long Island area women who have excess breast tissue, skin, or fat removed to reduce their breast size. Women with large or extremely large, heavy breasts (also known as macromastia) deal with physical as well as psychological limitations when it comes to this issue. Finding the right clothes that fit or worrying about people staring at them can have a dramatic effect on a person and their well-being. Even doing simple tasks like putting on a seatbelt or trying to sleep on your stomach, much less going for a run or playing a simple round of golf can be issued for women dealing with large breasts.
Solution:
A solution to this issue is to consider having a breast reduction surgery. Women with large breasts already deal with the issue of sagging (ptosis) due to aging, but add to that the general health issues that come with carrying large, heavy breasts can make daily life a struggle. Such health issues include:
- Poor posture, which can cause head, neck, and shoulder pain
- Skin rashes under the breast from constant contact with the stomach area
- “Grooves” in the skin of the shoulders from bra straps
- Labored breathing or inhibited lung capacity as large breasts sitting on the chest area can affect the lungs
- Weight gain is also a problem for women with large breasts as their ability to exercise is inhibited
With all these health concerns, there is a good reason why health insurance may cover or partially cover your breast reduction procedure in order to get you feeling healthier and feeling better about yourself.
Does insurance cover breast reduction surgery?
Breast reduction surgery is one of the few cosmetic procedures that health insurance will consider covering. Insurance requirements do vary by company and insurance plans, but usually, if a woman is experiencing the following their insurance might cover this procedure:
- Large breasts that could be reduced by at least 3 cups sizes or more (500g or more)
- Head, neck, shoulder or back pain that is not diminished by regular visits to a physical therapist
- If dermatological issues such as the painful “grooves” in the shoulders due to bra straps or having to wear 2 bras to support large breasts or rashes under the breasts are not able to be cured or treated properly without a breast reduction
- If an individual is not able to maintain a healthy body weight due to limitations in physical exercise or not being able to play sports due to their breast size
- Also if documented weight loss did not improve the breast size in order to give a person relief
For a pre-authorization to your insurance company, a letter of such documented issues must be submitted by your Long Island plastic surgeon or your general doctor. This can also require photographs documenting such issues like skin rashes or showing the massive nature of what the breasts look like for an individual. Some patients who can privately pay for their procedure choose to wait and not do a pre-authorization to their insurance company. They wait till after the procedure in order to have more freedom on what plastic surgeon they can choose and how much breast tissue or weight is removed since some insurance policies require a certain amount to be approved. Your plastic surgeon or general doctor can then submit before and after photos as documentation to your insurance company as well as what health issues you were experiencing.
Steps to ensure you are covered…
Unless you can privately pay for your breast reduction surgery it is recommended to do the following before your breast reduction procedure to see about insurance coverage:
- Check your insurance policy to see if such a procedure could be covered or partially covered to alleviate symptoms you are experiencing.
- Call your insurance company to see if a pre-authorization letter is needed for breast reduction surgery.
- Find out what documentation is needed by your regular medical doctor or a plastic surgeon in order to be considered for coverage or partial coverage.
- See if your insurance company needs a second opinion or medical exam by another general doctor or plastic surgeon in order for them to possible cover or partially cover the procedure.
- Find out if you need to use an in-network plastic surgeon of their choice in order to be covered or partially covered or if you can find your own doctor. Choosing the right plastic surgeon or doctor to do this procedure or any cosmetic surgery is the most important step in the process.
So the good news is that in some or most cases breast reduction surgery may be covered by your health insurance. Even though health insurance doesn’t typically cover cosmetic plastic surgery unless to repair the body after an injury or accident, reconstruction surgery for breast cancer treatment, or fix a birth defect — in some cases breast reduction surgery can be added to this list. If the end result is improving a woman’s quality of life or eliminating health issues due to having large breasts then it is an option and worth checking into your health insurance to find out if you are covered.
Breast Reduction Requirements
Overly developed breasts can lead to a number of undesirable health conditions, such as back, neck and shoulder pain, sleeping issues and even skin conditions. Quite apart from the physical challenges, woman with overly large breasts usually face an equally difficult emotional burden. The issues of self-consciousness and insecurity that so often accompany this condition are very real and are usually reason enough to consider breast reduction surgery.
In some cases, breast reduction surgery may be covered in part by your insurance company. However, if your Body Mass Index (BMI) is over 35, breast reduction surgery will not be covered by insurance, and it is not safe to perform. Furthermore, the procedure will only be performed on patients who want to reduce their breasts by a minimum of 2 cup sizes.
For those who do not qualify for breast reduction surgery, a breast lift may be advisable. If you have drooping, sagging, or flattened-out breasts, a breast lift (mastopexy) can give your breasts a more youthful appearance. The procedure can be performed with or without the use of implants, depending on your individual needs and desired results.
Before surgery, our billing team will verify your benefits to see if your insurance covers breast reduction.
If you struggle with the size of your breasts, you are not alone. Every year over 100,000 women plagued with this condition seek out treatment and successfully undergo the plastic surgery procedure known as reduction mammoplasty. If you are considering breast reduction, it is normal to have lots of questions, and our breast reduction surgeons are here to help. Your first question should be: How do I know if breast reduction surgery is right for me?
Symptoms which may indicate that you are a candidate for breast reduction
If you are experiencing one or more of the following symptoms or conditions you may be considered a good candidate for reduction mammoplasty:
- Breasts that are too large in proportion to one’s body size.
- Back, neck and shoulder pain caused by heavy breasts
- Grooves in shoulders caused by tight bra straps
- Poor posture due to breast size
- Heavy breasts that droop significantly, with downward pointing nipples and areolas
- Breasts that are not equal in size (one significantly larger than the other)
- Trouble sleeping due to breast discomfort when lying down
- Rashes and/or infection affecting the skin trapped beneath one’s breasts
- Inability to participate in athletic/physical activities due to breast size
- Feelings of self-consciousness regarding breast size
If you regularly experience one or more of these symptoms, a breast reduction may bring tremendous relief. After a breast reduction surgery your breasts will be in correct proportion to your body size. Aside from alleviating uncomfortable symptoms, a breast reduction can enhance the shape and appearance of your breasts and greatly improve the comfort and fit of your clothing.
Breast Reduction and Lift Before & After
28 years old and a California native. The patient’s bra straps were causing shoulder groining and back pain. A breast lift and reduction was performed.
“How I feel right now, Lovely! Confident! Everyone in this place was incredibly attentive to my needs and professional. Exercise used to be impossible for me because of constant back pain. After having my breasts reduced, I am able to jog every day without experiencing any pain. In years, I had not felt this fantastic.” – S. A.
Does being a qualifying applicant imply my insurance will pay?
When talking about surgery “Candidate” refers to a person who is a good candidate for a specific surgical operation based on physical characteristics, health problems, and other criteria. Your doctor or surgeon will decide whether you are a good candidate for breast reduction after carefully reviewing your circumstances and reviewing your medical history. A completely different, perhaps confusing issue is whether or not your insurance provider will pay for the surgery.
All four incisions are still regarded as viable possibilities for the insertion of saline implants, and three of the four can be used for silicone implants, despite the fact that many plastic surgeons agree with me that the inframammary incision is the best procedure overall (it is not considered standard of care to place silicone implants via the belly button incision). I continue to use the other incisions since every patient is different and has a unique set of factors that should be carefully taken into account and may change how we proceed. See a board-certified plastic surgeon if you’re considering breast augmentation; they can further explain all the problems with choosing the right incision and help you choose the best course of action.