On the whole, plastic surgery is an expense you have to pay out of pocket. While reconstructive procedures will usually be covered by insurance, anything that leans more cosmetic is almost always off the list. However, there are a handful of procedures that are covered by insurance plans despite not being reconstructive — or at least they are in many cases.
One of these procedures? A breast reduction.
How Breast Reductions Are Performed
A breast reduction is a surgical procedure that removes excess tissue from the breasts, making them smaller and more proportionate to the body. The surgery can be performed using various techniques, but all of them involve removing skin, fat, and glandular tissue from the breasts. The nipple and areola may also be reduced in size or moved to a new position.
Why Insurance Sometimes Covers Breast Reductions
While breast reductions are not reconstructive, they can have a major impact on a woman’s quality of life. Large breasts can cause back and neck pain, skin irritation, and bra strap indentations. They can also make it difficult to participate in sports or other activities, and many women feel self-conscious about their appearance.
Breast reductions can have a meaningful impact on the health of the patient. Since they are not strictly cosmetic, many insurers will cover them.
Because large breasts can cause health problems, insurance companies sometimes cover breast reductions as a medically necessary procedure. However, coverage varies from plan to plan, so it’s important to check with your insurance company before scheduling surgery. Bring your insurance information to your breast reduction consultation.
3 Ways a Breast Reduction Can Improve Your Health
1) Relieve Severe Discomfort
Back and neck pain, skin irritation, and bra strap indentations are all common problems for women with large breasts. A breast reduction can relieve these symptoms and improve your quality of life.
2) Correct a Proportional Imbalance
Breasts that are too large or too small can alter your balance in a negative way. A breast reduction can correct an imbalance and improve your overall appearance.
3) Improve Physical Functioning
Many women with large breasts find it difficult to participate in sports or other activities. A breast reduction can help you be more active and improve your quality of life.
Who Might Qualify for Insurance Coverage for a Breast Reduction
If your insurance covers a breast reduction, you’ll need to meet certain criteria before the procedure will be approved. For example:
- The patient must be at least 18 years of age.
- Breast size must cause physical discomfort or impair daily functioning.
- Breast size must not be due to obesity (weight loss surgery may be the solution in this case).
- The patient must have tried other methods of relief (pain medication, physical therapy, etc.) without success.
It’s important to note that insurance coverage for a breast reduction varies from plan to plan. You should contact your insurance company to find out if you qualify and what the procedure will cost.
So if you’re considering a breast reduction, don’t despair! It’s possible to get breast reduction insurance approval, and after you recover, you may find it improves your health in ways you never imagined.
Dr. David Dellinger at Elysian Plastic Surgery in Austin is a double board-certified plastic surgeon who maintains a practice focus on body contouring surgery, breast enhancement and facial rejuvenation.
