Insurance coverage for breast surgery

Sean A. Simon, MD answers: Would insurance cover Breast lift to relieve pinched nerve on shoulder?

My breasts are heavy and I wear tight bra straps 24/7 for support or else I have shooting pain down down the outer side of each breast. I have shooting pain/painful itching sensation toward the outer part of my shoulder and up the right side of my neck.

Initially, I used slip on strap pads, then was given a Rx strength hydocortisone cream Nexttreated for shingles. The pain has not responded to anything. The Dr. suspects pinched nerve on my right shoulder.

Will insurance cover Breast lift to provide some relief in the right shoulder area where I have to wear the strap so tightly?


Sean A. Simon, MD
2 months ago

 Insurance companies will often cover the cost of a breast reduction.  A pure breast lift (which involves removing excess breast skin and a small amount of breast tissue) is not covered as it is considered purely cosmetic.  A breast reduction which involves removing excess skin and a significant amount of breast tissue (close to a minimum of one pound per breast) may be covered by certain insurance carriers.  The particular symptoms associated with macromastia (very enlarged breasts) are neck, shoulder, and back strain and irritated skin in the folds under the breasts.  The symptoms that you are asking about in your question may not improve at all after a breast reduction and the exact cause should be further investigated by your doctor.  If reducing the weight of the breast and the tight bra strap that is required to support your breasts will decrease your discomfort, then the surgery may be helpful.  The best course of action is to see a board certified plastic surgery for a consultation.  

Dr. Sean Simon

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