Breast Reduction Went Wrong: Will Insurance Cover a Revision?

I tried to have a breast reduction 14 years ago but the doctor did one side and let a resident do the other. It was a disaster and after two more surgeries he had put big implants in with one side much bigger than the other. They were never reduced.

They have gotten larger with age and I have had 10 back surgeries. Do you think the insurance will cover it. I am 5'7" 130 lbs and wear a 36-38 DD. My shoulders and upper back hurt all the time. I don't have the money to pay for it.

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DD cup 5 ft 4 in to 5 ft 7 in 130-149 lbs back pain insurance revision shoulder pain

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7 Doctor Answers | Asked by Maryannob in Ontario, CA

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Breast Revision and Insurance Coverage?

Thank you for the question. Unfortunately, there is no way of knowing what a specific insurance company will deem “medically necessary” and covered by their plan. It will be in your best interest to visit with a well experienced board-certified plastic surgeon who can approach the insurance company on your behalf. The more support you have from your other treating physicians the better. Best wishes.

Is secondary surgery covered by insurance?

Usually, if a breast reduction was covered by insurance, additional surgery to deal with complications would also be covered. However, your revisional surgery involved implants, which are, in most instances, not covered except for in breast reconstruction after mastectomy. The rule of thumb is that if the insurer paid for those implants, they will probably also pay for correction---unless your policy provisions have changed or their clinical guidelines have been modified since the time of... more

Maybe.....

Hello, While I feel for you and your situation, trying to predict what an insurance company will cover these days is difficult at best. Try to obtain pre-approval and hope for the best. Best Regards, John Di Saia MD

Breast Reduction - Will Insurance Cover a Secondary Reduction?

Hi Maryannob I'm obviously sorry for what you've been through and are going through. There are many issues with respect to insurance. Each insurance company is different, and each has its own rules with respect to "coverage." You'll first have to contact your company to make sure it's covered, and then you have to find a surgeon who will accept the payment the insurance company says is "usual and customary." That may or may not be... more

Will insurance cover breast reduction surgery

There is no easy answer to your question. Based on your story, you do seem to be a good candidate. However, it really is dependent on your insurance company and your doctor. So, I would suggest working closely with your doctor and your insurance company to make sure that every effort is made to help get your surgery covered by insurance. Good Luck.

Your Insurance Should Cover Your Breast Reduction

With your back surgeries and history of failed surgery I would think that your insurance would cover your breast reduction, lift, reconstruction, implant explantation. Who is your carrier? PPO? HMO? Consult with a Board Certified Plastic Surgeon in your area. I suggest a member of the American Society of Aesthetic Surgeons and one who does many breast reductions a month. Revision surgery of this kind can be trickey. Good... more

Breast Reduction Problems

Your history of problems is unfortunate. The simple ansqwer is yes your insurance will cover . If there is an argument be tough and if necessary get an attorney. You will be covered by any insurance. Dr George Commons, MD