Will Insurance Pay For a Reduction if You Have Implants? I Was a Saggy C Before, Now 40E?

asked 4 months ago by Reduce me Mpls
Latest answer by Darryl J. Blinski, MD
Question viewed 122 times
Tags: 10 years post-op, DDD cup, implant, insurance

I am a patient at Mayo for severe pain and back issures. I'd love a reduction but I have implants so I'm wondering if I would be covered? I'm 5'2" and a 40DDD? The doc went bigger "made an executive decision" after he put me under, without my permission. I've had them for over 12 years. Also wondering if I could get really small implants after getting the bigs ones taken out and getting a reduction. Originally I was a large C cup but was saggy, so I had a lift with implants.

6 answers to Will Insurance Pay For a Reduction if You Have Implants? I Was a Saggy C Before, Now 40E?

Small implant helps improve results of breast lift

Hi Reduce Me Mpls, Insurance company coverage varies for each procedure by policy. You should check with your insurance company. In my experience, in New York State, this is not covered. Now, as to what your options are. You said before surgery you were a C cup and sagging; you then had a lift with implants. Currently, your breast size is very large. The question is, when you were a C cup, were you happy with the size in a bra? If so, then a lift... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

drpfeifer.com

Breast Reduction by Implant Removal

Hello Reduce me Mpls, Symptomatic macromastia (painful large breasts) is a medical condition, regardless of whether the cause is natural breast tissue or implants. So theoretically it is coverable by insurance. You and your chosen surgeon may opt to have removal of implants covered by insurance and still do non-medical procedures performed simultaneously (breast implant replacement and breast lift). This is not insurance fraud and perfectly legal, as long as you... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

Implants and reduction

I doubt that an insurance company will "cover" a reduction when a patient has implants. You certainly can ask the insurance company what their policy is.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast Reduction Candidate?

Thank you for the question. Obtaining coverage for breast reduction from insurance companies becomes more challenging every year. The fact that you have breast implants in place will further increase the challenges of obtaining coverage. The first place to start would with be a visit with a well expensed board-certified plastic surgeon who after direct exam will be able to advise you. Best wishes.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Breast Reduction After Implants.

Most insurance companies would not cover reduction done by removing implants. You would almost certainly need some kind of a lift after taking the implants out but do NOT do it at the same time. The breasts can change significantly over 3 months and you really don't know how much to lift them until after that change takes place.

Ronald V. DeMars, MD
Portland Plastic Surgeon