Will Insurance Pay for Inverted Nipples with Sagging Breast?

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9 Doctor Answers | Asked by cathy15 in u.s.

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Inverted Nipples/Mastopexy and Insurance Coverage?

Thank you for the question. Correction of inverted nipples and/or breast lifting surgery are not procedures generally covered by health insurance plans. Some information regarding inverted nipple surgery may be helpful... Inverted nipples can cause functional problems for women and emotional concerns. An inverted nipple can look flat or a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples possible. Whether a patient... more

Insurance does not pay for inverted nipples or breast lifts

Both these diagnoses are considered cosmetic and insurance will not pay for either surgery. This would be a fee for service procedure as there is no functional necessity involved.

Insurance rarely pays for cosmetic surgery

It is very rare for any health insurance to pay for cosmetic surgery. Inverted nipples that occur with ptosis (sagging breast) may be nicely corrected with a breast lift or Mastopexy. For patients undergoing breast reconstruction, insurance companies will pay for a Mastopexy on the opposite side to correct for asymmetry. Other than this situation, it is unlikely that they would pay for the procedure you are inquiring about. Good luck.

Insurance and inverted nipples and sagging breasts

It is hard enough to get a formal breast reduction covered by insurance. I would be extremley surprised if an insurance company would cover basically a breast lift and inverted nipple repair.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

VIDEO: Mastopexy (breast lift) and inverted nipple repair: Insurance coverage

In my experience, insurance companies do not pay for breast lift procedures nor do they cover inverted nipple repair unless you have a liberally interpreted medical savings account plan. see video

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Medical Insurance Does NOT Pay for Cosmetic Surgery

Medical Insurance plans do not pay for Cosmetic Surgery (intended to improve a normal appearance). Inmany cases, they have a hard time paying for Reconstructive Plastic Surgery (intended to either return appearance or function back to normal from where birth defects, disease on injury have put them). A sagging breast does not fall in this category and if you want to make them more perky and attractive you will have to personally fully pay for it. Dr. Aldea

Breast sagging is a cosmetic problem.

Sagging of the breast is call ptosis. While it may make you unhappy this condition does not cause risk to your life or health. As such it is a cosmetic problem and health insurance does not cover cosmetic surgery.

You own the insurance

If your insurance covers cosmetic problems -- then it might pay 00 but dont expect it to. Call the company and ask them.

Inverted nipples

Not usually as this is a cosmetic problem. There is also a difference between nipples that cannot be teased out and nipples that can be pulled out but then retract. Often the sagging of the breast and the lost of subareolar tissue support will cause a nipple to invert. Restoration of volume with an implant may provide enough support for the nipple to evert again.