Can my Insurance Pay for Removal of Breast Tissue on Armpit While I Have a Breast Augmentation at the Same Time?

I have had breast tissue on my left armpit for the past 14 years. Since puberty. It can be very painful (was very painful during pregnancy). I am very thin and it is very visible. I really want that removed and I'm wondering if my insurance can pay for something like that. If so, I am also considering breast augmentation since my B cups lost volume after pregnancy. Could my plastic surgeon do both at the same time if the insurance did pay for it? Since he is a plastic surgeon.

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7 Doctor Answers | Asked by Cecy18 in sunnyvale, ca

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Axillary breast tissue

Occasionally I will do liposuction to this area to improve the contour. The tissue can be quite fibrous and it is a hard area for postoperative compression so patients have firmness in this area for several months. On two occasions, I have even excised the extra "wad" of breast and left a scar in the anterior axillary crease. I do this at the same time as the other breast procedure be it augmentation, lift or reduction. Whether or not... more

Removal of Axillary Breast Tissue and Breast Augmentation?

Thank you for the question. Generally speaking, it may be difficult for you to obtain insurance coverage for removal of axillary breast tissue. The only way to know for sure is to seek “authorization” prior to the procedure; your plastic surgeon will be able to help you with this. Yes, this is a procedure commonly performed by plastic surgeons and can be done at the same time as breast augmentation surgery. I hope this helps.

Breast Reduction - Insurance Coverage

In general, insurance will pay for procedures that are deemed (by them) to be medically necessary. This often includes a breast reduction if about 500 grams of tissue are removed from each side (more if you're a larger-than-average person, less if you're smaller). The insurance MIGHT pay for the removal of the axillary breast tissue if you and your surgeon can demonstrate the symptoms it's causing (and the presumed benefit the removal would offer). You probably... more

Combined Cosmetic and Reconstructive Surgery

Combined Cosmetic and Reconstructive Surgery is commonly done in my practice.. It is key to have prior authorization from your insurance company for the "insured" part of it as it is very hard to get authorization or payments after the fact. Typically the OR, Surgical Facility, and Anesthesia bills for the insurance part and you will pay for the time taken for the cosmetic portion (breast augmentation).

Axillary breast tissue and breast augmentation

It is quite possible that your surgeon remove the axillary breast tissue at the same time as the breast augmentation.

Steven Wallach, MD

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Manhattan Plastic Surgeon

Excision of axillary mass at the time of breast augmentation

Many surgical facilities will not accept the hybrid cosmetic/reconstructive case because of the differences in billing fees and concerns about legality. You will not achieve a cost saving by combining the procedures and I would not recommend the transaxillary approach simply as a mechanism to attempt to achieve insurance coverage because it has its own intrinsic risks and complications.

Axillary breast tissue and breast augmentation

We have reduced axillary breast tissue at the time of transaxillary breast augmentation. Insurance coverage will depend on a predetermination from your particular insurance plan as to what is of 'medical necessity'. This can be tricky where cosmetic procedures are also involved.