Can I get a breast reduction and implants in at the same time?

Question

I am a 38 E and have had progressive back problems due to this. I was wanting to get my natural breast reduced to a B cup so that not much fat is left and getting implants to put me back at a DD. Implants are weightless compared to fat so I would achieve the aesthetic I want without the back issues. Will my insurance pay for the breast reduction part of this, if it was ordered by a physician to help with my back problems? Or will I have to pay for it all since I would be adding on Implants?

Brian K. Reedy, MD · Answer

Hello, thank you for your recent question.  You would want to have the reduction first and wait at least 3-6 months before you have a secondary surgery to place implants. Reason being for this would be you want the swelling to go done and healing to occur before you have the implants placed.  As far as the insurance covering the BBR that is something that would need to be prior approved by your insurance.  Some insurances pay for this procedure and others do not.  Best of luck !

Ozge Ergun, MD · Answer

Thanks for the question. Yes, you can get a breast reduction and breast implants at the same time. You should meeting with a Board Certified Surgeon and planning the process. After planning, everything will be better. I wish you all the best.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster and drains are not necessary. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.
  
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  
  
Best of luck!    
  
Dr. Schwartz 
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon 
  
#RealSelfCORESurgeon

Kenneth Hughes, MD · Answer

A breast reduction's main goal is to reduce the size of the breasts and hopefully help back, neck, and shoulder pain. In general, large breast reductions are better left at "D" cups, because if the breasts are left too small, this is not a great solution.  It would be silly to perform a breast reduction and then turn around and perform a breast augmentation because the breasts are now too small.  You have to realize that after breast reduction, your belly, legs, and arms will appear bigger as well.  Finally, the skin envelope and fullness generated from a "D" is usually more aesthetically pleasing.  Medical insurance companies are quite strict about the requirements for covering the cost of breast reduction surgery,  BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a year) are typically covered by medical insurance.  Determine what medical information is required for your insurance provider to issue a preauthorization or predetermination of benefits for BR surgery. Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, and help you in completing the paperwork required by your insurance provider.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

Please can I correct a misconception. Breast implants are not weightless compared with fat. Silicone implants have a similar weight to breast tissue (marginally lighter) and saline implants would be slightly heavier size for size. Having a breast reduction to then replace the lost volume with silicone or saline will not result in a helpful reduction in weight.There is a new implant called a B Lite which is made up of hollow borosilicate microspheres in a silicone network. These are 30% lighter than standard implants. However they have only been around for a few years and are 3 times the cost of standard implants. They are available in some hospitals in the UK. I am not sure if they have been approved for use in the USA.Hope this is useful, good luck.

Kris M. Reddy, MD, FACS · Answer

The question is not uncommon. Patients seek upper pole fullness but want to reduce the overall size of the breasts. Some reduction and breast implants are possible at the same time. However, you may want to consider separating the two procedures into 2 stages. Consult in person with an experienced and expert board certified plastic surgeon to understand your options.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi there, This is one of the biggest controversies in breast surgery. I totally understand where you are coming from, and having a reduction then implants although counter intuitive,  is not as silly as it sounds.Having a breast reduction will not add volume to the upper pole of your breasts. So if that is what you want then you will need to have an implant. It is the only way to achieve that lookThe issue is timing. Reducing the size of your breasts and skin envelope provides opposing forces to adding a breast implant. In addition, after your breast reduction you may actually be happy.My advice. Have a breast reduction, understanding you may still need an implant down the track. Allow everything to heal and then if you want more upper pole fullness have a breast implant. That is the safest approach.As to your insurance, I do not know whether it will be coveredRichard

Steven Wallach, MD · Answer

If you are having symptoms realted to the weight of your breasts, then adding an implant which basically adds weight directly related to the volume of the implant is counterintuitive.

Ricardo Ventura, MD · Answer

hello thank you for your question and provided information as well.. you can get both surgery, but about the theme about pay, its good to get a consultation in personal with your surgeon and asking about this concerns

Tom J. Pousti, MD · Answer

I understand your goals.   In my practice, I would recommend doing the significant breast reduction first and allowing full healing to occur prior to proceeding with a second stage breast augmentation procedure.   Performing a significant breast reduction and breast augmentation procedure at the same time,  carries too much risk ( potential complications),  in my opinion.  The time between the two operations generally is 3 to 6 months for most patients. My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals.  
Best wishes.

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