Cosmetic or medically necessary? Every healthy looking change we make to our bodies has tremendous benefits to our general wellness. Aesthetics and wellness are connected. Every operation should be performed with respect for the aesthetic quality of the result, and all good plastic surgeons do this with every surgery. All patients care how they look, even the ones who claim they do not.
Some breast reductions are considered non cosmetic by insurance companies who do not want to reimburse these cases. From my perspective, the difference between a cosmetic and a non cosmetic breast reduction is purely semantic. All breast reductions make people feel better. Patients who have been rejected for insurance coverage, including people who have tummy tucks who feel their problem is more reconstructive/medically necessary than cosmetic wonder how the decision of cosmetic or medically necessary is made. There is simply a shortage of resources for medical care.
A breast reduction operation is both cosmetic and reconstructive in nature. The confusion usually comes from insurance companies who are the ones determining what constitutes whether or not the operation is "medically indicated." Whether or not a patient meets all of the criteria of a "medically indicate" breast reduction, the goal of the operation is still the same: to create a smaller, more aesthetically pleasing breast mound.
A breast reduction is one of my favorite operations to do because it is both functional (pain relief etc) and aesthetic (breast lift and shaping improvements) - in our practice, about 50% of our patients pay for the procedure out-of-pocket and the other half get the procedure covered by insurance, although insurance coverage is becoming less common in our area.
Reduction mammoplasty is a procedure to breast a more proportional appearance and alleviate physical discomfort caused by large, heavy pendulous breasts. Reduction mammoplasty can correct symptoms from excessively heavy breasts causing an inability to do certain exercise, causing back, shoulder and neck pain, poor posture, and bra-strap shoulder indentations. Sometimes large breasts can rest on the chest wall causing chafing or rashes under the breasts. The reason some refer to reduction mammoplasty as non-cosmetic is because it can commonly be covered by insurance though criteria differ amongst insurance providers. Despite it being non-cosmetic, it is a very similar operation and produces similar scaring to mastopexy. It is always done in an aesthetic fashion. Hope this clarifies the definition!
Breast reduction is definitely an aesthetic procedure but the outcome of successful surgery can also eliminate medical symptoms attributable to large breasts.
Breast Reduction can sometimes be covered mostly by insurance, making it considered more non cosmetic. This is due to the number of discomforts to the body caused by large breast, such as neck and back problems or yeast and skin problems.
A breast reduction is performed to reduce the discomfort on the back, neck and shoulders that is caused by large heavy breast. It is performed for functional reasons even though it also improves the aesthetics (appearance) of the breasts.
Breast reduction surgery is mostly cosmetic for most women; they want to have smaller breasts to look less busty. For a smaller group of women, it is an issue of shoulder and neck pain, headaches, and tenderness with activities. This is considered a medical problem.
Insurance companies will only pay for breast reduction surgery if they feel it is for medical purposes. It's a fine line, and they are now erring on the side of non-coverage in most women.
When most surgeons who specialize in breast surgery perform breast reduction, we try to make it a cosmetically pleasing result regardless of whether it was for a symptomatic patient or not.
Best of luck!
A breast reduction can be considered reconstructive when it causes symptoms of neck pain, shoulder pain, rashes etc. When performed properly by a skilled breast surgeon care is taken to make it look as aesthetic as possible. That is why I frequently liposculpt the sides of the breast to help me get a better cosmetic result. Frequently I see fatty tissue in the armpit area that I will want to remove. Go to a board certified plastic surgeon.
Andrew Cohen MD
Cosmetic surgery is surgery that is not done to treat a medical condition. Breast reduction is most often done to treat back, neck and shoulder pain, poor posture, rashes and grooving of the shoulders from bra straps, thus it is not considered cosmetic surgery for insurance purposes. The results are very attractive when properly done.