Would a Breast Lift Be Covered if I Have Hidradenitis Supp?

Question

I have HS under my breast and would like to get a breast lift so that the hanging skin is lifted and therefore not harboring sweat and bacteria.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry. My first thought is your insurance company probably would not, but seeking a board certified plastic surgeon in your community who could submit a pre-determination to your insurance company would not be an unreasonable idea. Remember if you seek the opinion of a surgeon for a medical condition which generates a medical determination, you will most likely be charged an office visit and all deductibles and copays would apply for office visits and procedures. By going to such a consultation you could also learn the costs if your insurance does not cover the procedure. Good luck.

Kurtis Martin, MD · Answer

No, this would not be covered. Only excision of the diseased tissue would be covered. You might be able to combine these procedures however.

Curtis Wong, MD · Answer

can be addressed with either a lift or reduction. I have had some insurance companies cover a lift, especially if small breasted but very ptotic. Your surgeon should be able to explore this further for you once you establish a relationship with one of your local plastic surgeons.

Lewis Ladocsi, MD, FACS · Answer

Hi Puga. I have never heard of an insurance company paying for a breast lift. However, they do frequently pay for breast reductions when the patient meets their criteria. If you are willing to have a significant reduction in your breast size, then this may be a good option for you. However, you should ask your plastic surgeon about infection risks. If you have open, draining lesions at the time of surgery, your may risk surgical wound infection. Therefore, it may be better to have two separate surgical procedures.

Jeffrey Zwiren, MD · Answer

I have had patient who were approved for a breast reduction for the treatment of HS.  I am not sure about a breast lift.  I would say that this would have to be determined on a case by case basis.

Matthew Concannon, MD · Answer

Thanks for your question. The short answer is no. The surgery for hidradenitis supprativa is not a breast lift, although (depending on where your diseased skin is) that MIGHT be an elegant combination, to do the lift and the diseased skin resection at the same time. That will definitely put you at a higher risk for peri-operative infection, which is something to discuss thoroughly with your surgeon if you want to go down that road. Nevertheless, an insurance company is not going to spring for a breast lift, which is a cosmetic procedure, even though you have this underlying issue. Good luck!

Brian Dorner, MD · Answer

You can try, sometimes it passes and sometimes not. However, my office wastes a lot of time on these pre-authorizations. I'm getting to a point where I'm just going to drop insurance completely. However, you might be able to find somebody who can get it approved legitimately.

Raffy Karamanoukian, MD, FACS - Account Suspended · Answer

There are biologic, immune 
modulating, and surgical treatments for Hidradenitis. In my office, we 
begin by controlling the onset of HS and the longterm scarring is 
mitigated. Treatments for hidradenitis scarring are many including 
topical treatment protocols and laser therapy.

Best,

Dr. Karamanoukian

Realself100 Surgeon

Donald Nunn, MD (retired) · Answer

I doubt that insurance will cover a breast lift for any reason.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Would a Breast Lift Be Covered if I Have Hidradenitis Supp?

Answers (9)

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