So Confused: Breast Reduction without a Lift?

Breast reduction surgery that is approved by insurance includes the reduction of breast tissue and lifting the breast.  It also includes any additional removal of tissue such as some liposuction if performed at the same time as part of the breast reduction (this does not mean liposuction of areas off the breast).  Insurance companies have requirements on the amount of breast tissue needed to be removed for you to qualify for the breast reduction.  If you do not have enough tissue to qualify or refuse the removal of the mandated amount of tissue, then the surgery would be considered cosmetic.  Cosmetic surgery means that you have to pay for the surgeon fee, hospital fee, and anesthesia fee.  There may have been a misunderstanding between you and your surgeon.  I would recommend going back for a second consultation or finding a second opinion with a plastic surgeon certified by the American Board of Plastic Surgery.Trey Aquadro, M.D.Auburn, AL

Hi, thanks for your question and we (as Plastic Surgeons) understand your confusion. It is possible to have a breast lift without a reduction (or with a very minimal reduction), however, if a patient's nipples are lower than the ideal height then a breast lift is an inevitable component of a breast reduction. In short, if your insurance is accepting cover for your breast reduction they are also covering the lift. Your Plastic Surgeon will be able to guide you through this process. You're in good hands. 

A breast reduction always includes a lift unless the breast reduction is performed with liposuction alone.  If your surgeon has preauthorized you for a breast reduction not performed by liposuction alone then you will receive a lift.  It sounds as though you may have some miscommunication with your surgeon.  He would be best to go back and discussed your concerns again.

A breast lift is part of a breast reduction. The only exception is reduction done by liposuction. Typically, insurance companies do not approve lifting, but reductions can be. If a reduction is approved, the lift is part of it. 

Yes, nipple re-positioning (ie an uplift) is always part of a breast reduction.  The only exception is a liposuction-only breast reduction, which removes mainly breast fat via liposuction but then allows the skin to tighten by itself.  The nipple usually moves up a little bit.  This type of minimally invasive, minimal scar breast reduction is usually done in older women who are simply looking to remove some excess weight from their chest and not as much concerned about any residual droop or nipples that might still be low on the breast.  This particular technique is not covered by insurance because no intact specimen is produced.Insurance companies have become very difficult in providing appropriate reimbursement for the standard breast reduction, where solid breast tissue specimens are routinely sent to a lab.  Many insurance companies require at least 450 grams or more (about one pound) to be removed from each breast.  If less is removed, then it is considered cosmetic and not reimbursed.Elliot W. Jacobs, MD, FACSNew York City

Thank you very much for your message, in fact this is
a topic that often confuses people. In a
breast reduction a breast lift is also performed.Breast reduction is like an uplift in that the nipple
is elevated and the areola (the brown area around the nipple) reduced in size; the difference is in a breast reduction actual breast tissue is removed as
well.For more information it might be worth looking at our
website: aurora-clinics.co.uk which has
lots of information including videos of breast reductions and uplifts and
will give you a good idea of what’s involved in the procedures. I hope this has been helpful.Best wishes.

If your insurance company is covering a breast reduction for you, the lift is part of the procedure. Now, your doctor may not be on your insurance plan and therefore will charge you his usual and customary fee.

This confuses many patients but you can not do a breast reduction without a breast lift.  It is part of the procedure.  

Thank you for your question.  Do I understand correctly that your surgeon is charging you for the lift part of the procedure?  A breast reduction includes a lift.  Your insurance company will pay a certain amount to the surgeon for the reduction procedure, including the lift.  If your plastic surgeon participates with that insurance plan, called in-network, that is the amount he/she has agreed to accept as the payment for the procedure, which includes the lift.  In some situations the surgeon is allowed to charge the patient additional money.  If your surgeon is out of network with the insurance company, then the surgeon is allowed to charge the patient an additional amount.  Not all surgeons will charge this additional amount.  Find out if your surgeon is in-network or out of network.  It makes a difference in terms of whether or not they can charge you an additional amount.  A second opinion can only help.  Hope this helps.Tracy Pfeifer, MD, MS

Hi,   The insurance company does not separate the lift component from the reduction component.  If they are covering the breast reduction rest assured that they are including the lift. Please discuss this with your surgeon to be clear on what will be done during the surgery.  Good Luck.  Doctor Bev