Can health insurance help pay for a butt lift? (Photos)

Question

I am still searching for a doctor to assist with my saggy butt. However, I was wondering if there is some way to get health insurance to assist in paying for this procedure. I feel that there are serious health impacts caused by the skin folds. I have suffered painful carbuncles and infections. It hurts to sit and my posture is poor. I cannot sit correctly as it is too painful. I am not sure if it is possible or how I could build a case for this to be considered a health necessity.

J. Timothy Katzen, MD, FACS · Answer

Hello, LPK752 in Tulsa,
Thank you for reaching out with your question about the possibility of health insurance covering a butt lift, and for providing your history and photos.
Unfortunately, obtaining health insurance coverage for a butt lift is quite challenging. The likelihood of approval largely depends on several factors:
Quality of Your Health Insurance: If you have a high-quality health insurance plan, there may be a possibility for coverage, but this is not guaranteed.
Anatomical and Medical Necessity: Insurance companies typically consider the severity of your condition and any related medical issues. The procedure must be deemed necessary from a medical standpoint, not just for cosmetic reasons.
Plastic Surgeon’s Experience and Advocacy: The ability of your plastic surgeon to effectively communicate the medical necessity of the procedure in their authorization letter can impact the decision. Surgeons who are experienced in dealing with insurance companies might be more successful in obtaining approval.
However, it's important to be realistic and understand that most health insurance companies are reluctant to approve cosmetic procedures like buttock lifts, even if there are associated medical issues.
From a surgical perspective, a butt lift can provide excellent results, especially when it involves removing excess skin while preserving the underlying soft tissue and fat to maintain volume in the buttocks.
My advice is to consult with a plastic surgeon who has experience working with insurance companies. They can help you explore the possibility of getting coverage. If insurance coverage is not possible, you might still want to consider the procedure due to the significant benefits it can offer.
I hope this information helps you in your decision-making process regarding a butt lift. Best of luck as you explore your options.
Sincerely,
Dr. Katzen

Thomas Trevisani, MD · Answer

Generally speaking - Cosmetic Surgery is not covered by insurance. You can discuss it with your insurance company. Most all Practices offer financing to assist patients with their Cosmetic Surgery needs

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Buttock “sagging” is usually a combination of loss of volume or deflation (after weight loss, liposuction, or post-BBL) and/or the effect of aging and gravity. So,  I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will be shortened but may appear more flat with just a buttock lift. A lower buttock tuck is usually then performed at six months following implants. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck. Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel away from your local area to seek consultation with this particular type of surgeon.

Regarding insurance coverage, it not typical that this will be covered under most plans. However, the best place to start is by making sure your primary care doctor has documented all of your health problems associated with the skin folds.

Glad to help.

Mats Hagstrom, MD (license on probation) · Answer

A BBL is considered a cosmetic operation and no insurance company is going to pay for it. I don’t think you’ll find any literature, supporting fat grafting improving the conditions you describe.
The skin laxity on your upper thigh and lower buttocks looks unusual. It has the appearance of having had previous liposuction. Whether that’s the case or not there is a significant amount of skin laxity in this area.
Skin laxity can make fat transfer and liposuction results a bit more unpredictable and challenging procedures.
To find out what your insurance company covers and doesn’t cover I suggest you contact them and ask for a copy of the policy or ask them by calling the number on the back of your insurance card. All policies are based on a contractual relationship indicating exactly what is covered and what is not.
Attempting to get insurance coverage from what is considered cosmetic surgery is extremely labor-intensive for surgeons requesting authorization. It will inevitably go to manual review, requiring multiple back-and-forth conversations, writing letters, and in the end, the answer is very likely going to be no.
Personally, I don’t think medical insurance should pay for cosmetic surgery. Insurance is a community resource that should be allocated to those who is need is the highest. Despite you having medical conditions, there is no correlation with these being improved from fat transfer.
I suggest having a few in person, consultations with plastic surgeons in your community to see what they have to say.
Best,
Mats Hagstrom, MD

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