Left side reduction, right side lift? How does insurance go about that? Is that what I would need? (Photo)

Doctor Answers 3

Left side reduction, right side lift?

You do look like you would be an excellent candidate for a right breast reduction and a left breast lift in order to obtain better symmetry, and your smaller left breast is full enough that matching this size would leave you with a nice size and fullness. As to your question about insurance coverage, they would not cover a lift and not cover treatment of asymmetry as they would consider this cosmetic. Each insurance company has their own requirements for coverage of breast reduction, and these generally dictate the minimum amount of tissue that must be removed from the breast, and many also require a history of symptoms (such as back pain) that is documented by your primary care physician and that has failed conservative treatment such as physical therapy, etc. The problem is that this minimum requirement of weight of tissue to be removed may lead to an over-reduction of your right breast such that it would not match your left breast unless you ALSO reduced that side further (and a more minor reduction of the smaller left breast might leave you smaller than you desire AND would most probably not meet the minimum requirement for insurance to cover this left reduction). 

Breast Reduction and Insurance Coverage

Thank you for adding your photos.  From what can be seen you would need a breast reduction on the right side and a breast lift on the left in order to get symmetry.  While insurance does not cover a lift, it may cover a reduction for the right side.  It is impossible to say if they will.  What is required is a consultation with a surgeon who will gather the necessary information, determine how much would be removed and then submit all of that to your carrier for pre-authorization.   Whether or not they cover the procedure is impossible to tell.  One just has to submit the information and wait for their determination.I hope that helps.Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 50 reviews

Left side reduction, right side lift?

It would take an exam to be sure but I doubt you have enough weight to come off the larger breast to qualify for insurance. A lift is never covered. But see an experienced surgeon to see if you qualify for the one side reduction, you never know until after the exam and a letter by the surgeon to the insurance carrier. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

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