What Happens if You Estimate More Tissue Removal Than You Can Take out in Surgery?

Insurance companies often want an estimate of the amount of tissue to be removed before giving approval for the surgery. Often times I under estimate the number for my personal comfort to obtain at least the amount that they require.  I have never had one denied in retrospect after initial approval..

Most insurance companies use an arbitrary amount of breast tissue that needs to be removed to differentiate between a breast lift and a breast reduction.  There was a time when If the patient had symptoms related to large breasts then insurance coverage was never questioned.  In 25 years of practice I have never had an insurance company retroactively deny coverage.  We try to give a fair estimate of the amount of breast tissue that will be removed during surgery but this is only an estimate and does not take into account individual anatomy and possible restriction of the blood supply.  As a plastic surgeon I work for the patient and not the insurance company.  If during a surgical procedure I felt that it was unsafe and not in the patients best interest to remove enough breast tissue to meet these so called weight requirements then I would do just that.  To do otherwise would be below the standard of care.