Will insurance cover breast reduction w/lift if I have implants?

Hi,

Thank you for the question.

Based on what you are describing, it does sound that you have large/heavy breasts causing physical symptoms, and breast reduction may be an option for you. However, it is difficult to tell without seeing the photos and/or in person consultation.

During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller. It is easiest to think of breast reduction as including the breast lift.

Schnur Sliding Scale is a scale used by many insurance companies as a guideline for how much breast tissue should be removed in order to improve your physical symptoms. In addition, most insurances in order to approve the surgery, will require for 2-3 letters of medical necessity (from your chiropractor, primary doctor, OBGYN, Dermatologist, etc) demonstrating that your physical symptoms due to large breasts are not improving with conservative management.

Breast implant removal is typically considered cosmetic in nature and is not covered by insurance. But breast reduction surgery is typically covered by insurance.

I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.
Best regards, Dr. Karanetz

Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon

In most cases insurance companies do not deem implant removal as medically necessary and therefore do not provide coverage. You can call your insurance company for clarification, but this is typically considered cosmetic.