Back, neck, and shoulder pain plaques me. 50+ years old and desire smaller breast than 42H. Will HMO pay for reduction in this case? Does reduction automatically lift breast?
December 3, 2018
Answer: 42H. Can large, beautiful, but hanging breasts remain beautiful after reduction? Does reduction automatically lift the breast? Breast reduction reduces the size of your breasts and helps with the pain as well as lift the breasts. None of us can predict what decisions insurance companies will make regarding coverage for BR surgery, what documentation will sway their decision, or the length of the approval process. BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered by most medical insurance providers. If not, they may try to deny you based upon a lot of things such as lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. The insurance companies will dictate the amount of tissue to be removed, not the PS. Read your HMO medical insurance certificate of coverage. Determine what medical information is required for your insurance provider to issue a pre-authorization or predetermination of benefits for BR surgery. Seek consultation with a board certified PS who can evaluate your medical condition and history, discuss the pros and cons of this surgery as it applies to you, and help you in completing the paperwork required. Kenneth Hughes, MD, Board Certified Plastic Surgeon Los Angeles, CA
Helpful 1 person found this helpful
December 3, 2018
Answer: 42H. Can large, beautiful, but hanging breasts remain beautiful after reduction? Does reduction automatically lift the breast? Breast reduction reduces the size of your breasts and helps with the pain as well as lift the breasts. None of us can predict what decisions insurance companies will make regarding coverage for BR surgery, what documentation will sway their decision, or the length of the approval process. BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered by most medical insurance providers. If not, they may try to deny you based upon a lot of things such as lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. The insurance companies will dictate the amount of tissue to be removed, not the PS. Read your HMO medical insurance certificate of coverage. Determine what medical information is required for your insurance provider to issue a pre-authorization or predetermination of benefits for BR surgery. Seek consultation with a board certified PS who can evaluate your medical condition and history, discuss the pros and cons of this surgery as it applies to you, and help you in completing the paperwork required. Kenneth Hughes, MD, Board Certified Plastic Surgeon Los Angeles, CA
Helpful 1 person found this helpful
December 1, 2018
Answer: Breast reduction and appearance after surgery Thank you for your question. Yes, your large breasts will most likely appear beautiful after your reduction. The goal of a reduction is to make the breast smaller to reduce your back, neck, and shoulder pain. A breast reduction will reduce the size, lift the breast up, make the areola smaller, and place the nipple in the proper position. This procedure has a very high satisfaction rate (almost 99%) with near complete symptom relief. Best to check with a board certified plastic surgeon for optional advice. Good luck.
Helpful
December 1, 2018
Answer: Breast reduction and appearance after surgery Thank you for your question. Yes, your large breasts will most likely appear beautiful after your reduction. The goal of a reduction is to make the breast smaller to reduce your back, neck, and shoulder pain. A breast reduction will reduce the size, lift the breast up, make the areola smaller, and place the nipple in the proper position. This procedure has a very high satisfaction rate (almost 99%) with near complete symptom relief. Best to check with a board certified plastic surgeon for optional advice. Good luck.
Helpful