Will insurance cover for a revision after it originally covered the breast reduction in full? (Photos)

Question

I had a breast reduction in March 2018. My surgeon didn’t insert jp drains in surgery and I believe that is why my incisions opened up a week later and were draining. my surgeon didn’t close them back up, instead he recommended aquaphor and to do dressing changes frequently. Now I'm left with these nasty scars 1 year later and my left breast is slightly bigger than the right. I plan on going back to my surgeon.

Kenneth Hughes, MD · Answer

This may require multiple modalities to achieve the best results.  Laser may help to some extent with some types of scarring issues. 
As an author of Scars and Scar Revision in Reoperative Plastic and Reconstructive Surgery, I am well versed in the potential treatment options.  One treatment may be helpful for one patient while another treatment may help another patient. It is unlikely that your insurance will cover the cost of the scar treatment.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Thomas Trevisani, MD · Answer

Not all Plastic Surgeons utilize drains. Some of us believe that they pose a higher risk than not. There is no constant belief that drains do anything to improve the final result. Scar quality depends on many factors. You may want to evaluate your post-op environment that can affect the healing process as well as your body's healing capacity. Scar revision is not a medical necessary procedure and is considered Cosmetic.

Miguel Delgado, MD · Answer

Unfortunately scar revision would be considered cosmetic and not medically necessary, so it is unlikely that it would be covered. However, talk to your surgeon and see what options might be available to you. Good luck.

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.
Contact your surgeon regarding this issue. Your Insurance company will have to be notified to find out if this is a covered benefit  under your plan. Best wishes!

Norman M. Rowe, MD · Answer

Thank you for sharing your experience with us and I would be happy to help you. Drain placement is dependant on surgeon preference and size of breasts. In terms of scars, it looks like you may have some keloid formation around your areolas, which we can treat in the office with a steroid. In terms of the color of the scar, we have lasers in our office that can help. If your breasts are still large and heavy, you maybe a candidate for repeat breast reduction where we can try to go through the insurance again. It doesn’t hurt to try. We’d love to see you for a consultation.

Tarek V. Copty, MD, FACS · Answer

Dear Resourceful2415,
Not all surgeons use drains so this is unlikely the cause of your complications. Scar revision is considered a cosmetic procedure and is not deemed medically necessary so will generally not be covered by insurance. Speak with your surgeon regarding your concerns and hopefully he/she can revise your scars. 
Best regards, 
Tarek V. Copty, MD FACS
American Board of Surgery 
American Board of Cosmetic Surgery 
Jordanian Board of Plastic & Reconstructive Surgery 
Fellow, American College of Surgeons
Fellow, American Academy of Cosmetic Surgery 
Fellow, International Society of Aesthetic Plastic Surgeons

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