Would insurance cover 2nd breast reduction (17 years later) and arm lift? (Photos)

Question

Excess skin weight is causing severe back pain. I have 36G breasts and had a reduction at 19. The doctor didn't remove ANY tissue and just gave me a lift the first time. I am now 36. I wear a size 8/10 pant. My back KILLS ME. It's like the weight from my chest and the skin from my upper arms and back is just too much to hold up after major weight loss. Would insurance cover excess arm/armpit skin and breast reduction? I've lost all the weight, and paid for other procedures for hidradenitis suppurativa on my own (body lift/thighplasty).

Kenneth Hughes, MD · Answer

Typically insurance companies required 500 grams composed of fat and glandular tissue be removed  from each breast.  You may just need another BL.  Depending upon how the skin redrapes and the contour looks, the PS makes judgments in creating the best looking breasts possible with the smallest scar.  It's unlikely that the arm lift will be covered by your medical insurance.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 medical insurance.  If not, your medical insurance may try to deny you based upon a lot of things such as weight, lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. 
Read your medical insurance certificate of coverage. Determine what medical information is required for your medical provider to issue a pre-authorization or predetermination of benefits for BR surgery.  Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, determine the amount of tissue to be removed, and help you in completing the paperwork required by your medical insurance company.

Scott C. Lindsay, DO · Answer

Thanks for your question! Depending on your insurance, I think there is a chance that insurance would cover a breast reduction; however, I think it's unlikely that it would cover the upper arm lift. I would suggest consulting with a board-certified plastic surgeon to evaluate your options. Best of luck!

Tim Neavin, MD · Answer

Thank you for your question. Sorry to hear about the pain you are experiencing. With documented information some insurance companies can possible cover a breast reduction. I with advise you to schedule a consultation with a board certified surgeon.

Gary M. Horndeski, MD · Answer

From your photographs, you do not appear large enough to meet insurance requirement for a breast reduction.  The technique I recommend is The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Insurance companies do not cover breast lift or brachioplasty for extra arm skin.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear selghadi,
it is hard to tell for sure without an examination. Breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term. 
If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Would insurance cover 2nd breast reduction (17 years later) and arm lift? (Photos)

Answers (8)

Answer: Insurance coverage is unlikely

Answer: Insurance coverage is unlikely

Answer: Breast reduction

Answer: Breast reduction

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.

Would insurance cover 2nd breast reduction (17 years later) and arm lift? (Photos)

Answers (8)

Answer: Insurance coverage is unlikely

Answer: Insurance coverage is unlikely

Answer: Breast reduction

Answer: Breast reduction

Browse related questions

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.