What are the odds of my insurance covering a revision?

Question

I developed a seroma in my right breast a few days after surgery. Three weeks post op, my doctor went back in to evacuate it. Because of the seroma, my breast is larger than my left. It's alsoo sllightly deformed and bulges on the side. This makes it feel awkward when my arm is down at my side and sometimes painful. Im also having a hard time find bras that fit my right breast without being too big for my left breast. What are the odds of my insurance covering a revision to correct it?

Gary M. Horndeski, MD · Answer

If you have a breast reduction covered by insurance then they should also cover a revision due to a complication.  If you did the reduction electively and paid out of pocket then they probably will not cover a revision.

Best Wishes,

Gary Horndeski, M.D.

Scott C. Lindsay, DO · Answer

Thank you for your question.
It will take time to heal and for your breasts to settle. Reach out to your surgeon with these concerns. I suggest calling your insurance company to see if a revision is a covered benefit for you. Best wishes!

Krishna Vyas, MD, PhD, MHS · Answer

The likelihood of your insurance covering a revision for complications, such as a seroma or asymmetry, largely depends on whether the original surgery was covered by insurance and whether the revision is considered medically necessary. If your breast reduction was covered by insurance and the complication (such as the seroma and resulting deformity) occurred as a result of that procedure, many insurance companies may cover the revision surgery. However, if the surgery was elective (e.g., paid out of pocket), they may not cover the revision. It is best to contact your insurance provider directly to discuss your situation, and your surgeon can assist in submitting the necessary paperwork. The office may also have a revision policy.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Camille Cash, MD · Answer

You can begin by contacting your insurance carrier to discuss your situation and find out the criteria that would be needed for approval if coverage is available.  Your surgeon can help you to submit the correct paperwork.  If not, your surgeon may offer to work with you on costs to revise your reduction.

Connie Hiers, MD, FACS · Answer

If this occurred after a breast reduction, your insurance company may cover the revision. It would be best to contact your company for prior approval, especially if prior approval was needed prior to your first surgery.

What are the odds of my insurance covering a revision?

Answers (5)

Answer: Insurance coverage

Answer: Insurance coverage

Answer: Revision

Answer: Revision

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What are the odds of my insurance covering a revision?

Answers (5)

Answer: Insurance coverage

Answer: Insurance coverage

Answer: Revision

Answer: Revision

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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.