I have Medical which has no plastic surgeons in network to pay for medically necessary reduction. What should I do? (Photo)

I'm a 32I. I've not been nursing for 5 months and had hoped for more shrinkage than I got. I have suffered cronic neck, back, and sholder pain since I was 19 and a 32g. Im in my 20s and have begun experiencing numbness in my arms and hands. I do daily strengthening and stretching exercises for my core and neck which I learned from the physical therapy I began five years ago, but had to stop attending because my copay was too high. I can't imagine how bad this will be by the time I'm in my 30s.

Doctor Answers 10

Lipo-lift, breast lift, breast reduction, mastopexy, benelli, augmentation mastopexy

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I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same. A lot of patients come to see us when insurance wont cover. We offer financing to assist. 

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon



University teaching programs

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will accept Medi-Cal so contact one of the programs to get scheduled.  I'm sorry that no private practice plastic surgeons accept this but no one can keep a viable practice with Medi-Cal reimbursements.  If you choose to go private pay, you can obtain financing from Care Credit and Prosper  and see what you qualify for... then find the surgeon whose costs are most reasonable.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

I have Medical which has no plastic surgeons in network to pay for medically necessary reduction. What should I do?

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You should go to the plastic surgery clinic at The University of California San Diego Medical School and make an appointment.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon

Finding plastic surgeon for breast reduction procedure…

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Thank you for the question. Based on your description, it sounds like you may be an excellent candidate for breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.

 You are correct in that Medical has been known to cover breast reduction surgery. For multiple reasons, most plastic surgeons that I know of do not work with this organization any longer. 

Ultimately, you may need to save up for the procedure and/or utilize finance companies in order to have the procedure performed by a well experienced board-certified plastic surgeon.  You may find the attached link helpful to you as you learn more.

Best wishes.

Breast reduction under Medi Cal

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from your photos it is impossible to know whether your reduction is large enough to qualify for coverage anyway.  However, it is is you should consider going to the plastic surgery decorate the at UCSD.  That would be your best chance and they do excellent work.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast reduction and insurance

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Hi and very sorry to hear about your medical problems. Many highly skilled and experienced plastic surgeons have opted out of taking insurance due to poor reimbursement and the hassles of dealing with these companies. Please visit with an experienced and board certified plastic surgeon to discuss your options. That's my best advice after my decades of experience with aesthetic plastic surgery. Good luck!

Richard Chaffoo,MD,FACS,FICS

Triple Board Certified Plastic Surgeon


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Thank you for the question and go on some complimentary consultations till you find a surgeon who can work with you to get your procedure covered 

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Breast Reduction

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I understand all the suffering you've been through all these years due to the weight of your breasts, that can change with a reduction of breasts.
It is essential to look for a BOARD CERTIFIED PLASTIC SURGEON. That is endorsed by the official society of their country, which are those that certify that surgeon has the appropriate training.

Mármol Shailyn MD

Shailyn Marmol, MD
Dominican Republic Plastic Surgeon

Scarless reduction

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there is a significantly less expensive option which is also quicker simpler safer with virtually no downtime.  Find a board-certified plastic surgeon in your area specializes in the Liposuction only operation. it's certainly not perfect but it might be something to get you through this very difficult time. 

Sherwood Baxt, MD
Paramus Plastic Surgeon

Breast Reduction and Insurance

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Unfortunately there are some insurance companies that do not cover breast reduction surgery. You might try to change to another provider that does cover it. Otherwise perhaps you could finance your surgery through a company like Care Credit that specifically makes loans for cosmetic surgery. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.