Do surgeons remove armpit fat when doing a Breast Reduction?

Question

I am considering getting a breast reduction through my insurance and I was wondering if surgeons usually remove armpit fat as well when doing a breast reduction.

David Shokrian, MD · Answer

Hello and thank you for this question. This is a topic I’m asked about during every consultation I do for both breast reduction and breast augmentation. There is an area of fat right under the armpits that plagues women of all shapes and sizes. It’s very simple to treat with liposuction during your procedure. It’s not typically covered by insurance but the cost, time and recovery are often minimal and can be done at the same time as your reduction or performed later under local anesthesia in the office. HopeThat helps

James N. Romanelli, MD, FACS · Answer

Dear Terrific

Thanks you for your question, and the answer is "It Depends"

Armpit fat may be a little bit of fat, which can be removed by liposuction and is generally not covered by insurance.  But if there is a large amount of tissue, that tissue may be breast tissue, called "axillary breast tissue" or "ectopic breast tissue."  In most cases an insurance company that covers your breast reduction will also cover surgical removal (cutting away) of that axillary breast tissue.

In the link below, our patient underwent breast reduction and liposuction of the armpit fat.

Best of Luck,
Dr. Jim Romanlli

Jonathan Heistein, MD · Answer

Hi.  The fat in your armpit can be addressed and removed at the time of your breast reduction, but that part would not be covered by your insurance.

Jacob Carlson, MD · Answer

Surgeons have the ability to remove armpit fat during the same case, but that portion of the surgery likely would not be covered by insurance. The insurance company will say that they are covering a breast reduction surgery that is being performed with the intent of improving symptoms of macromastia (e.g. shoulder pain, shoulder grooving, neck pain, upper back pain, headaches, rashes underneath or between the breasts). Fat that is in the armpit area is not contributing to those symptoms, so your insurance company will likely reject paying for that.
That being said, your surgeon may still be able to perform the surgery if he/she strictly documents the time at which the surgery transitions from a "insurance-based" surgery to an "aesthetic surgery." In that instance, the patient will usually pay for the anesthesia fees, surgeon's fees, and/or facility fees for the aesthetic portion of the surgery but not necessarily for the breast reduction portion.

Emily C. Wirtz, MD · Answer

Assuming you meet criteria for medical necessity for breast reduction through your insurance carrier, you can expect your insurance to cover only the removal of excess breast tissue. Any additional procedures such as skin or fat removal by direct excision or liposuction will not be covered by insurance. Depending on where the excess fatty tissue is, you may be a great candidate for some lateral chest liposuction to address the stubborn tissue that interferes with your bra band under your arm. Some women have skin excess that extends from the breast towards the back in this area, and that might be contoured with skin removal at the time of breast reduction, but leaves a significantly longer scar. It would be best to mention all of your concerns to your surgeon when you schedule your consultation with a board certified plastic surgeon, that way she can be sure to address each of them.

Do surgeons remove armpit fat when doing a Breast Reduction?

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