I have poland syndrome. And was told I have to get a tissue expander to stretch my skin etc . My right side has no breast but my left side does and it’s. 36 D cup. That side hurts the most. And my breast saggs. Saying I need a lift on that side always gets my claim denied. What can I say so it can be approved as medically necessary
Answer: Surgery Insurance does not cover breast lifts, since this is cosmetic, but will cover a reduction, which does include a lift. To balance your opposite breast, I would suggest a reduction. If you want to be a D cup, you will need tissue expanders first. Only with a mastectomy for cancer is the opposite breast lift approved.
Helpful
Answer: Surgery Insurance does not cover breast lifts, since this is cosmetic, but will cover a reduction, which does include a lift. To balance your opposite breast, I would suggest a reduction. If you want to be a D cup, you will need tissue expanders first. Only with a mastectomy for cancer is the opposite breast lift approved.
Helpful
April 28, 2024
Answer: Poland syndrome Dear polanddepress, you can use tissue expanders to stretch skin before you get implant on that side. Also, it looks like you would need breast lift on larger breast. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations. Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery
Helpful
April 28, 2024
Answer: Poland syndrome Dear polanddepress, you can use tissue expanders to stretch skin before you get implant on that side. Also, it looks like you would need breast lift on larger breast. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations. Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery
Helpful
April 26, 2024
Answer: Breast reduction Thanks for your question! Unfortunately, insurance doesn't always help when we need them to. I would suggest a reduction for the larger, droopier side. That might be an option. Best of luck!
Helpful
April 26, 2024
Answer: Breast reduction Thanks for your question! Unfortunately, insurance doesn't always help when we need them to. I would suggest a reduction for the larger, droopier side. That might be an option. Best of luck!
Helpful
April 27, 2024
Answer: Breast implant + other side we can do breast lifting with implant Hello, thank you for your question, we can do breast implant and for the other side we can do breast lifting with implant, If you want to check the doctor's Instagram page, I added the link, you can take a look and have an idea about the surgery. We can offer you a virtual consultation for a better evaluation, please send us your full name and phone number on our email: hi@estherianclinic.com. We will contact you as soon as possible. Hope it helped!
Helpful
April 27, 2024
Answer: Breast implant + other side we can do breast lifting with implant Hello, thank you for your question, we can do breast implant and for the other side we can do breast lifting with implant, If you want to check the doctor's Instagram page, I added the link, you can take a look and have an idea about the surgery. We can offer you a virtual consultation for a better evaluation, please send us your full name and phone number on our email: hi@estherianclinic.com. We will contact you as soon as possible. Hope it helped!
Helpful
April 28, 2024
Answer: Treatment options To get quality outcome requires as staged approach that should be thought through carefully before having any surgical intervention. Have you had any surgery on your right side? You definitely need a lift on your left side and mostly a reduction for the sake of symmetry. Understand first and foremost what your right breast is going to look like then plan symmetry surgery accordingly. Symmetry surgery is covered for patients who have breast cancer, but may not be covered for Poland syndrome. You need to read your insurance policy carefully and see what’s covered and what’s not. Medical insurance is a contracted agreement, and certain things are covered and certain things are not. It’s not subjective it is objective. An expander is one option. If you opt for an expander, then that should be the first surgery. There are significant advantages and disadvantages to using expanders. They tend to create a lot of scar tissue and thick capsules that can be long-term problems. They can also stretch out tissues to accommodate a much larger implant. You need to be assessed to understand if you’re pectoralis muscle is fully developed or not. Your situation is complex and you should be in the hands of plastic surgeons who have extensive experience with breast reconstruction. Your situation is far beyond what’s appropriate to get solid advice posting on this website. To find the right provider sometimes requires having multiple in person consultations. Look for who does most of the breast cancer reconstruction in your community. Consider academic medical institutions if there are any medical schools in your area. Symmetry, surgery may not be a covered benefit under your plan. I’ve only seen that covered for patients with a breast cancer diagnosis. What’s covered and what’s not should be in your insurance contract. Reading through medical legal contracts is tedious but that’s where you need to start. Best, Mats Hagstrom, MD
Helpful
April 28, 2024
Answer: Treatment options To get quality outcome requires as staged approach that should be thought through carefully before having any surgical intervention. Have you had any surgery on your right side? You definitely need a lift on your left side and mostly a reduction for the sake of symmetry. Understand first and foremost what your right breast is going to look like then plan symmetry surgery accordingly. Symmetry surgery is covered for patients who have breast cancer, but may not be covered for Poland syndrome. You need to read your insurance policy carefully and see what’s covered and what’s not. Medical insurance is a contracted agreement, and certain things are covered and certain things are not. It’s not subjective it is objective. An expander is one option. If you opt for an expander, then that should be the first surgery. There are significant advantages and disadvantages to using expanders. They tend to create a lot of scar tissue and thick capsules that can be long-term problems. They can also stretch out tissues to accommodate a much larger implant. You need to be assessed to understand if you’re pectoralis muscle is fully developed or not. Your situation is complex and you should be in the hands of plastic surgeons who have extensive experience with breast reconstruction. Your situation is far beyond what’s appropriate to get solid advice posting on this website. To find the right provider sometimes requires having multiple in person consultations. Look for who does most of the breast cancer reconstruction in your community. Consider academic medical institutions if there are any medical schools in your area. Symmetry, surgery may not be a covered benefit under your plan. I’ve only seen that covered for patients with a breast cancer diagnosis. What’s covered and what’s not should be in your insurance contract. Reading through medical legal contracts is tedious but that’s where you need to start. Best, Mats Hagstrom, MD
Helpful