When a Person Under Goes Breast-reduction Paid by Insurance Will a Breast Lift Be Needed? Or is All in One?

Cause I got approved through my insurance company. surgery date oct.4 but he won't do my surgery cause he says i need to pay for the breast lift.but they tried to do finance but it ain't work out cause I have insufficient credit and my friend came out no credit at all so his secretary said that they'll have to canceled everything on the dr.information and I'll have to try to get requalify through another dr.that will do the surgery without the breast lift plz help!

Doctor Answers 5

Breast Lift a Partner of Breast Reduction

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I know of no methods of breast reduction that do not also include a breast lift.  A straightforward breast reduction done for cosmetic purposes or paid for through insurance should be almost identical.  Occasionally, however, we add on other procedures such as lateral chest liposuction in order to get an improved result.  This is not part of what is covered by insurance.  If this is done during an insured procedure, it is reasonable to charge extra for it.  Many physicians also do not contract with the insurance company but will bill the insurance company.  This means that they charge you the difference between their fee and what the insurance company pays.  It may be that the person you saw is trying to make up this difference another way.  I suggest that you obtain from your insurance company a copy of the certification that you obtained with the first physician and take it to a board certified plastic surgeon who is on your insurance company's list of providers.


Highlands Plastic Surgeon

Both a lift and reduction are performed at the same time

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virtually all breast reductions include a breast lift as part of the procedure. you need to get a different surgeon, who is a board certified plastic surgeon.  he should not be charging you for a lift after a BR.

david berman md

plastic surgeon, northern va

Will a Breast Lift Be Needed as part of a #BreastReduction?

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I would say that virtually all breast reductions performed surgically (ie, not with liposuction alone) have both a reduction and a lift as part of the procedure.  (The reverse is not true - there are many breast lifts that would not qualify strictly-speaking as reductions.)  If you have enough breast tissue to warrant its being covered by insurance then you would normally have a breast lift performed as part of that procedure.  That being said, a surgeon who is not a participating provider in your plan - and assuming you have out-of-network benefits - is not automatically obligated to accept your insurance as full payment.  You, though, have the right to find a surgeon who does participate in your plan and who will accept it as full payment.  

I hope that this helps and good luck,

Dr. E

Is breast lift part of a breast reduction

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I am sorry to say this, but your doctor is trying to scam you.  Let's face it, a breast reduction is a $10,000 case and many of the managed care companies pay less than $2,000.  However, the lift is essentially part of the reduction.  More bad news--you will have to go through the preauthorization process again with a new doctor.  This may have been a blessing in disguise

Breast Reduction=Breast Lift

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A breast reduction typically includes a breast lift as part of the procedure. I recommend seeking a second opinion.  Good luck and best wishes.

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