Breast reduction without breast lift?
I have Aetna Choice PPO II plan and my insurance will pay for my breast reduction if I meet the criteria. However, their Explanation of Benefits says they don't pay for breast lifts AT ALL so here's my question. Is it possible to have a breast reduction (from size F reduced to size D) without a lift? I really think it would result in freakish breasts without a lift and there's no way I'd go through with it if that were the case. Thanks for your help.
Most insurance companies do not pay for breast lifts because true breast lifts remove far more skin than breast tissue. Breast reductions remove significant amounts of breast tissue and skin. Therefore, in a properly executed breast reduction a lift is a necessary part of the procedure.
As the previous physicians have stated, an elevation of the breast to a more appropriate level on the chest is done as part of the reduction. If is not consider a separate procedure and is not billed as such.
There should not be a problem. When your surgeon performs the breast reduction procedure, they will be lifting and re-positioning the remaining breast tissue to give you a pleasing appearance. That's a routine part of breast reduction. He or she would not be separately listing a breast lift procedure (mastopexy) even though lifting is done, because it is included under the definition for the reduction already. Your insurance company appears to mean that they would not pay for a lift without reduction, which is considered cosmetic rather than reconstructive.
A Breast Lift is often considered part of the Breast Reduction Surgery. Consider addressing your concerns with your Plastic Surgeon who pre-approved your surgery.
Best,
Gary R Culbertson, MD, FACS