Thinking about a Breast Lift/Reduction? - Here's what you need to know.

I hope everyone has adjusted to writing/typing 2020!  I still want to use '19!

I thought I would spend the next few weeks highlighting some of the most commonly performed plastic surgery procedures.  I am going to start with breast reduction and mastopexy surgery, otherwise known as a breast lift.  These are among the most frequently performed procedures not just by me, but across the field of plastic surgery.  Additionally, they are associated with high patient satisfaction rates!

So what is a breast reduction?  As the name implies, the surgery reduces the size of the breast.  In addition to the volume reduction, the breast is typically lifted, as well.  A breast lift alone (mastopexy) usually does not remove significant breast volume, and sometimes is performed in conjunction with placement of breast implants when a patient's volume is deficient or less than desired.

There are several techniques for a breast reduction and or lift.  Once in awhile I get a question as to whether the breast can be reduced by liposuction.  The short answer is "yes."  However, in my opinion, liposuction is not a preferred method because it does not address that skin laxity and sagging of the breast, which may be worsened after the liposuction. The most typical scar patterns are in the configuration of a lollipop or an anchor (the Wise pattern), though sometimes the scar may be fashioned only around the areola(e).  There are risks with any surgery, but one of the biggest downsides to the surgery is the fact that there are resultant scars.  I cannot emphasize scarring issues enough, though I my experience, breast reduction patients are accepting of the scars given the benefits afforded by the reduction and or lift.

Sometimes the surgery is performed simply for cosmetic concerns to achieve improved proportions, correct asymmetry, and address saggy breasts.  Sometimes a breast reduction is performed to address symptoms of back, neck, and shoulder pain, and also rashes under a woman's breasts.  For certain women, the weight of a woman's breasts may contribute to headaches, and the surgery may improve these symptoms as well.

In cases where the breast size is causing such symptoms, the surgery may be deemed medically necessary, and can be submitted to one's health insurance for coverage.  Unfortunately, even in the presence of symptoms, insurance companies do not always cover breast reduction surgery.

I have seen insurance companies with exclusion clauses in the policy regarding breast reduction surgery.  The insurance company also usually requires a pre-certification to determine eligibility for the surgery.  Many companies use something called the Schnur Sliding Scale to make their decision for coverage, which basically looks at the patient's height, weight, and bra size, as well as the amount in grams I estimate that I will remove; based on that calculation, the insurance company will grant an approval or denial.

Over the last year, I have been surprised by some of the denials that have come through my office. It makes me wonder whether this could be a trend, with insurance companies being less willing to cover breast reduction surgery.

Even when coverage is granted, out of pocket expenses may be comparable to when the breast reduction surgery is performed simply as a cosmetic procedure, after deductibles and copays are taken into account, because of high deductible plans (which are more and more common). 

If you or someone you know is interested in learning more about breast reduction and breast lift surgery, feel free to give the office a call, and well be happy to see you for a consultation.

Have a great week.

Dr. Heidi Williams