Reduction Mammoplasty (Breast Reduction)

By: Oklahoma Plastic Surgeons

Posted in General, Mammoplasty | January 21, 2019

Breast reduction, also known as reduction mammoplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size more proportionate with your body size. Breast reduction will help alleviate back, neck and shoulder pain and discomfort associated with large, pendulous breasts (macromastia).

The excessive weight of breast tissue can limit your ability to lead an active life. In addition to pain and discomfort, other important concerns to consider are self-image issues, emotional discomfort, and self-consciousness.

If you are considering breast reduction surgery, you may be a good candidate if:

1. You are in good physical health
2. You have realistic expectations
3. You don’t smoke
4. You are bothered by your excessively large breasts
5. Your large breasts limit your physical activity
6. You have persistent back, neck and shoulder pain due to the weight of your breasts
7. You have shoulder indentions and skin irritation beneath your breast crease

When choosing a surgeon to perform your breast reduction procedure, it is important to remember that the surgeon’s experience and your comfort with the surgeon are important. You want to research your surgeon thoroughly and choose a board-certified plastic surgeon.

Aesthetic breast reduction costs may include:

• Surgeon’s fee
• Anesthesia Fees
• Facility Fees
• Post-Operative Support Bras
• Prescriptions

Some health insurance plans cover reduction mammoplasty based on pre-conditions. Prior authorization from your insurance carrier will be required. You will be financially responsible for any co-insurance and deductibles. Prior authorization can be somewhat difficult, however, with appropriate documentation the process can be simplified. If you are planning to utilize health insurance benefits to cover the procedure costs, you must meet certain criteria. You and your surgeon of choice will be required to submit the following documentation:

1. A letter of medical necessity along with photographs from your plastic surgeon documenting symptoms, physical findings, and total weight to be removed
2. 2-3 documented reports from other specialists (chiropractor, orthopedist, pain management physician, physical therapist) indicating 6-12 months of failed conservative therapy
3. Secondary consultations with other health care providers

Once you meet the criteria established by your health insurance carrier, the insurance company may then consider breast reduction as a reconstructive procedure and cover the surgery. The criteria will vary from insurance company to another. Your health insurer can provide a written policy of their criteria. You can also contact, Holly, at Dr. Webster’s office and she will be happy to guide you through the process and answer any questions you may have that relate to breast reduction surgery and health insurance coverage.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.