American Society of Plastic Surgeons
For Medical Professionals
4 years ago

Breast reduction and lift NYC Aetna

I am looking for a doctor who accepts Aetna to perform a breast reduction and lift. Concerns are sagging, breasts too big for clothes, and back pain. I want a smaller perky result with upper pole fullness. I am based in NYC area but willing to travel for a great doctor within my insurance. Any recs or advice?

Procedure: Breast Reduction
Location: Staten Island, NY

Replies 6

Steven Wallach
ASPS Surgeon
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I am not an Aetna provider but if you have out of network benefits and meet their criteria I can probably take care if you. Good luck

Larry Weinstein
ASPS Surgeon

Breast reduction for back, shoulder and neck pain is usually covered. I am not an AETNA provider but can work with out of network benefits. You will need documentation from your primary doctor, a back specialist, a physical therapist and or chiropractor. Good luck ..,

S. Daniel Huang
ASPS Surgeon

Hi, my office is in Great Neck, NY, which is just outside of Queens. We participate with Aetna. Please prepare for your appointment with the documentations as listed by Dr. Weinstein. The more that you have, the better chance that the procedure be authorized. You will need to be a non smoker and not be exposed to second hand smoke for at least 1 month prior to scheduling.

Below is a guideline for what the insurance companies consider medically necessary breast reduction.

Thank you for your inquiry.

Nelson Castillo

Thank you for sharing your question. You seem to be an excellent candidate to have this procedure covered and instead of searching by each individual physician practice, I would ask for a list of credentialed providers that can be given to you by Aetna. Hope this helps

Andrew Rosenthal
ASPS Surgeon

Thanks for your question. This is a difficult problem for many women. Breast reduction paid for by insurance used to be a simple equation based on amount of breast tissue removed and your body surface area (which is a calculation of height and weight). Times have changed. Most policies have weight requirements as well as others for documentation of rashes, back and neck problems, etc. not fixed by other interventions (dermatology treatments, physical therapy, weight loss, wide strapped bras and NSAIDs). This is unfortunate since even modest reductions can help women. Check your policy for individual requirements. For significant, long lasting upper pole fullness, fat grafting or an implant may be required. These portions are not usually covered by insurance. Make sure you get a pre-approval (which may be a long process) or you may get stuck with high bills if your insurance eventually denies it.


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