American Society of Plastic Surgeons
For Medical Professionals
2 years ago

Will i be eligible for insurance coverage

I just had a consultation for breast reduction surgery. I have been experiencing back shoulder and neck problems for years my surgeon says i meet all of the other requirements as far as my chronic pain and bra strap grooves in skin moisture under my breasts. But he can only remove 150g per breast. Im waiting on insurance to approve or deny me.

Procedure: Breast Reduction
Location: culpeper, VA

Replies 2

Gary Culbertson
ASPS Surgeon
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Insurance company's dictate health care coverage. Most insurance carriers are going to base the amount of breast tissue resected per breast in a patients breast reduction based upon a patients height and weight (BMI). A minimum resection weight per breast can often be 400 grams. In terms of weight remember there are 454 grams in a pound.

A breast lift or mastopexy typically can have a lower weight of breast resection. Breast Lifts are considered "Cosmetic Surgery" and not normally covered service by the majority of health care insurance carriers.


Gary R Culbertson, MD, FACS

Nelson Castillo

Thank you for sharing your question. If that weight is what is anticipated for removal it is unlikely to be covered by insurance, but your surgeon can always submit the paperwork and see what your insurance says.


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