- Dr. Nicolas Zwillinger, Plastic and Cosmetic Surgery
Is it possible to have breast reduction surgery covered by Medicare?
Breast reduction, also known as breast reduction surgery, is a surgical procedure designed to correct breasts that are excessively large, by removing excess fat, breast glandular tissue, and skin from the breasts to achieve a breast size more proportionate to the patient’s body, relieve the discomfort associated with overly large breasts, and ultimately improve the patient’s silhouette.
Breasts that are too heavy and disproportionate can cause distress for patients. They typically experience physical discomfort due to the weight of their breasts. The resulting pain can make it difficult to engage in everyday physical activities.
Breast reduction surgery is intended for people whose breasts are too large, sagging, or heavy, and out of proportion with their body type, which can lead to the following problems:
Breast reduction surgery covered by Medicare is provided in cases of confirmed breast hypertrophy—breast hypertrophy is caused by abnormal development of the mammary gland in both women and men (gynecomastia: breast reduction for men) with or without excess fat—which requires the removal of at least 300 grams of tissue from both breasts (corresponding to a reduction of 2 to 3 bra cup sizes).
If less than 300 grams are removed from each side of the breast during the procedure, the operation is considered purely cosmetic surgery and is therefore not covered by health insurance.
The result of a moderate breast reduction (the patient’s left breast) to correct breast asymmetry.
Breast reduction surgery covered by insurance is performed either under general anesthesia on an outpatient basis or with an overnight hospital stay. The procedure takes between 1.5 and 2 hours.
Breast reduction surgery is typically performed using incisions that either form a circular pattern around the areola or consist of an inverted T-shaped incision around the areola and a vertical incision extending to the breast crease.
The technique used to reduce breast size will be determined based on the composition of the breasts, the desired breast size, the patient’s personal preferences, and the plastic surgeon’s recommendations.
Once the incision has been made, the nipple—which remains connected to its original blood and nerve supply—is then repositioned. The areola is reduced by excising skin around its perimeter, if necessary.
The underlying breast tissue is reduced, lifted, and reshaped. In some cases involving extremely large, sagging breasts, it may be necessary to remove the nipple and areola and reposition them higher on the breast.
The incisions are closed and sutured to create a smaller breast. Sutures are placed deep within the breast tissue to shape and support the newly formed breasts, and near the surface to close the tissue and skin.
A successful breast reduction can significantly relieve pain in the upper back, neck, and shoulders. It can also make it easier to resume physical and social activities and help improve self-esteem.
The results of a breast reduction are visible immediately after the procedure; however, you should plan to resume physical activity 2 to 4 weeks after the operation (with a one- to two-week recovery period). It is recommended that you wear acompression braday and night for the first 2 weeks following the procedure. Postoperative pain is moderate; pain medication is prescribed by the plastic surgeon performing the procedure.
It takes three months for the final results to become apparent, as this is how long it takes for post-operative scars to begin fading. There is alsoIPL (Intense Pulsed Light) technology, which can help fade these scars more quickly.
However, it is important to keep in mind that aging, weight fluctuations, pregnancy, and other factors can cause changes in the size or shape of the breasts over time.
The main difference between the two procedures is simply that with a breast lift—which aims to lift sagging breasts (a breast lift procedure without implants)—patients end up with firmer, more shapely breasts after recovery, but the size of the breasts remains unchanged: they will be neither larger nor smaller, whereas a breast reduction significantly reduces the size and weight of the breasts by removing excess fatty tissue, breast glandular tissue, and breast skin.
If you are considering breast reduction surgery, talk to your board-certified plastic surgeon. It is important to understand what breast reduction surgery involves, how it is performed, including the risks and complications.