Breast Reduction vs Breast Lift, what do I qualify for?
Asked 2022-07-25
I would like to get a breast reduction and hopefully have it covered by our extended health plan. But I'm not sure if I will qualify. I have no gram requirement on my coverage.
My breast size (bust inch - band inch, 1"=1cup) has been as big as 32N while breast feeding. I have been trying hard to lose weight and I have now gone down to a 32i. That I cup is very saggy and deflated with excess skin.
I am hoping to lose another 20lbs so I imagine my size will go down a bit more.
At what point does it go from being a breast reduction to a breast lift?
I want to go down to a C cup. I still have a lot of tension, HA's, discomfort/pain from bras, and irritated skin under the breasts, but the pain has gone down as their size has been reduced.
Age:
40 years
Weight:
155 lbs
Height:
64.0 inches
Skin Tone:
Light -
1 answer
Procedure(s)
Thank you so much for your question.
A breast lift and reduction are similar procedures and often confused as the scar patterns can be identical. If you went the strict definition in plastic surgery textbooks a procedure becomes a reduction when you take more breast tissue (in the book 500g). Also a reduction is typically performed for functional reasons (pain, grooving, rashes) and is covered by insurance whereas a lift is for cosmetic purposes and is paid out of pocket.
IN the real world; a lift is a cosmetic procedure that is not performed for functional reasons (to eliminate pain etc). Though one could argue that a breast reduction ALSO has a cosmetic component to it as well.
The real question you may be asking is; will my procedure be covered by insurance still. To be covered by insurance; your surgeon will need to document you are having symptoms (neck pain, back pain, shoulder grooving), that you have tried conservative measures to eliminate symptoms (weight loss, NSAIDs, PT, chiropractics etc). Then we submit clinical photographs and document the expected amount of tissue in weight to be removed. The last part may pertain to your question as insurance providers use a system called the Schnurr scale in which for a given body surface area, your surgeon needs to remove a certain amount of tissue.
In order to optimize your long term results I would get to your goal weight before undergoing any procedure. After you reach your goal weight, meeting with a board certified plastic surgeon should be able to answer your questions.