Breast Lift | The Office of Dr. Vincent Hung
Breast lift surgeries continue to rise in popularity—the American Society of Plastic Surgeons reports a 30% increase in breast lift procedures from 2019 to 2022 alone. This signals a growing trend among women seeking to restore their breasts’ natural position and shape. For many women considering this procedure, the primary concern is cost, which often prompts questions about insurance coverage. Since insurance providers maintain strict guidelines between cosmetic and medical procedures, getting coverage requires meeting specific criteria. This blog puts these considerations in perspective.
Why Get a Breast Lift?
A breast lift, also called mastopexy, helps women achieve firmer, more youthful-looking breasts. During this surgery, your plastic surgeon removes extra skin and lifts the breast tissue to create a natural, uplifted shape. Beyond the physical improvements, patients often find renewed confidence in their appearance and greater comfort in their daily activities.
Here are common reasons to consider a breast lift:
- Restore breast shape after pregnancy and breastfeeding
- Improve breast appearance after significant weight loss
- Correct naturally sagging breasts
- Address uneven breast position
- Reposition downward-pointing nipples
The best candidates for breast lifts are women at a stable weight, in good health, and have realistic expectations about the results. Ideally, candidates should be finished having kids, as future pregnancies can affect the surgery’s results. Before proceeding, schedule a consultation with a board-certified plastic surgeon to discuss your goals and medical history.
The Difference Between a Cosmetic and Reconstructive Breast Lift
Most breast lift procedures are performed for cosmetic reasons, like improving your appearance or boosting self-confidence. That said, some cases qualify as medically necessary. Understanding this distinction is important for insurance coverage purposes.
Cosmetic breast lifts focus on improving the appearance of sagging breasts caused by natural aging or changes after pregnancy. These elective procedures help women feel more confident but aren’t considered medically necessary. On the other hand, reconstructive breast lifts address specific medical conditions, such as rebuilding breasts after cancer surgery, correcting severe asymmetry, or repairing injury-related damage.
Insurance companies generally limit coverage to medically necessary procedures. This means they will cover reconstructive breast lifts if properly documented medical conditions exist.
When Is a Breast Lift Medically Necessary?
As mentioned earlier, insurance companies may cover breast lifts when medical conditions justify the procedure. While cosmetic concerns often motivate patients to consider breast lifts, several physical symptoms can make this surgery medically necessary.
A breast lift might be considered medically necessary when patients experience:
Physical Discomfort:
- Chronic back pain
- Persistent neck strain
- Shoulder discomfort
Skin-Related Issues:
- Recurring rashes under the breasts
- Frequent skin infections
- Irritation that doesn’t respond to treatment
Daily Life Impact:
- Limited physical activity
- Sleep disruption
- Restricted movement during regular activities
Coverage for a Medically Necessary Breast Lift
Getting insurance coverage for a breast lift requires substantial medical evidence to support your claim. While most insurance providers classify breast lifts as cosmetic procedures, they may approve coverage if you can demonstrate genuine health issues that require surgical intervention.
Building a strong case begins with thorough medical documentation. Your healthcare providers should record all symptoms, treatments, and their outcomes, usually over 6-12 months. Be sure to include reports from various medical professionals, such as your primary care physician, specialists, and physical therapists.
How to Increase the Chances of Coverage:
- Keep detailed records of your symptoms and their impact on your daily life
- Collect evaluations from multiple doctors
- Document all previous treatments that didn’t work
- Ask your doctors for letters stating why you need the surgery
- Work with your surgeon to submit the proper insurance codes
Remember that each insurance provider has different requirements, so contact your insurance company early in the process to understand their specific coverage criteria and documentation needs.
Interested in a Breast Lift in Pasadena, CA?
While insurance coverage for breast lifts depends on several factors, Dr. Vincent Hung and our experienced team have successfully helped many patients secure coverage for their procedures. As a triple board-certified plastic surgeon with extensive experience in breast surgeries, Dr. Hung combines advanced surgical techniques with attentive care to deliver beautiful, natural-looking results.
Ready to discuss your breast lift options? Schedule a consultation with Dr. Hung by calling our Pasadena office at (626) 432-5032 or completing our online form. Our friendly staff is here to help you understand your coverage options and create a treatment plan that meets your goals.
