It is not mysterious as to what makes a breast reduction medically necessary as most health insurance carriers have a very specific list of requirements. In fact, it is one of the most scrutinized of all plastic surgery procedures covered by insurance. There are several important issues including your weight and breast size, how much tissue the plastic surgeon plans to remove, documentation of painful symptoms, and what other non-surgical treatments have you had.
Your body weight is an important consideration. if you are over 20% of your ideal body weight, your insurance company may say you need to lose weight first. We all know that weight loss will not decrease the size of your breasts (it some cases it may make the skin sag more, causing greater strain on your neck, shoulders, and back), nevertheless, this is a criteria that insurance companies use. At the least, if you are overweight, attempts at weight loss must be done and documented. If you can only lose so much weight, then so be it. But some weight loss effort may be required.
Breast size is an obvious important criteria. There is no precise breast size that makes the cut-off for insurance coverage. Rather it is a combination of your height, weight, and breast size. Technically, your height and weight are put into a formula to create your BSA. (body surface area) Based on your calculated BSA and the amount of breast tissue your plastic surgeon says will be removed (there is an industry standard graph and table which determines this) is the numerical determinant for medical eligibility. The amount of breast tissue your plastic surgeon says he will remove is an estimate but that submitted number is of critical importance. The whole concept of this numerical determinant is for the insurance company to determine that they are not really paying for a breast lift which is mainly a cosmetic operation. I call this compensation for the 'sins' of the past done by plastic surgeons from decades ago.
One of the hardest criteria to document, but is one of the big three, is what have you done non-surgically that may make your breast and body pain go away without surgery? We all know that nothing short of reducing large breasts will make their symptoms go away, but again, we must play by their rules. Some form of physical therapy, chiropractic treatment, or even acupuncture must usually be tried first (for three months) and documented that it did NOT work. Most breast reduction consults that I see are usually lacking in this criteria of eligibility. It may feel like a waste of the insurance's money and your time, but it often must be done.
To determine possible medical coverage, your plastic surgeon will take photos and measurements of your breasts and bundle up all of the information listed above and send it to your insurance company. The more complete this information is, the less likely you will get a letter (4 to 6 weeks later) that says there is not enough information to make a predetermination. Your breast reduction may be determined to be medically necessary if you meet all the required criteria! It can be a slow process, and it may take more than one letter from your plastic surgeon, but persistence and perseverance is the key to a medical necessary breast reduction.
Some men have deposits of excess breast tissue and fat in their breasts, giving their bodies a somewhat female form. While sometimes related to the effects of medicines or a hormonal imbalance, these inciting causes are not often found to be a factor. A root cause is rarely determined for individual cases, and most cases are a matter of bad luck!
Correction of this problem known as Gynecomastia is usually able to be accomplished with a procedure Liposuction. In rare cases, there is so much extra skin that this must be reduced as well as the internal deposits.
This is generally an outpatient procedure performed at a state of the art outpatient surgery center, requiring only 2-3 days of recovery time.
What is Male Gynecomastia?
Studies show that 30% to 60% of adult men will develop a condition we call male gynecomastia, or excessive growth of breast tissue, over the course of their lives. Although the condition isn't usually serious, it can be linked to potentially dangerous health problems, so the best advice is to see your doctor.
First, your doctor will do a simple physical examination, feeling the area to see if the problem is caused simply by excess fat. If so, he or she may recommend that you get some exercise and lose some weight. However, if your doctor detects an abnormal growth of glandular tissue, the next step is to figure out why.
Being overweight may still be part of the explanation. Excess fat tends to cause a man's body to produce more of the female hormone estrogen, which can stimulate breast tissue growth. In about one-fourth of cases, excess breast tissue from puberty doesn't go away as it normally would. In another fourth of the cases, gynecomastia is caused by such medications as hormone supplements, blood pressure drugs, or diuretics that either push up estrogen levels or block the production of male hormones. An equal number of cases are linked to more serious problems; for example, some potential causes could be tumors that affect the glands that produce hormones. And for the remaining cases, the cause is still unknown.
Usually, something can be done about the problem. If weight loss doesn't solve it, plastic surgery may be needed to remove the excess tissue from your chest area.
Having excess breast tissue may be embarrassing to you, but in most cases it is not serious and can be easily treated.
Both Dr Barry Eppley & Dave Stringham are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Dr Barry Eppley has sinced written about articles on various topics from Anger Control, Cosmetic Surgery and Botox. Dr Barry Eppley, board-certified plastic surgeon of Indianapolis, is in private practice at Clarian Health in two suburban Indianapolis locations. He writes a daily blog on plastic surgery at. Dr Barry Eppley's top article generates over 165000 views. to your Favourites.
Dave Stringham has sinced written about articles on various topics from Tummy Tucks Before and After, Health and Breast Enlargements. Beverly Hills Physician is an online resource for Learn more about this and other plastic and. Dave Stringham's top article generates over 368000 views. to your Favourites.