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Breast Reduction: Ranks High in Patient Satisfaction

March 30th, 2015

breast reductionJust as some women may experience a decrease in breast size over time, some will notice an increase in breast size, others simply want a change. When a woman is uncomfortable with having too much breast tissue, there are several options to correct this condition. A  dramatic  increase in size may have resulted due to an increase in overall weight gain or a pronounced sagging of the breast tissue. As we’ve discussed in earlier posts, overly large breasts may cause physical discomfort, including  symptoms like neck pain, back pain, shoulder grooving and irritation beneath the breasts. Patients routinely turn  to breast reduction or breast lift surgery to reduce their symptoms, along with their breast size and or position. Patient satisfaction rates are particularly high for this cosmetic surgery. Reducing breast size can be done with direct surgical removal of breast tissue or by using liposuction. Liposuction is effective only when there is a significant amount of fat in the breasts. Liposuction does not adjust nipple position, which requires removing and re-positioning the nipple.

Traditional breast reduction surgery reduces breast size through excision of breast tissue, while repositioning the  nipple and areola (pigmented skin around the nipple). The size of the areola  can also be reduced. Breast reduction scars, which are similar to breast lift surgery, are placed around the nipple and beneath the breast as well. Scars will be less noticeable as they continue to heal. I recommend any breast tissue that is removed should be sent for examination by a pathologist. This laboratory examination includes a  visualization under a microscope after tissue  staining, to determine the presence of conditions or abnormalities which might increase chances of breast cancer. On rare  occasions, breast cancer is diagnosed this way.

Our patients choose of their desired final breast size, based on decisions made during our office consultation, unless insurance is being considered. A range of implant “sizers” are helpful in this regard.
 The appropriate time to schedule reduction surgery following pregnancy is determined by normal involution of breast tissue and the end to breast-feeding. Generally this takes six months to a year after delivery or three months after ending breast-feeding. There is a possibility that some women will not be able to breast feed again after breast reduction surgery. Therefore, if breast-feeding  is an important consideration, we advise our patients to postpone breast reduction surgery until they are finished having children. According to statistics provided by the American Society of Plastic Surgeons (ASPS), more than 120,000 patients have chosen breast reduction/ lift surgery last year.  

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Is Weight a Factor in Breast Reduction Insurance Coverage?

March 26th, 2015

 scale w braIt is common for insurance companies to require a certain amount of breast tissue be removed from each breast in order for  the breast reduction  to be considered a medically necessary procedure covered by insurance. The proposed amount or weight of breast tissue to be removed is determined based on your height and weight. Often this weight requirement is in conflict with a woman’s aesthetic goals. Insurance companies are less concerned with the way you look. Yet physical appearance after breast reduction surgery can have an impact on quality of life regardless of the weight of breast tissue removed. Breast reduction procedures are often performed as an elective procedure without insurance coverage. Patients choosing elective cosmetic breast reduction have control of the volume of breast tissue removed. They report a high degree of satisfaction as a result.

Dr. Paul Schnur, a Mayo Clinic affiliated plastic surgeon, in 1991 developed the sliding scale from a survey that asked plastic surgeons. Years later, he challenged insurance carriers’ use of the scale and indicated that the scale may no longer be useful criteria for insurance coverage.

Each person responds differently to the physical symptoms of having large breasts. Breast reduction should be considered within the context of each individual woman’s quality of life. If you disagree with your insurance carrier’s decision, you are entitled to multiple levels of appeal of which you should take advantage. Letters from a family doctor, physical therapist, chiropractor, or massage therapist can help support an appeal. You should write your own letter describing your physical symptoms and how they have limited your quality of life. Ask your plastic surgeon to submit your personal letter, supporting letters and a list of medical literature references with the appeal.  

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