A breast lift is a procedure that reshapes sagging breasts by removing excess skin, tightening and lifting the tissue around the nipples and areola (the dark area surrounding the nipple), and repositioning the nipple/areola complex. The goal is to give women with drooping breasts a perkier, more youthful look.
In this blog post, we’ll discuss when is a breast lift medically necessary and how to get Insurance to cover skin removal.
Does Insurance Cover Breast Reduction
The weight loss journey can be difficult, and the path you take to become healthier and more fit isn’t straight. For many, while their weight loss struggle transforms into a happier, more positive lifestyle, they are still burdened by the memories of their old life. Excess skin accumulation, while typical for most dramatic weight loss patients, is an unwanted reminder of the old body they once had. Folds of skin after weight loss are not only unsightly but can also be physical and emotionally painful. That is where a body lift comes in.
With body lift surgery, we can remove hanging skin, tighten the contours of your body, and show off the new, healthy definition of your abdominal area. The hurtle many people face isn’t if they should undergo body lift surgery, but how they will afford it.
Using Insurance
While most plastic surgery procedures are considered elective and aren’t covered by insurance, body lift after weight loss or bariatric surgery might be. Since body lift surgery is often performed for medical and hygiene reasons, in addition to aesthetic, it may be covered by your insurance. While insurance coverages vary among companies, if you are considering body lift surgery, the first step you should take is to contact your insurance company and discover your coverage options.
Using Patient Financing Options
Medical-based financing may be the ideal option for people who don’t qualify for insurance coverage and otherwise cannot afford the procedure as an out of pocket cost. It can take years to save up the money to undergo a body lift procedure. With medical-based financing options that are designed around the patient’s needs, you can be one step closer to the body you love. Dr. William Carpenter works with CareCredit® and Parasail® to offer financing in a variety of terms. You can visit their websites to see what you are pre-approved for today with CareCredit® or Parasail®.
IS A BODY LIFT AFTER WEIGHT LOSS COVERED BY INSURANCE? PLUS 5 OTHER QUESTIONS YOU HAVE ABOUT POST-WEIGHT LOSS PLASTIC SURGERY
Losing a significant amount of weight is a huge feat that deserves to be celebrated—congratulations on all of your hard work! While we’re sure you’re enjoying your success, it’s normal to feel a bit defeated if excess skin is keeping you from feeling confident at your new weight.
It’s common to experience areas of heavy, drooping skin after massive weight loss, which can make you feel both physically and emotionally uncomfortable. Many choose to have body lift surgery, also called post-weight loss plastic surgery, at La Jolla Cosmetic in San Diego to restore a more normal contour to the body while reducing discomfort.
If you’ve been considering a body lift, read on for answers to some of the most frequently asked questions we receive here at LJC.
Though heavy, excess skin left behind after weight loss can be considered a medical condition due to discomfort and increased risk for skin conditions, most insurance providers do not cover body lift surgery.
Breast Lift Cost
1. How much does body lift surgery cost in San Diego?
A body lift in San Diego typically costs between $20,000 to $23,000. It’s important to understand that the final cost of your post-weight loss surgery can vary greatly depending on how much skin needs to be removed, what areas are being lifted, and how many procedures you need.
There are a few different types of lifting procedures that weight loss patients typically benefit from, depending on where they have sagging skin. The cost of an arm lift typically ranges between $15,000 to $16,000 and the thigh lift is typically $14,500 to $24,000. The breast lift cost at our San Diego practice ranges from $10,500 to $11,500.
The best way to get a more specific understanding of how much your post-weight loss skin lifting procedures will cost is to schedule a complimentary consultation with one of our board-certified plastic surgeons. After they’ve listened to your concerns and you’ve worked out a plan together, we’ll prepare a detailed fee quote.
2. Is a body lift after weight loss covered by insurance?
Though heavy, excess skin left behind after weight loss can be considered a medical condition due to discomfort and increased risk for skin conditions, most insurance providers do not cover body lift surgery.
That being said, some insurance carriers do offer partial coverage of body lift expenses if you meet certain criteria. Below are examples of criteria cited by insurance companies:
- You lost at least 100 pounds.
- You have held a stable weight for at least six months.
- You had bariatric surgery, and it was performed at least one year ago.
- You have documented skin disorders resulting directly from excess skin.
- Your primary physician has recommended a body lifting procedure.
Typically, breast reduction and panniculectomy (removal of “skin apron” on lower abdomen) are the most likely to be covered by insurance. However, these procedures may still be deemed unnecessary or may not provide all of the lifting required to achieve optimal results.
If insurance won’t help you cover the cost of your procedure, there are options for fitting procedures into your budget. There are a number of reputable, third-party plastic surgery financing companies that can help you make comfortable monthly payments.
3. How much weight do I need to lose before a body lift?
Before surgery, you should be at or near a stable, healthy body weight. If you intend to lose more weight and have your surgery too soon, it can impact your results, leaving you with more skin. Additionally, risks associated with having surgery of any kind are greatly increased if you are carrying too much excess weight.
4. What is recovery like after a lower body lift?
Body lift surgery can be one of the most uncomfortable procedures because of the substantial amount of skin removal and lifting required. After surgery, you’ll likely be with an aftercare nurse for a day or two for expert, round-the-clock care. The nurse can stay with you at your home, or you may choose to go to an aftercare facility that caters to post-op patients. Due to special health issues, a small fraction of patients may need to spend a few days in the hospital immediately after surgery.
Once you’re back at home, your next phase of healing will begin. You’ll have drains to make sure there is no fluid buildup around your incisions and compression garments to keep you comfortable, minimize swelling, and protect your incisions. You will need dedicated help around the house for a week or so while you rest—overexertion can strain your incisions and cause pain, so it’s important to plan the necessary downtime to recover.
Brief periods of walking will be recommended to ensure proper circulation, though much of your time will be spent lying down with your favorite book or Netflix show. You’ll be prescribed pain medication to help keep you comfortable for the first week or two. Depending on your healing progress, stitches may be removed around two weeks after surgery, though lower body lift incisions can take four weeks or longer to fully heal.
Once your drains have been removed, moving around will be easier. Expect to be out of work for about three weeks, depending on the nature of your job.
Exercise will need to be avoided for at least 8 weeks (or until you get the green light from your surgeon). You can slowly start resuming other normal activities (light housework, driving, etc.) around the 4 – 6 week mark. It’s critical that you follow your surgeon’s instructions and wait until they give you the go-ahead to begin activities.
5. How long does swelling last after a body lift?
While you’ll start to see swelling going down after a few weeks (compression garments and your drains will help), it’s normal for some swelling to last for a few months before your final results begin to take shape.
We urge you to avoid supplements or products to reduce swelling unless your surgeon has specifically recommended them.
6. What will my scars look like after body lift surgery?
To achieve dramatic lifting, body lift incisions can be quite long. That being said, the appearance of the scars will fade over the course of about a year, and, when possible, incisions are placed where they can be hidden by clothing.
Typically, our body lift surgery patients are so thrilled with their results that the light scars are a small price to pay. In fact, a study published in 2020 found that body contouring surgery after massive weight loss notably improves patients’ lives. We talk more about the health and emotional benefits of achieving your goal weight and following it up with post-weight loss surgery in our related blog post.
To help your scars heal as nicely as possible and fade over time, it’s important to follow your surgeon’s aftercare instructions to a T.
How to Get a Breast Lift Covered by Insurance
Does Insurance Cover Breast Lifts?
In general, each specific insurance company determines what procedures they will or will not cover. The biggest factor insurance companies consider is whether the procedure is reconstructive or cosmetic in nature. The American Medical Association (AMA) defines these as follows:
- Reconstructive surgery refers to procedures performed to correct trauma, developmental defects, infection or disease. Reconstructive procedures focus on improving function or normalizing appearance of the patient.
- Cosmetic surgery refers to procedures that are focused on improving the aesthetic appearance of the face or body to improve a patient’s appearance or self-esteem.
Many insurance companies, however, can interpret the above definitions differently depending on the specific procedure and situation. Due to these variances it is very important to contact your insurance provider and discuss how your procedure will be classified. While plastic surgeons (and their billing representatives) can counsel you on the potential for insurance coverage it’s always best to go to the source.
In general, breast lift surgery is considered cosmetic in nature and is not likely to be covered by medical insurance. For such a procedure to be approved, medical necessity would have to be demonstrated. There are some circumstances where back/neck/shoulder problems can be traced to very enlarged breasts and a case of medical necessity for breast reduction surgery has successfully been made. But if you are just losing the battle with time and gravity, you should not expect a breast lift to be covered by your health insurance.
When Is A Breast Lift Medically Necessary
The Binelli (Doughnut) Mastopexy involves making two circular incisions in the areolas and is ideal for mild breast sagging. After the “doughnut’s” inner tissue has been removed, the skin is drawn together like the handles of a purse. The Binelli technique is commonly used for breast augmentation with a lift.
Breast tissue is reshaped by Dr. Hause into a new cone, which is then suspended higher on the chest wall and held in place with internal sutures in the Lejour limited scar breast lift technique. Doughnut incisions are repurposed for the Lejour mastopexy, and an additional incision is made that extends to the breast fold. This method has the potential to produce longer-lasting and more lifelike results.
To correct severe breast ptosis and enhance breast shape with an implant, a surgeon may choose to perform a vertical mastopexy, a procedure that provides the surgeon with the most access to the breast tissue. The anchor incision involves making two concentric circles around the areola, one line to the breast crease, and a second line along the fold. The most noticeable change in bust line and breast form can be accomplished with a vertical mastopexy.
How To Get Insurance To Cover Skin Removal
To say that Glow Theory Premier Aesthetic & Dermatology Studio is merely a med spa would be an understatement. Leading dermatologists and aestheticians are here to help you look and feel your best. We are the go-to Med Spa for those living in Carlsbad and the surrounding areas.
Our team creates a unique encounter for you by fusing scientific precision with an eye for aesthetics. This is not your typical day at the spa or visit to the dermatologist. To help you bring out your best features, we employ innovative techniques and state-of-the-art equipment. There are no imperfections, only opportunities to celebrate your uniqueness and feel better about yourself at Glow Theory Aesthetic & Dermatology Studio (Carlsbad Spa CA).