The choice to undergo a breast reduction compared to other elective surgeries is differentiated simply by the fact that it’s often associated with a medical condition or discomfort rather than vanity. Women considering breast reduction are typically driven by physical discomfort due to large or heavy breasts, such as back pain, neck strain, skin rashes, difficulty fitting into clothes, and unwanted attention.
In this guide, we review the Average Cost Breast Reduction, breast reduction weight requirements, how much is a breast reduction out of pocket, and is breast reduction covered by insurance.
For that reason, we’ve created this article to help women like yourself who are looking for answers to how much breast reductions cost; and weed out the wide range of estimates you likely stumbled across in the process.
Continue reading for a breakdown of the factors contributing to the cost of a breast reduction to provide you with a realistic view of what to expect when weighing the costs and benefits of surgery.
Average Cost Breast Reduction
If your breast size is causing you discomfort, or if you want smaller breasts for cosmetic reasons, breast reduction surgery may be an option for you.
It’s important to first discuss this procedure with a surgeon. You’ll want to understand the potential benefits versus the side effects associated with this type of surgery and whether it’s right for you.
In preparation for that discussion, here’s some general information on breast reduction surgery, including what you can expect during the procedure, what the recovery is like, potential side effects, and more.
Breast reduction surgery (also called reduction mammaplasty) is a type of invasive procedure that involves incisions (cuts) in your skin to decrease the size and weight of your breasts. If elected for cosmetic purposes, the surgery may also reduce sagging.
In addition to decreasing your overall breast size, the surgery will lift your nipples and breast mound higher on your chest and typically improve the shape of your breast.
Why people consider having breast reduction surgery
The decision to undergo breast reduction is based on a number of factors. While some people elect to have this surgery for cosmetic reasons only, others may want smaller breasts to ease physical discomfort, including:
Additionally, a breast reduction may help soothe emotional distress that may occur with large breasts due to possible related physical discomforts you may chronically experience. Such considerations may lead to an overall improved quality of life.
A plastic surgeon can help determine whether you’re a good candidate for breast reduction. Chronic back pain is the most common reason individuals elect to have this surgery.
Breast surgeries are most typically done in adults. But some teens may also qualify for a breast reduction when they have significant discomfort that lasts for a year or longer, and in individuals who retain the same breast size for at least a year.
Other considerations include your overall health and whether you engage in certain behaviors that could affect the recovery process, such as smoking.
Most breast reduction surgeries are performed on an outpatient basis with the help of general anesthesia, which is when a combination of medications called anesthetics are used to put you in a sleep-like state before a surgery or other medical procedure.
Incisions are made directly along your breasts so the surgeon may remove excess fat, skin, and tissues. Your breasts are then reshaped, and the incisions are closed with sutures.
Another potential option is a combined breast lift and augmentation. Most often used for aesthetic purposes, this procedure involves a traditional breast reduction along with implants to achieve the desired shape and lower the risk of sagging.
A breast reduction is a major surgery, so it’s important to plan for ample recovery time to allow for proper healing. You may leave your surgery with drainage tubes that you’ll need to care for. These tubes keep fluid from collecting in the surgical area and are typically kept in place for a few days.
Although you may be able to go home on the day of your surgery, you should plan to take 1 full week off of work or school.
A doctor or healthcare professional will instruct you to take prescription pain medications for a few days and, if needed, an over-the-counter version for a couple of weeks after your procedure. Your breasts will be bandaged to reduce bleeding and swelling, and you’ll be sent home with a surgical bra.
Initially, you can expect pain, swelling, and soreness. While you may be able to resume most of your usual activities within 3 to 4 weeks, you may be restricted to light walking only within the first few weeks following breast reduction surgery.
It will also take time for you to experience the full effects of a breast reduction. At first, your breasts may be swollen as they heal, but they may also feel lighter within the first 2 to 3 months. In all, it can take up to 1 year for your breasts to fully soften.
As with any major surgery, a breast reduction may pose the risk of infection, scarring, and bleeding. There’s also possible anesthesia side effects to consider too, such as nausea, dry mouth, or a sore throat.
Also, talk with a surgeon if you plan on any future pregnancies, as this may affect the shape and size of your breasts after having surgery. For some people, doctors may advise that you wait until you’re finished having children.
Deciding to have a breast reduction is a major decision and one that you should make with a qualified and experienced surgeon.
At the minimum, a prospective surgeon ought to be board certified. They should also be able to show you a portfolio of their work with before and after photos.
breast reduction weight requirements
Many of the patients I see coming in for information on breast reduction surgery are overweight. In today’s blog post I am going to discuss how being overweight can affect breast size, and whether or not you should lose weight prior to considering surgery. Let’s break it down into several commonly-asked questions:
Will my breasts be smaller if I lose weight?
Maybe, maybe not. Breasts are composed of both fat and glandular tissue. Younger women tend to have more glandular tissue, whereas older women tend to have more fat. If you lose weight, the amount of glandular tissue does not change, so if your breasts are largely glandular tissue, you won’t see a dramatic size decrease. In addition, everybody loses and gains weight differently. I tend to gain weight in my hips and thighs, whereas another person might gain weight in her stomach. So losing weight in and of itself is no guarantee that your breast size will decrease.
What if I lose weight after I have breast reduction surgery?
The answer to this question is similar to the question above. You may or may not see a decrease in breast size if you lose weight. The more weight you lose, the more likely you are to see a change in your breast size. An if your breasts do decrease in size, they can become droopy (ptotic). I generally recommend to my patients that if they are planning on losing more than 25-30lbs, they should try to do this prior to having breast reduction surgery.
What if I’m happy at my current weight, even if I am overweight?
We all have dreams, er… goals, of losing that last 10, 15, or 20lbs right? If you are considering breast reduction surgery, ask yourself honestly if you have a plan of losing weight, or if it’s just a dream. It’s okay to be happy at your current weight. But my goal as a surgeon is to perform a safe operation and minimize the risk of complications, and a patient’s weight does affect the risk of complications. A study published in Plastic and Reconstructive Surgery looked at the number of complications after breast reduction in 675 patients. They noted a significant association between body mass index (BMI) and complication rate. This complication rate increased significantly when BMI was 35.6 or larger.
Download my FREE breast reduction preparation guide!
In my own practice, I balance the risks of surgical complications with the benefits a patient is likely to obtain from having a breast reduction. I often ask patients with a BMI>35 to lose weight prior to surgery, especially if they have other risk factors such as diabetes or a history of smoking. There are no hard and fast rules regarding weight, but understanding a patient’s weight loss goals is an important part of the surgical decision-making process.
how much is a breast reduction out of pocket
If you’re considering breast reduction surgery, cost could be a factor in your decision. The surgery removes fat, glandular tissue, and skin from the breast to make it smaller. For women, it may be medically necessary to treat health problems from overly large breasts. For men with enlarged breasts, the procedure is usually cosmetic—you may want it, but you don’t need it for health reasons. Insurance companies typically cover medically necessary procedures, but not cosmetic procedures.
What determines the cost of breast reduction?
Like most products and services, costs for breast reduction vary depending on where you live. Costs also vary from surgeon to surgeon. In general, cosmetic or plastic surgeons can charge based on market demand—whatever people in your area are willing to pay. A surgeon’s fees may also depend on their years of experience, advanced training, and expertise in the procedure.
The average cost of breast reduction in the United States is about $5,900. This amount only covers the surgery itself. Other costs may include:
Insurance may cover the cost of breast reduction.
Insurance usually covers breast reduction for women who have health problems due to the size of their breasts. For example, overly large breasts can cause back, neck and shoulder pain that interferes with your daily life. Your insurance company may require preauthorization for the surgery. As part of the process, they will likely require documentation of your health problems.
Your insurance company may also require you to try other treatments first. This may include weight loss, physical therapy, and wearing wide-strapped bras for at least 12 months. Each company will have their own criteria for approving breast reduction surgery. You will need to call your insurance provider and review the specifics of your policy.
If your insurance company denies your authorization for surgery, you can appeal the decision. You will need your surgeon’s assistance for the appeal. It may just be a matter of providing more information about your condition.
Insurance usually does not cover breast reduction for males, also called gynecomastia surgery.
is breast reduction covered by insurance.
Considering breast reduction surgery? Not sure if your insurance covers breast reduction or whether you are eligible? Can’t seem to find any one who knows the answer to your questions? We’re here to help. At the Breast Reduction Center Los Angeles, we are asked these and other question every day by patients who just want to understand what their options are and what they are entitled to as a health insurance policy holders.
What are the general Breast Reduction insurance requirements?
Most insurance carriers will offer breast reduction covered by insurance as long as it meets certain requirements to be deemed “medically necessary”. Traditionally the main point an insurance company considers is the amount of tissue to be removed from each breast. Most major insurance companies have established basic criteria as to the amount of tissue that must be removed relative to a patient’s height and weight. However, these days insurance companies are beginning to focus more and more on patient’s symptoms in order to determine whether breast reduction is medically necessary. Health concerns such as back and neck pain, or skin rash developing in the skin underneath one’s breasts may be sufficient to qualify a patient for insurance coverage for breast reduction. Typically any procedure in which the breasts are reduced by less than two cup sizes is categorized as a breast lift and will not be covered by insurance.
Free Insurance Verification
Just fill out the form and click “submit.” We will do our best to contact you within 48 hours with your verification results.
How do I find out my insurance provider’s terms regarding Breast Reduction?
Most major insurance companies provide insurance coverage for breast reduction, but there are several factors that must be looked at in order to determine whether you are eligible for coverage.
Your insurance company must first determine whether they consider your breast reduction medically necessary. The terms and guidelines used to determine this may vary depending on your insurance company, the state you live in and your specific policy. It can be a little a confusing, but don’t worry. You don’t have to figure it all out on your own. Our friendly and knowledgeable staff can help you to quickly determine what your insurance will cover and whether you meet the requirements. Call us for a free insurance verification today or simply fill out the form below to get started.
How breast reduction insurance coverage is determined:
When you come in to the Breast Reduction Center for your initial consultation, the breast reduction surgeon will conduct a thorough examination of your situation. During this consult your surgeon will determine how many grams of tissue need to be removed to make your breasts proportional to your body and alleviate any health concerns. Once this has been determined, your surgeon will submit this information to you insurance company for approval.
Most insurance companies use a simple, standard calculation which to determine your body surface area or BSA. Height and weight is all that is needed to calculate your BSA. Once you BSA has been established, it is compared to something called the Schnur Sliding Scale.
The Schnur Scale was developed by a plastic surgeon and is used as a method of evaluating the medical necessity of a breast reduction. Your insurance company will use the scale to compare your body surface area to the amount of tissue your surgeon has recommended for removal and determine if you truly need a breast reduction for medical reasons.
Again the amount breast tissue to be removed is not the only criteria used by insurance companies to qualify patients for breast reduction surgery, but it is an important factor in the insurance eligibility process.
