When Is a Breast Reduction Medically Necessary?

Female Plastic Surgeon in Tulsa, Oklahoma Also Serving Jenks, Broken Arrow, Owasso & Nearby Areas

Posted: January 15, 2024

 Breast ReductionLarge breasts can present health issues for women. In some cases, women may find relief through breast reduction surgery. If you are struggling with back pain and other issues due to having large breasts, this surgery may be right for you. There are several situations in which breast reduction surgery may be medically necessary. 

How Does a Surgical Procedure Become Medically Necessary?

Medically necessary is not an arbitrary designation doctors attach to procedures and treatments. Instead, it is a term used by insurance companies to determine whether or not they will cover a particular procedure or treatment.

Because insurers are the ones deciding if a specific procedure is medically necessary, you will have to speak to them to find out if you can get breast reduction surgery. You can also check your policy to confirm if your breast reduction may be deemed an eligible procedure based on the conditions already set forth by your insurer. Note that insurers have different guidelines for determining if a procedure is medically necessary.

Unfortunately, there is a distinct chance that the surgery you need will not be covered. In that case, you can get a different health plan and get the surgery down the line or cover your expenses out of pocket.

What Qualifies as Medically Necessary?

While the conditions set for medically necessary procedures by insurers may vary, they still share some similarities. For instance, almost all insurers will only cover breast reduction surgery if their client’s large breasts are causing health problems. Those health problems may include:

  • Chronic pain affecting your back and shoulders
  • Unusual spine curvature
  • Spine issues
  • Rashes near the breasts
  • Numbness affecting the upper extremities

Qualifying health problems may still go beyond the ones listed. It is vital to work closely with your insurer and our team at South Tulsa Plastic Surgery to get the treatment you need.

Schedule a Consultation Today

If you believe that breast reduction surgery may improve your health, alleviate pain, and help you live happier and healthier, contact our team at South Tulsa Plastic Surgery today by calling 918-518-5144 to schedule an appointment at our office in Jenks, OK. 

Dr. Brenda Schiesel can meet with you to discuss your surgery and what you can expect. As an active member of both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, you can expect that Dr. Schiesel will provide you with quality and trusted services throughout the entire process.

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