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Breast reduction surgery, also known as reduction mammaplasty<\/a>, involves the removal of skin and tissue from the breasts, then reshaping them to a smaller size.<\/p>\n This type of surgery has been on the rise since the pandemic. Cosmetic breast reduction surgeries\u2014those that were not considered medically necessary and paid for out of pocket\u2014increased by 54%, from 2019 to 2022, according to the American Society of Plastic Surgeons (ASPS)<\/a>.<\/p>\n ASPS suggests several factors may have contributed to this trend, including an increased health and fitness focus, remote work and flexible schedules allowing for easier surgery recovery, and more time for reflection about personal comfort and well-being.<\/p>\n Benefits of breast reduction surgery<\/a> may include relief from upper back, neck, and shoulder pain, an increased ability to exercise and participate in physical activities, and an improved self-image.\u00a0<\/a><\/p>\n Dr. Lynn Damitz, chief of the Division of Plastic and Reconstructive Surgery<\/a> and Director of Aesthetic Surgery at the UNC School of Medicine in Chapel Hill, NC, and ASPS board vice president of health policy and advocacy, has seen an increasing number of women 65 and over pursuing breast reduction surgery.<\/p>\n \u201cI\u2019ve definitely seen an increase in the last two decades,\u201d she says. \u201cMy patients over 65 are highly motivated. Often, they have been thinking about doing the surgery for a long time, and are ready to do something for themselves.\u201d<\/p>\n The cost of the surgery can be significant. According to ASPS, the average cost<\/a> of a surgeon\u2019s fee for cosmetic breast reduction is $6,771. Additional fees may include anesthesia and hospital or surgical facility costs, medical tests, prescriptions, and post-surgery garments.<\/p>\n \u201cWhile many women choose to pay for the procedure out of pocket, commercial insurance, as well as Medicare and Medicare Advantage<\/a>, may cover it,\u201d says Damitz.<\/p>\n To get coverage for breast reduction surgery by Medicare or Medicare Advantage<\/a>, it needs to be medically necessary, not cosmetic<\/a>. Specifically, the surgery should be necessary:<\/p>\n Large breasts may cause a number of uncomfortable symptoms, including back pain, neck pain, heaviness, shoulder grooving, posture problems, neuropathic pain, numbness, discomfort with skin-on-skin contact, rashes, skin conditions, and hygiene issues.<\/p>\n \u201cBefore Medicare or Medicare Advantage coverage is considered, patients must have experienced a number of these symptoms,\u201d says Damitz. In addition, the Centers for Medicare & Medicaid Services (CMS)<\/a> details these rules:<\/p>\n\nOlder women and breast reduction surgery<\/strong><\/h2>\n
The cost of breast reduction surgery<\/strong><\/h2>\n
How to qualify for Medicare and Medicare Advantage coverage of breast reduction surgery<\/strong><\/h2>\n
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