Insurance Breast Reduction
Consultations offered at our two convenient locations in Manhattan, NY and Queens, NY
Insurance breast reduction (reduction mammaplasty) is a medically necessary procedure that decreases the size of the breasts and repositions them on the chest to improve comfort and balance proportions. Large breasts can cause excessive strain, resulting in back, neck, and shoulder pain. Breast reduction covered by insurance can help patients find relief from back, neck, and shoulder pain, improve mobility with exercise, expand clothing options and eliminate the need for specialty bras, treat rashes and moisture issues under the breasts, lessen migraine headaches, reduce negative attention toward your chest, improve the symmetry of your breasts and boost your self-esteem. Each year, plastic surgeons perform breast reduction more than 76,000 times to help patients enhance the appearance of their breasts. (1)
Dr. Marc Everett is the premiere breast reduction specialist in NYC and performs breast reduction surgery several times weekly, more than nearly any other board-certified plastic surgeon in the region. At The Everett Clinic, we take care of a wide range of patients coming to the office with a wide range of complaints from the teenage years through the retirement years of life. Meet with Dr. Everett to determine if you are a candidate for him to help you achieve life-changing results, improving your mobility and body proportions and empowering you to make a change for an overall enhanced quality of life.
Contact our offices in Manhattan or Queens or call (212) 774-7715 to learn more and schedule your consultation today!
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Before and After Photos
About Insurance Breast Reduction
Whether you developed heavy, oversized breasts at puberty or if you recently experienced changes to your breasts after pregnancy-related changes, breastfeeding, or fluctuations in your weight, breast reduction can rebalance your proportions to help you feel more comfortable and confident. During the procedure, Dr. Everett will reshape the breasts to create a smaller breast mound, removing both fat and glandular tissue for natural-looking results. If you are struggling with back pain, neck pain, or skin irritation from large breasts, the procedure can help you address these concerns.
Whether you experienced changes to your breasts after weight fluctuations, breastfeeding, or pregnancy, breast reduction can help improve your comfort in your daily life. During the procedure, Dr. Everett will reposition the nipple and/or reduce its size during surgery to achieve a natural, harmonious appearance.
Breast Reduction After Weight Loss
After weight loss, it is common for the breasts to sag and remain overly large, a condition colloquially known as “Ozempic breast.” If you are looking to improve the appearance of your breasts after weight loss, Dr. Everett can remove the excess tissue for a smoother, curvier figure. Depending on your aesthetic goals, he can combine breast reduction after weight loss with other post-weight loss body contouring procedures.
Benefits of Insurance Breast Reduction
After a medically necessary breast reduction, you can enjoy:
- Improved posture: You can find relief from back, neck, and shoulder pain after the procedure, which can improve your posture.
- More clothing options: Many patients feel more comfortable in different types of clothing with a more proportional figure.
- Improved breast symmetry: Dr. Everett can reshape the breast mounds to balance the breasts and address asymmetry.
- Improved self-confidence: You can enjoy feeling better about your figure with a curvier, more proportional appearance.
- Enhanced mobility: With smaller breasts, you can enjoy improved mobility, making exercise easier.
Candidates for Insurance Breast Reduction
Suitable candidates for insurance breast reduction need to undergo the procedure to improve their quality of life.
Although there is no age limit for the procedure, you will need to have fully developed breasts for the procedure. If you are pregnant or breastfeeding, you will need to wait until a few months after you finish breastfeeding.
Consultation
During your consultation, Dr. Everett will ask about your aesthetic goals and examine your breasts to determine the best treatment plan for your needs. He will also ask about your lifestyle, current medications, and medical history.
Please come prepared with any questions about the procedure to help him create a personalized plan. He can perform several different types of body contouring procedures to sculpt your figure and help you achieve your aesthetic goals.
To learn more, see the blog!
Preparation
To prepare for breast reduction, you will need to follow all of Dr. Everett’s recommendations. This includes stopping to take oral birth control medications and many weight loss medications including semaglutide or Ozempic. You must stop using all nicotine products at least a month before and a month after surgery. Ahead of surgery, Dr. Everett will make sure you have all of the required post-operative support garments and all of your home medications before your day of surgery. Depending on what you do for work or school, he will help you determine how long you should set aside for your recovery.
Procedure
The operation is performed under general anesthesia, which means you will be completely sleeping throughout the operation.
In general, Dr. Everett believes that breast reduction surgery should be performed through an anchor-shaped incision (inverted T): This incision goes around the areola and extends vertically down to the inframammary crease, then continues horizontally along the crease. Fortunately, this incision pattern has the least tension on it and tends to heal beautifully with most scars difficult to even see in 1 year’s time. For patients who are candidates for an internal bra procedure, Dr. Everett will use an absorbable mesh to support the shape and position of your breast in the early healing phases. Dr. Everett will also perform a procedure that helps to block your sensation of pain in the breasts after surgery and because of this, most patients do not require heavy pain medication during their recovery. After surgery, you will be monitored in the recovery room, and you can return home to rest afterward. All of these operations are same-day surgery. Dr. Everett will send you home with specific instructions to help you recover.
Results
Your results will depend on your aesthetic goals, as discussed during your consultation. After breast reduction surgery, you can enjoy a smaller breast mound, balanced body proportions, and less discomfort associated with overly large breasts.
Many patients find that the procedure improves their mobility and self-esteem because they can exercise more easily and their clothing fits better. Many patients also notice fewer rashes. Results are long-lasting and can be maintained if patients exercise consistently and eat healthily to maintain a stable weight.
Insurance Coverage Process
After your breast reduction is deemed medically necessary, your coverage will depend on the type of insurance you have. Dr. Everett’s office will obtain To obtain coverage, your insurance may require prior authorization– using documentation about your medical history, photographs, and findings from your initial consultation that proves the procedure is medically necessary. After your consultation, we can provide the necessary documentation. You will also need to consider your:
- Deductible: The cost of your procedure will depend on whether or not your insurance has a deductible. If you have not met your deductible for the year, your insurance will adjust the cost of your procedure accordingly.
- Co-insurance: Depending on the type of plan you signed up for, your insurance may have co-insurance. This means that the insurance company will pay a percentage of the cost of healthcare services after you meet your deductible (if your plan has a deductible).
- Out-of-Pocket Maximum: Your out-of-pocket maximum is the maximum amount you will pay for healthcare services for the year before your insurance company covers the full cost of services.
The Cost of Insurance Breast Reduction in NYC
The cost of insurance breast reduction will depend on the condition you are seeking treatment for and whether or not you need additional cosmetic procedures to achieve your goals.
After your insurance company processes the claim for your procedure and deems it medically necessary, we can proceed with a breast reduction that will be covered by insurance. Most patients with qualified insurance plans have low or no out-of-pocket costs.
Contact our offices in Manhattan or Queens or call (212) 774-7715 to schedule a consultation and learn more about the procedure!
FAQ
Do you accept all kinds of insurance?
We work with a great many of the insurance carriers. We do not accept any Medicaid-managed plans (including United Healthcare Community Plans or Blue Cross plans starting with JLJ, Tri-Care, Amida Care, Fidelis, Oscar, and MetroPlus plans. If you’re unsure, contact us, and our insurance verification team will check your benefits and get right back to you!
Will my breast reduction be covered by insurance?
For your breast reduction to be covered by insurance, it must be deemed medically necessary. If you suffer from back and neck pain because of overly large breasts, your breast reduction will likely be covered by insurance.
Can I combine breast reduction surgery with other procedures?
Absolutely. If you have recently lost weight, we can perform additional procedures to refine your silhouette and assist in shaping your body for a slimmer, more athletic appearance.
How long will the results of breast reduction surgery last?
During breast reduction, we permanently remove the breast gland and excess skin, so the results can last for years and for some, the rest of their lives. However, pregnancy-related changes after breast reduction surgery can change the appearance of your breasts.
References
- American Society of Plastic Surgeons ® Endorsed Partner. https://www.plasticsurgery.org/documents/news/statistics/2023/plastic-surgery-statistics-report-2023.pdf