Plastic Surgeon Helps Women Get Needed Breast Procedures Covered By Insurance

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Many women are surprised to hear that some seemingly cosmetic procedures can be covered by insurance. One that is commonly asked about is the breast reduction procedure.

Many women are surprised to hear that some seemingly cosmetic procedures can be covered by insurance. One that is commonly asked about is the Breast Reduction Procedure ( Recently Jill Barrett, the insurance expert for Quinn Plastic Surgery Center, was asked if this procedure could be covered by insurance and this is what she had to say:

Macromastia is the medical term for large, heavy, pendulous breasts that are out of proportion on an otherwise average-sized patient. Many women with macromastia desire breast reduction surgery, and would love to have surgery covered by their insurance. The American Society of Plastic Surgeons (ASPS), the FDA, and most doctors consider breast reduction surgery to be reconstructive rather than cosmetic because it's done to improve the quality of life for women suffering with extra-large breasts. However, some insurance companies beg to differ. All insurance companies require authorization before this type of surgery is performed so they can determine whether they consider it medically necessary or cosmetic in nature.

Insurance companies collect information from the physicians the patient has visited to treat symptoms of having macromastia including a letter asking for pre-authorization from a plastic surgeon who would perform the procedure. Consultations with Dr. Quinn ( at Quinn Plastic Surgery Center include a thorough exam, as well as taking measurements, photographs, and a history of symptoms. These things will assist the surgeon in proving to the insurance company that a reduction is medically necessary.

An insurance company will look for evidence of at least two of these symptoms:

  •     Back and neck pain
  •     Postural problems
  •     Disrupted sleep
  •     Breasts that hang against the underlying skin causing irritation, rashes, and infections
  •     Deep groves or irritation on the shoulders from bra straps
  •     Tender back muscles

If a patient has been treated by a primary care doctor and tried other methods of alleviating symptoms- pain medication, physical therapy, or chiropractic treatment- it's important to provide documentation of that. An insurance company is more likely to approve coverage of a breast reduction if the patient has tried other things that haven't worked.

About Quinn Plastic Surgery
Quinn Plastic Surgery Center has been providing plastic surgery treatments to patients in the Kansas City area for more than 20 years. Dr. John Michael Quinn ( and his practice, Quinn Plastic Surgery Center, are acclaimed by patients and colleagues alike for the deep commitment to providing the utmost in surgical care, safety and results.


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Jerri Harris
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