The cost of gynecomastia surgery is determined by the surgeon’s experience, the treatment chosen, and the geographic location of the practice.
Male breast reduction and related problems are not covered by most health insurance plans, however many plastic surgeons offer patient financing programs, so be sure to inquire.
Can male breast reduction be covered by insurance?
Male breast reduction is not usually covered by insurance, but there are certain exceptions if certain requirements are met. It’s always advisable to talk to your insurance company about coverage issues. Our office will assist you with the necessary papers for approval if your insurance covers the treatment.
How can I get my insurance to cover gynecomastia surgery?
The major criteria in determining whether plastic surgery is covered by insurance is if your doctor and the insurance company agree that it is “medically necessary.”
Most cosmetic procedures, such as breast augmentation and tummy tucks, are not covered by health insurance since they are not medically essential. However, in cases of breast reconstruction and gynecomastia, health insurance may fund the procedure.
If a patient is under the age of 18 and meets the following requirements, gynecomastia surgery may be reimbursed by your health insurance.
It’s worth noting that most insurance policies require patients to be assessed for coverage when they’re in their teens or early twenties.
Moderate To Severe Chest Pain
If the breast growth causes moderate or severe chest pain, it affects one’s ability to work or move around. The inability to participate in social activities, sports, or athletic events, on the other hand, is not considered a functional or physical handicap.
Persistent Gynecomastia After Cessation Of Certain Drugs
After the patient quits taking prescribed medications, recreational drugs, or anything that may induce gynecomastia, the gynecomastia persists. Testosterone, asthma medication, anabolic steroids, marijuana, and calcium channel blockers are some of these substances.
Gynecomastia Must Be Present For Two Years Or More
The ailment must have been present for at least two years, and the causes have been determined using numerous laboratory tests. Hormone testing, liver enzymes, serum creatinine, and thyroid function studies are some of the lab tests that may be done.
Other Factors
Some health insurance coverage will only cover gynecomastia patients under the age of 18 if they have stopped taking all nutritional supplements, non-prescription pharmaceuticals, and other medications that have been linked to male breast growth.
In addition, if glandular breast tissue, rather than fatty deposits, is the major cause of the condition, insurance may fund the surgery. If fat deposits are present, the insurance company may argue that the problem is obesity, and you will need to reduce weight before the operation is considered.
Before you decide to have this operation, check with your doctor and your health insurance company to see if the cost is covered.
How much is men’s breast reduction?
What is the cost of Gynecomastia? The overall cost varies depending on your situation, however most male breast reduction operations range from $6300 to $8500.
How can I convince my insurance to cover a breast reduction?
Large breasts (macromastia) can produce physical problems that interfere with a woman’s daily functioning, as I discussed in my earlier post. Symptomatic macromastia is a well-known medical disorder that requires treatment. Insurance coverage of reduction mammaplasty is just as suitable as coverage of cervical spine surgery, shoulder surgery, carpal tunnel release, or sleep apnea treatment because big breasts put constant strain on body systems. Non-surgical treatments should be attempted initially for some disorders, but there are no non-operative treatments for macromastia that are expected to provide long-term or permanent symptom alleviation.
If you’re thinking about having breast reduction surgery, make sure you read your insurance coverage first. If your insurer specifies reduction mammaplasty as a policy exclusion, you might not even be able to get coverage for a consultation to see if surgery is right for your symptoms.
In most situations, insurers demand that the surgeon produce a statement outlining the patient’s symptoms and physical results, as well as an estimate of the breast weight to be removed and a request for coverage. This should be done before scheduling surgery since if surgery is not preauthorized, the insurer may refuse to pay. If your insurer refuses to pay breast reduction surgery because it is considered cosmetic, your doctor must inform the insurer about symptomatic macromastia and the differences between breast reduction and its aesthetic cousin, the breast lift. Traditional Medicare and Medicaid plans may not offer preauthorization.
Current insurers should be aware of the current standard of care for treating macromastia and should accept coverage based on reasonable criteria and medical necessity verification. Unfortunately, too many insurance companies have yet to study the medical research from the last two decades demonstrating the usefulness of breast reduction surgery in alleviating macromastia symptoms independent of a woman’s body weight. Many of these businesses employ a chart based on the Schnur Scale of 1991, which correlated a woman’s reasons for breast reduction with her body weight. Because of their position on the chart, many women are denied coverage. The use of such a chart to discriminate against overweight women by refusing them coverage regardless of their symptoms has no medical validity, according to recent medical research, but insurers continue to do so.
Your doctor’s report of your symptoms and physical changes caused by your breast weight should be utilized to determine medical necessity. Even though non-surgical therapy trials have a low chance of success, they may be required before surgery is covered by insurance. Although it is reasonable for an insurer to require that a certain amount of breast tissue be removed, there should be a mechanism in place to ensure that special circumstances (such as a small-framed woman or a woman with a medical condition made worse by even moderate breast weight) are given special consideration.
You have the legal right to appeal a denial if you believe breast reduction is important for your health and well-being. The denial letter should include information about the appeals process. Multiple levels of appeal are available in most circumstances, and you should take use of them. A family doctor’s letter, an orthopedist’s letter, a physical therapist’s letter, a chiropractor’s letter, or a massage therapist’s letter can all help support an appeal. You should create your own letter in which you describe your symptoms and how they have hampered your life (focus on your physical problems rather than your difficulty finding a bathing suit). Request that your doctor attach your personal letter, supporting letters, current scientific information on the standard of treatment for treating symptomatic macromastia, and a list of medical literature references to your appeal.
Can male breasts be reduced without surgery?
Male breast reduction can be achieved through a variety of non-surgical methods. Among the techniques are:
- Diet and exercise are two things that you should do. Maintaining a healthy diet and exercising regularly can assist to balance hormones and burn fat.
- Putting an end to the usage of medicines or steroids. Male breast growth can be exacerbated by steroid use and certain medications.
- Reducing the amount of alcohol consumed. Male breast growth can be exacerbated by alcohol consumption.
- Treatments involving hormones. Male breast development is caused by hormonal imbalances, and hormone balancing treatment options may assist to reduce the appearance of breast enlargement.
- I’m trying to lose weight. Losing weight may aid in the reduction of breast size. This method may be effective for men who need to shed a lot of weight, but it may not remove all of the excess breast tissue completely.
These non-invasive therapy alternatives may help some men minimize the appearance of breasts. However, many men with moderate to severe Gynecomastia may discover that these treatments are ineffective in removing the excess tissue.
Chest fat will not be lost exclusively as a result of weight loss. Men with Gynecomastia frequently lose weight but do not observe a significant reduction in the size of their breasts. Because excess breast tissue contains more than just fat, it also contains muscle and glandular tissue.
Gynecomastia Surgery
Breast reduction surgery is required if you suffer from a feminine chest and want to completely eliminate superfluous breast tissue. This procedure produces long-lasting benefits and is quite successful in contouring and masculinizing the chest. Various forms of surgery and incisions are available, depending on your specific ailment and desired outcome.
Liposuction is one of the most common treatments for this condition. Excision is another treatment option if a considerable volume of glandular tissue needs to be removed. Surgery, regardless of technique, aids in the contouring of a more manly chest. Men who have had these procedures report feeling less anxious and embarrassed, as well as having a more favorable body image.
Do I have gynecomastia or am I just fat?
A firm lump can be palpated or felt under the nipple/areola region if you have gynecomastia. The lump is usually stiffer than the fat. This is one of the most effective ways to distinguish it from pseudogynecomastia. It’s possible that this tumor is uncomfortable or sensitive to touch. When you feel for this bump, you can usually tell which of the two conditions you have. There is no palpable hardness or mass in persons who just have chest fat or pseudogynecomastia. Rather, the fat is soft to the touch and uniformly distributed throughout the chest.
Is it worth getting gynecomastia surgery?
In the category of worthwhile cosmetic surgery, gynecomastia (excess male breast glandular tissue) surgery came in third. Gynecomastia (man boobs) surgery, according to patients, is 98 percent worth it. It was the same for women who had breast enlargement and breast reduction in the research.
The advantages of plastic surgery are evident to guys with gynecomastia, and this survey on Real Self backs up this tendency. Gynecomastia surgery is a surgical operation as well as a type of male breast surgery, thus it is more likely to be beneficial than non-surgical procedures.
Why is gyno surgery so expensive?
Anesthesia is one of the main causes for the gynecomastia cost difference. Certain procedures, such as liposuction alone, can be performed under local anesthesia, which is less expensive, whilst others, such as gland excision, will necessitate sedation and/or general anesthesia. Furthermore, some patients will require the removal of extra skin in order to obtain a smooth, flat chest. This is especially true for individuals who have gained and lost a significant amount of weight, as well as those who are older. Our skin’s capacity to “bounce back” and regenerate over your new chest contour decreases as we age. I’ll need to put the patient under general anesthesia any time I remove skin. It’s the only method to guarantee a safe and predictable result.
Can you finance gynecomastia surgery?
Fortunately, there is a simple way to reduce the cost of gynecomastia surgery. We are pleased to provide financing options to patients interested in gynecomastia surgery at the Plastic & Cosmetic Surgery Center of Texas. Patients can obtain a more inexpensive treatment with financing alternatives by dividing the cost of their therapy into monthly payments that better fit their budget. This is especially useful for cosmetic procedures like as gynecomastia, which are often not covered by health insurance. CareCredit, American Healthcare Lending, and United Medical Credit are just a few of the financing alternatives available to patients at our practice. These solutions make paying for gynecomastia surgery as simple as paying with a credit card, and many of them provide low or no-interest financing to qualified patients.
How do I qualify for a breast reduction?
Breasts that are too big might create health and emotional issues. You may also endure physical pain and discomfort in addition to self-image concerns. Excess breast tissue can make it difficult to maintain an active lifestyle. Emotional distress and self-consciousness are frequently associated with large pendulous breasts, and they can be just as problematic as the physical discomfort and agony.