When It is Breast Reduction Covered by Insurance?, Raleigh, NC
Many women wonder if their breast reduction will be covered by insurance. Patients considering this must be referred by their primary care physician . They must exhibit symptoms associated with neck pain, upper back pain, shoulder pain , shoulder grooves and possibly rashes developing underneath the breast folds. They must also document measures to treat these symptoms such as use of anti-inflammatories, physical therapy or chiropractic manipulation and use of support bras. Efforts at weight loss are also recommended. The plastic surgeon then documents physical signs of macromastia including measurements to determine the distance from the sternal notch to the nipple which generally needs to be 28 cm or greater which demonstrates breast ptosis. Additionally, the amount of breast removal per breast must meet the Schnurr sliding scale criteria. This is the amount of breast tissue required for removal and depends on body surface area; larger patients with larger body surface area require more tissue removed. Some patients will benefit from reduction although the amount of tissue removed would not meet insurance-based criteria. In these cases, patient may pay out-of-pocket but still reap the benefits of breast reduction such as relief of neck and back pain as well as improved breast appearance. Although Dr. Lyle does not participate with insurance plans he still performs many cash pay breast reductions.
Dr. Lyle offers a wide range of Breast Reduction surgery options depending on your anatomy, excess tissue to remove and your desired outcomes. The reduction procedure can also be combined with another surgery.
Dr. Glenn Lyle is a board-certified plastic surgeon serving the Raleigh, NC community at Lyle Plastic Surgery & Aesthetics Center since 2002. With over 30 years of experience, he specializes in breast surgery and body contouring, to enhance patients’ appearance after weight loss, pregnancy, and the effects of aging.
Lyle Plastic Surgery is committed to exceptional patient care – you can read Dr. Lyle’s 5 star patient reviews on Google, Realself and Facebook.
Dr. Lyle completed his medical degree at Wayne State University School of Medicine, followed by a general surgery residency at the University of Massachusetts and a plastic surgery residency at the University of Texas Medical Branch.
He is certified by the American Board of Plastic Surgery and is a member of both the American Society of Plastic Surgeons and The Aesthetic Society (previously American Society of Aesthetic Plastic Surgeons).
Throughout his career, Dr. Lyle has contributed to the field of plastic and cosmetic surgery through research, publications, and presentations at national meetings. His practice emphasizes patient safety and personalized care to achieve natural results.
Next Steps
To find out more about our procedure prices and costs of surgery – visit our surgical pricing page. Please note that our practice no longer takes insurance patients.
If you’re considering surgery in Raleigh NC and want personalized advice about your suitability, recovery, risks, and results, Dr. Lyle would be happy to meet with you for a consultation.
Let’s work together to help you achieve your best results – safely and beautifully. To make an inquiry or book a consultation, please fill in the contact form or call (984) 367-1110
