Breast Reduction Surgery Cambridge, MA
Breast Reduction Surgery Cambridge, MA, is frequently performed by Plastic Surgeons.
- Office Address
- Directions from Cambridge
- Breast Reduction Surgery Cambridge
- Breast Reduction Surgery Cost
- Is Breast Reduction Surgery covered by insurance?
- Insurance Providers and Breast Reduction Surgery
25 Walnut St, Suite 400,
Wellesley, MA 02481
Monday: 8:30 am – 4:30 pm
Tuesday: 8:30 am – 4:30 pm
Wednesday: 8:30 am – 4:30 pm
Thursday: 8:30 am – 4:30 pm
Friday: 8:30 am – 4:30 pm
Office Directions from Cambridge
- Get on I-90 W in Boston from Dana St, Memorial Dr and Soldiers Field Rd.
- Head SW on Ellery St towards Broadway. Turn left onto Broadway. Turn right onto Dana St. Turn left onto Massachusetts Ave. Turn right onto Bay St.
- Turn right at the 1st cross street onto Green St. Turn left onto Putnam Ave. Turn right onto Flagg St. Turn left onto memorial Dr. Turn right onto Western Ave
- Turn left onto Soldiers Field Rd
- Merge onto I-90 W. Take exit 16 to merge onto MA-16 W/ Washington St towards Wellesley. Slight left onto Wales St/ Walnut St.
- Destination will be on the right.
Breast Reduction Surgery Cambridge, MA
Many women who develop a larger chest can become dissatisfied with their breasts.
Developing a larger breast is not always the desired outcome for many women and considering breast reduction surgery may help them attain a more refined look.
Patients considering breast reduction surgery do so for a number of reasons which can include, relief from discomfort caused by overly large breasts, balanced figure proportion or to refresh and improve their body contour.
Suffering with low self-esteem, feeling self-conscious and having difficulty when exercising are just some of the reasons women would consider a Breast Reduction. However, there are further issues such as suffering from the physical symptoms of back, neck or shoulder pain (known as macromastia).
The removal of excess breast tissue and fat during a Breast Reduction procedure in Cambridge, MA will help to achieve the goal of reduced size, weight and shape of large, heavy breasts. The reduction of sagging skin, which gives the breasts an uplift, is performed simultaneously during surgery.
Often smaller, more manageable and youthful looking breasts with less chafing and pain, would be achieved by having this procedure.
Learn more about Breast Reduction Surgery by reading our blog on the most frequently asked questions.
Breast Reduction Surgery Cost
The average cost for a breast reduction in 2018, according to the American Society of Plastic Surgeons was $5680. However, this cost can often double when the fees for anesthesia, operating room facilities and other related expenses are taken into account.
Is Breast Reduction Surgery covered by insurance?
Surgery which is thought to be medically necessary (for health reasons) may be covered by health insurance but, as with all surgery, if the procedure is required for aesthetic reasons only, this will not be covered.
An insurance policy may cover some or all of the costs if the Breast Reduction procedure is being performed because a patient can no longer live with the physical impact of having large breasts or how this is affecting their life on a daily basis.
Patients should clarify with their insurance provider the written information needed from their chosen surgeon to process a claim and no surgery should be booked until how much of the cost, the insurance provider, will cover.
Insurance Providers and Breast Reduction Surgery
Blue Cross and Blue Shield of Massachusetts
In their Medical Policy for Reduction Mammaplasty for Breast-Related Symptoms, Blue Cross Blue Shield of Massachusetts state that breast reduction procedures may be considered medically necessary for the treatment of macromastia when specific clinical symptoms are present.
A history of shoulder, neck or back pain that has not responded well to therapy, relaxant, or intertrigo that is resistant to treatment are some of the clinical symptoms recognized.
They also suggest that a minimum of 500g per breast should be removed or that the plastic surgeon “must also follow the Schnur sliding scale, which suggests a minimum amount of breast tissue removed based on a patient’s body surface area”.
Learn more about Blue Cross and Blue Shield of Massachusetts and their Breast Reduction Procedure medical policies.
Fallon Community Health Plan
In their Cosmetic, Reconstructive and Restorative Services Clinical Coverage Criteria guidelines, FallonHealth states that Breast Reduction surgery “may be medically necessary to relieve a physical functional impairment caused by hypertrophic breasts”.
A patient suffering with “significant symptoms that have interfered with activities of daily living” (intertriginous maceration, shoulder grooving, back and/or shoulder pain and arthritic changes) would be a typical candidate for a Breast Reduction.
In line with other insurance providers, there is a minimal amount of breast tissue that should be removed for the breast reduction procedure to not be considered cosmetic .
Learn more about Fallon Community Health Plan and their Breast Reduction Procedure medical necessity guidelines.
Harvard Pilgrim Health Care, Inc.
In their policy on Cosmetic, Reconstructive and Restorative Procedures, Harvard Pilgrim Health Care writes that they cover reconstructive procedures “(i.e., surgery performed to improve function of a body part damaged or impaired by congenital defect, developmental abnormality, trauma, infection, tumor or disease) that are reasonable and medically necessary to improve or correct a physical functional impairment or remedy ongoing medical complications.”
They also state that they do not “cover most cosmetic procedures (i.e., surgery or treatment performed primarily to reshape or improve a patient’s appearance), such procedures are generally not considered medically necessary, even when intended to improve an individual’s emotional well-being or treat a mental health condition.”
Learn more about Harvard Pilgrim Health Care and their Breast Reduction Procedure medical necessity guidelines.
In their Guidelines for Medical Necessity Determination for Reduction Mammoplasty, MassHealth consider the principal candidates for breast reduction as “Women presenting various forms of breast hypertrophy (for example, macromastia or gigantomastia) accompanied by persistent clinical signs and symptoms that adversely affect health”.
When making a determination of medical necessity and coverage for patients, MassHealth will consider (among other things) back, neck or shoulder pain, or persistant intertrigo, that has been unresponsive to other treatments.
With MassHealth, reduction mammoplasty is not covered for normal sized breasts, per the American Society of Plastic Surgeons definition. Reduction mammoplasty for surgically enhanced breasts or for reductions of less than 300 grams are also not covered.
Learn more about MassHealth and their Breast Reduction Procedure medical necessity guidelines.
Tufts Health Plan
In their Medical Necessity Guidelines: Reconstructive and Cosmetic Surgery, TUFTS state that “reconstructive surgery and procedures are covered when the services are necessary to relieve pain or restore a bodily function that is impaired as a function of congenital defect, birth abnormality, traumatic injury or covered surgical procedure.”
Like other providers, TUFTS do no cover any types of cosmetic surgery or procedures. They defined cosmetic as “to change or improve appearance”.
Learn more about TUFTS Health Plan and their Breast Reduction Procedure medical necessity guidelines.
For women suffering from macromastia, UnitedHealthcare will consider covering Breast Reduction Surgery when the patient has functional impairment(s). This may include, but is not limited to, headaches, intertrigo, shoulder grooving, and other pain and restrictions to physical activities.
Breast Reduction surgery, when performed solely to improve cosmetic appearance, will not be consider by UnitedHealthcare.
UnitedHealthcare defines Functional Impairment as: “Functional/Physical or Physiological Impairment causes deviation from the normal function of a tissue or organ. This results in a significantly limited, impaired, or delayed capacity to move, coordinate actions, or perform physical activities and is exhibited by difficulties in one or more of the following areas: physical and motor tasks; independent movement; performing basic life functions.”
Learn more about United Healthcare and their Breast Reduction Procedure medical necessity guidelines.