When Insurance Covers Breast Reduction

No matter the reason a woman decides to have plastic breast surgery, this decision may cause her stress: physically, emotionally and financially. Her stress can be lessened if she is presented with the right information, such as the symptoms that hint towards surgery, how she may obtain insurance coverage and what she can expect going through surgery. With these pieces of information, a woman can be comforted by knowing what to expect through her breast reduction.

When To Get A Breast Reduction
A woman inquiring about functional breast surgery has the best chance to have her surgery covered by insurance.  This woman will have large breasts that have caused her discomfort. Symptoms may include:

• Chest wall heaviness
• Neck strain
• Bra strap irritation
• Upper or lower back pain
• Poor posture
• Tingling or numbness of the fingers

These symptoms will make it difficult for a woman to be active in sports, make her want to wear clothing that will conceal her size and will have worsening symptoms during child bearing years. Typically, these women begin as a D cup or higher and wish to be reduced to a C cup or smaller.

How To Obtain Insurance Coverage
For a woman to be covered under insurance, it is essential for her provide the following information to her insurance carrier:

• The estimate describing the amount of reduction from the procedure (most patients will go from a D or DD cup to a C cup)
• A detailed list of the symptoms present and their duration
• Any records of a non-successful conservative treatment period 
• Documentation regarding her condition and any attempts to reduce symptoms from her primary care doctor 

Anticipating The Surgery
After a patient goes through surgery, she can expect the following, as part of the plastic breast surgery procedure:

• Overnight stay in the hospital
• Pain level roughly between 2 and 5 on a scale of 1 to 10
• A return to work within around two to four weeks (dependent upon the patients type of employment)
• Partial or full return of nipple sensation and ability to breast feed in 90% of patients
• The breast shape lifted, as well as reduced

During my 30 years as a plastic surgeon the breast reduction procedure has been by far the most appreciated by my patients.  I attribute this to the fact that they not only feel better with the reduction of symptoms, but they also have an improved appearance. The most frequent statement that we hear after the procedure is, "I should have done this years ago."

To set up a consultation, call our office at 715-833-2116 and visit our website at www.ruckermd.com. Our staff is happy to assist you with any questions.

Profiles Fall / Winter 2012

The NEW Profiles is here! Click below to see our online edition.

• 1st Annual Pink Ribbon Charity Golf Classic Recap
• Giving Mother Nature a Boost
• Saying Good-Bye to Wrinkles
• Tips for Luscious Lips
• Eating Healthy for the Holidays
• Botox Blunders

Also check out our specials on the back-page for the Enza Medispa.

Watch your mail-box or check out these newspapers for your own copy:
Nov 7th: Pioneer Press, New Richmond News, River Falls Journal, & Hudson Star Observer
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Open publication

Is Breast Reduction right for you?

During my 25-year career as a plastic surgeon I have noticed that one of the most misunderstood concepts is the difference between a breast reduction and a breast lift.

The woman who is a candidate for breast reduction will often present with a history of an enlarged breast size since high school. She may have found it difficult to participate in athletic activities, and she will often present with complains of back pain, neck strain, chest wall heaviness, bra-strap grooving and, on occasion, rashes beneath her breasts. She will often have a breast size of D cup or larger. She may have tried conservative methods of easing her symptoms including physical therapy for her back, heat treatments, chiropractic care, muscle relaxers and even pain pills. She may have heard about the breast reduction procedure from a friend or may have been referred to us by her family physician.  

The woman seeking a breast lift presents with essentially no symptoms; her complaints are that her breasts have begun to sag over the years. This sagging may have been accelerated by a large weight loss or following a pregnancy. She often feels that her breasts are now too long, the nipples too low and that she has lost her natural cleavage.

So in essence, we have the breast reduction patient presenting with symptoms because of the sheer weight of her breast, and the breast lift patient because of the shape of her breasts. The breast reduction procedure may well be covered by insurance because it is an attempt to alleviate the potentially harmful symptoms that come with the weight problem. With the breast lift candidate, the aim is to only improve the shape, and it is therefore considered a cosmetic procedure – one not covered by insurance.

It is worth noting that fifty percent of my breast lift patients also opt to undergo a breast augmentation at the same time. They feel that they can better achieve that natural-looking cleavage with breast enlargement.

What to Expect

• The Procedure: The breast reduction and breast lift procedures are very similar. The only major difference is that in a breast reduction, a predetermined portion of both the breast tissue and skin is actually removed. In a breast lift, only a portion of the skin is removed to lift and reshape the breast. Most breast reductions will go from a D cup to a small or medium C cup. Breast lift patients will go from a C cup to a perky C cup. In both procedures the nipple areola complex is left attached so as to preserve sensation and the ability to breast feed. The two-and-one-half-hour breast reduction procedure is done in a hospital setting under a general anesthetic, and there is usually an overnight stay required. The breast lift procedure is done on an outpatient basis and may require a general anesthetic. In some situations it may also be done with a local anesthetic and sedation in our office operative suite.In order to gauge the improvement of symptoms, we conducted a survey. Of approximately 100 breast reduction patients, 95 stated that their symptoms and quality of life had significantly improved following reduction mammoplasty.
• The Risks: There is a potential for complications in any operative procedure. The most common being infection, scarring and sensation changes. During your consultation a detailed discussion of these potential risks will be given to you.
• The Recovery: After performing nearly 1,500 breast reduction procedures and 600 breast lift procedure I have found most patients rate the pain, on a scale from 1 to 10, with ratings between a 2 and 5 for both procedures. The patient may be off work from one week with the breast lift, to two to three weeks with the breast reduction.Light activity is tolerated well in the first week. Most patients are never so incapacitated that they cannot take care of their own basic needs. You will return to see the doctor one week after your procedure. All of your dressings are removed; your postoperative recovery and activity levels are again discussed as well as an anticipated date for your return to work. Light employment is tolerated after two weeks with heavy lifting and regular activity in three to five weeks. You are also given detailed instructions for care of your suture lines so as to help prevent excessive scarring. Your final consultation usually occurs five months after your procedure.
• The Decision: The most common thing that I have heard from my breast reduction patients is, “I should have done this ten years ago!”

My staff at RUCKER MD Plastic Surgery Clinic and I hope that this information will be of help to you if you are considering breast reduction (mammoplasty) surgery. The staff has gained a considerable amount of experience and knowledge in helping nearly 1,500 patients during the preoperative, operative and postoperative periods of reconstructive breast surgeries.

Please feel free to contact Dr. Rucker’s office at 800.456.8222 with any concerns or questions that you might have about undertaking breast reduction surgery. 

New Plastic Surgery Article Finds Most Patients are Pleased with Results of Breast Reduction

A new PRS study finds that women generally rate the appearance of their breasts following breast reduction surgery as "good" to "very good" - but plastic surgeons are more critical of the cosmetic results.
Since starting my practice in 1984, I have performed approximately 2,000 breast reduction cases. This procedure has by far been the most appreciated by my patients. The presenting symptoms I see most commonly are:

• Upper and lower back pain,
• Chest wall heaviness.
• Shoulder grooving.
• Rashes beneath the breast.
• Upper extremity numbness of the hand is the most extreme finding.

Before

After

As far as the cosmetic result, proper  breast mound development to avoid that flat operated on look is imperative. 
Most of my patients have gone from a DD cup to a perky C cup.

• 80% of our patients have recovered full nipple sensation and the ability to breast feed.
• We have found that this procedure has been covered by insurance in over 85% of our patients. 

To view more before/after photos and learn about this procedure, visit ruckermd.com

Mommy Makeover

Childbearing can be one of life’s most rewarding experiences, but it can also take a toll on the mother’s body, often causing women to lose their hourglass figures. Each woman is affected differently, with age and genetics playing a significant role in how her body recovers. Even with the assistance of a personal trainer and a proper diet plan, both of which I strongly recommend, many women may find it difficult to get it all back together after pregnancy. This can cause a dilemma for mothers. They may feel guilty for thinking about themselves at a time when they feel they should be focused on their family. Many of our patients find that it’s essential to focus on both.

They want to feel good, look youthful and sexy and regain their self-confidence. They realize that having a positive self-image can also improve their relationships with loved ones.

Mrs. M, now 38, didn’t like her shape after pregnancy. “I lost fullness up top, I had badly stretched skin and nothing was where it was supposed to be, even though I was doing endless sit-ups,” she said. “ I just wanted my body back.”
A Mommy Makeover is a combination of plastic surgery procedures that may include a breast reduction or breast lift (with or without breast implants), a tummy tuck and liposuction. These procedures lift and tighten slackened skin and reduce the unwanted, hard to remove pregnancy fat.

Before

After

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Breast Reduction

This procedure has been helpful for women with large pendulous breasts who have medical problems caused by the excess weight of the breasts, which can often occur after pregnancy. These problems can include:
• Back and neck pain
• Skin irritation beneath the breast
• Skeletal deformities
• Bra strap irritation
• Breathing problems
• Occasional tingling sensation in the hands

The goals of breast reduction are to:
• Make your breasts look balanced when you are wearing a bra
• Regain your younger breast contour
• Reduce the size of the nipple areola to fit the smaller breast size
• Reduce the overall breast size to reduce the associated symptoms and to make the breast proportional to the rest of the body
Breast reduction is performed in a hospital under general anesthetic. Care is taken to make the breasts symmetrical and to preserve sensation to the nipple, as well as, hopefully, the ability to breast feed. Both of these goals are addressed by leaving the nipple areola attached to a pedicle of breast tissue. Through this pedicle run the nerves and vessels that help preserve sensation and a good blood supply to the nipple areola.
All incisions are closed under limited tension, resulting in a smaller breast and areola and a lifted breast contour. We have found that if symptoms are well documented, most of these procedures can usually be covered by insurance. Please visit my website, www.ruckermd.com, to view before and after pictures of breast reduction patients.

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Breast Lift
You’ve nurtured your children, now, your body could use a little help getting back to normal. Stretched and sagging breasts are common after child rearing. The breast lift (mastopexy) has become one of the most requested procedures in plastic surgery, with approximately 100,000 breast lift procedures performed in the U.S. in 2007.

Over time, a woman’s breasts lose their youthful shape and fullness. These changes may be the result of pregnancy, breast-feeding, weight fluctuations, aging and the natural effects of gravity. Heredity can also contribute to breast sagging. Many women are born with poor skin elasticity resulting in a loss of breast firmness.

A breast lift raises and firms the breast by removing excess skin and tightening the surrounding breast to reshape and support the new breast. The nipple areola may become enlarged over time. A breast lift will reduce the areola to place it in better proportion with the newly shaped breast. The goals of the breast lift are to improve a female breast that:
• Sags or is pendulous, but is proportionate with the body frame
• Has lost firmness and skin elasticity
• Has a flatter elongated shape
• Has a nipple and areola that point downward
As with breast reduction, we do not detach the nipple areola complex during a breast lift, in an effort to maintain nipple sensation later. It has been my experience that most patients want to be a “perky ‘C’ cup” after a breast lift. This is an outpatient procedure when performed by itself.

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Liposuction 

After pregnancy, unwanted, fat deposits on the hips, thighs, abdomen and buttocks can be extremely difficult to remove, even with an exercise and dietary program. Liposuction can be performed on any part of the body to remove fat deposits and sculpt a more pleasing contour. This procedure is best for someone of normal weight with good skin tone. Several areas can be reduced at the same time. Because the fat cells are permanently removed, the bulge cannot come back in that place. Your new figure should be a motivation to exercise and be mindful of a healthy diet. Liposuction is usually performed on an outpatient basis under general anesthesia, taking approximately 1-3 hours. Body contouring procedures are considered cosmetic and not covered by insurance.

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Tummy Tuck (Abdominoplasty)

The human body is more like plastic than rubber. Childbirth may leave you with loose abdominal skin and stretched abdominal muscles. The tummy tuck (abdominoplasty) procedure helps to flatten your abdomen by removing excess skin and fatty tissue. Tummy tuck should not be confused with liposuction, although your surgeon may elect to perform liposuction to improve the overall results.
Tummy tuck is the recommended treatment for sagging or projecting lower abdominal wall tissues. Good candidates are women who have muscles and skin stretched by multiple pregnancies, and men and women, who, after massive weight loss, still have excessive fat deposits or loose skin in the abdominal area. The procedure is usually done as an outpatient under a general anesthetic and will take 1-2 hours. 


There are several options for tummy tuck.

Your surgeon will examine you and then discuss your desired results and the anticipated outcome for each.
Complete abdominoplasty. The incision is made in the lower abdominal wall area, from hipbone to hipbone. Excess tissues beneath the umbilicus (belly button) are removed and the scar is hidden beneath the panty line.
Belt abdominoplasty is usually for patients who have lost a considerable amount of weight. The laxity of the skin and fatty tissues occurs on the abdomen and around to the back requiring a circumferential excision of these tissues to get the best result.
Partial or mini abdominoplasty is often performed on patients whose fat deposits are located in a small area beneath the belly button. This procedure can be done in the office with IV sedation.

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What are the risks of having multiple procedures?

Several studies have found that the combined Mommy Makeover procedure was not significantly more risky for the patient than a single procedure would be. It is important to stress that these procedures are best performed by Board Certified plastic surgeons at a fully-equipped surgical facility. I believe that the best way to avoid complications is to select my patients carefully. We try to avoid performing these procedures on patients with any significant medical problems that may compromise their recovery.

The benefits to the patient of performing multiple, carefully selected procedures as opposed to several separate procedures are:
1. A reduced overall time under anesthetic
2. Downtime for recoveries can be combined, especially when time away from work and other responsibilities is an issue
3. Reduced cost for combined use of surgical facilities, 
anesthesia, and medical staff.