This investigators stated that these studies should include data from older individuals affected by gynecomastia and utilize valid tools of psychological measurement in order to better quantify the effect; elderly patients affected by the disease have been over-looked in the current research; more data on this subject could improve the pre-operative evaluation of these patients and help identify the patients who will benefit from treatment. Preoperative patient factors and comorbidities, as well as intraoperative variables, were assessed. display: none; #closethis { 2008;121(4):1092-1100. color: #FFF; In a Cochrane review, Khan and colleagues (2015) stated that wound drains are often used after plastic and reconstructive surgery of the breast in order to reduce potential complications. For these reasons, there is insufficient evidence to support the use of reduction mammoplasty, without regard to the size of the breasts or amount of breast tissue to be removed, as a method of relieving chronic back, neck, or shoulder pain. Plastic Reconstr Surg. Schnur et al (1991) reported on a sliding scale assigns a weight of breast tissue to be removed based on body weight and surface area. width: 100%; Three review authors undertook independent screening of the search results. Priorities Forum Policy Statement. 2014a;34(1):66-73. }. These individuals cite evidence from observational studies to support this position (e.g., Chadbourne et al, 2001; Kerrigan et al, 2001). If reduction mammoplasty was performed before oncological treatment, the incidence of abnormal findings was higher. Is breast reduction covered by health insurance? | ASPS Covered items may include: A manual or standard electric pump (non-hospital grade) while you are pregnant or for the duration of breastfeeding. Breast reduction surgery is considered reconstructive and medically necessary in certain circumstances . CPT Codes 19316 & 19318 - Mastopexy & Reduction No significant changes have been made to the The NSQIP recorded two complication types: major complications (deep infection and return to operating room) and any complication (all surgical complications). Several important points should be considered in evaluating these challenges to insurers' criteria for breast reduction surgery. Policy. There were only 2 studies of a total 25 patients that were considered as good in quality. I have recently met with my primary doctor after speaking to my insurance company (aetna) for months about getting a breast reduction. Setala L, Papp A, Joukainen S, et al. Mayo Clin Proc. Grade II: Moderate breast enlargement exceeding areola boundaries with edges that are indistinct from the chest. Plast Reconstr Surg. In a liposuction-only reduction mammoplasty, a small access incision is made in one of the following locations: axillary (under the arm), periareolar (around the nipple) or in the inframammary fold (under the breast). Aesthetic Plast Surg. No data were provided on loss to follow-up. Surgical treatment of gynecomastia by vacuum-assisted biopsy device. Furthermore, no serious complications were observed in vacuum-assisted breast biopsy group. Patients undergoing surgery for gynecomastia should know that their scars may be visible when they are shirtless. 2012;69(5):510-515. Recommended criteria for insurance coverage of reduction mammoplasty. Early complications were rare (6.1%), with superficial skin and soft tissue infections accounting for 45.8% of complications. J Plast Reconstr Aesthet Surg. Ann Plast Surg. Breast Reduction Surgery: Procedure, Recovery, Cost, and More - Healthline The end-point was the complete resolution of gynecomastia. Surg Laparosc Endosc Percutan Tech. The Breast: Comprehensive Management of Benign and Malignant Diseases. Role of tamoxifen in idiopathic gynecomastia: A 10-year prospective cohort study. Of these 33 operative sides, 2 complications occurred, but satisfactory chest contour was attained in all subjects. 2000;45(6):575-580. Fischer S, Hirsch T, Hirche C, et al. 1998;41(3):240-245. Key takeaways: Health insurance does not cover cosmetic breast reduction, but it usually does cover breast reduction surgery that is considered medically necessary. background-position: right 65%; } It is not intuitively obvious, however, that breast weight would substantially contribute to back, neck and shoulder pain in women with normal or small breasts. Breast Reduction Surgery | Johns Hopkins Medicine Abnormalities in Adolescent Breast Development. Nelson et al (2014a) analyzed population data from the 2005-2010 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. The author average amount of breast tissue removed for women in 5 kg weight bands, ranging from 45-49 kg to 90+ kg. Alternatively, you may qualify if your breast size causes significant symptoms, such as: Long-term neck, shoulder or neck pain. Gland Surg. When seeking preauthorization for a breast reduction, your goal is generally twofold. The authors concluded that even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilized. American College of Obstetricians and Gynecologists (ACOG), Committee on Adolescent Health Care. All patients underwent routine investigations to exclude secondary causes of gynecomastia. 2002;33:208-217. .headerBar { Plast Reconstr Surg. Breast. Chadbourne EB, Zhang S, Gordon MJ, et al. Tang CL, Brown MH, Levine R, et al. Breast reduction surgery might also help improve self-image and the ability to take part in physical activities. The study by Schnur et al was based on a survey of 92 plastic surgeons who reported on their care for 591 patients. The authors (Nguyen et al, 2004) argue, based primarily on the results of the ASPS-funded BRAVO study (described below), that (with a single exception) no objective criteria for breast reduction surgery are supportable, including criteria based upon the presence of particular signs or symptoms, requirements based upon breast size or the amount of breast tissue removed, any minimum age limitations, any limitation based upon maximum body weight, requirements for a trial of conservative therapy, or the exclusion of certain procedures (liposuction). J Laparoendosc Adv Surg Tech A. Schnur PL, Hoehn JG, Ilstrup DM, et al. Plast Reconstr Surg. Until now, most published research on the subject has focused on how effective surgical treatment is on correcting the cosmetic appearance of the breast. Gynecomastia may be drug-induced. Grooving where the bra straps sit on the shoulder. PDF Breast Reduction Surgery - Commercial Medical Policy - UHCprovider.com Surgical management of gynecomastia--a 10-year analysis. Merkkola-von Schantz PA, Jahkola TA, Krogerus LA, Kauhanen SMC. Breast reduction surgery - Mayo Clinic Breast reduction outcome study. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna . height:2px; Reduction mammaplasty: A review of managed care medical policy coverage criteria. As explained below, the studies used to support the arguments for the medical necessity of breast reduction surgery are poorly controlled and therefore subject to a substantial risk of bias in the interpretation of results. For many patients the psychological impact of the disease is substantial. Am J Infect Control. Obstet Gynecol Clin North Am. Does Health Insurance Cover Breast Reduction Surgery? - GoodRx Aetna considers magnetic resonance imaging (MRI), with or without contrast materials, of the breast medically necessary for members who have had a recent (within the past year) conventional mammogram and/or breast sonogram, in any of the following circumstances where MRI of the breast may affect their clinical management:. They stated that no data are available for breast augmentation or breast reconstruction, and this requires investigation. This study included 35 patients who underwent breast reduction due to the idiopathic form of gynecomastia. American Society of Plastic Surgeons (ASPS). Aesthet Plastic Surg. J Plast Reconstr Aesthet Surg. Is there a rationale behind pharmacotherapy in idiopathic gynecomastia? Medical therapy should be aimed at correcting any reversible causes (e.g., drug discontinuance). In addition, Nguyen et al (2004) ignored a wealth of published evidence of the effectiveness of physical therapy, analgesics and other conservative measures on back and neck pain generally. Ann Plast Surg. } PDF Summary of Proposed Aetna Medicare Advantage Agreement Fan L, Yang X, Zhang Y, Jiang J. Endoscopic subcutaneous mastectomy for the treatment of gynecomastia: A report of 65 cases. (25 y/o female with a 38J bra size) according to aetna, I should more than qualify for a reduction as I have back, neck, shoulder pain, chest pain and pressure, arm numbness while laying on sides, etc. color: white; However, if liposuction is used as an adjunctive technique, the decision to use drains should be left to the surgeon's discretion. Saunders Co.; 1991. Burns JL, Blackwell SJ. A total of 15 articles met the inclusion criteria for review. Ages ranged from 18 to 66 years. Risk of bias was assessed independently by 2review authors. These investigators support its use for idiopathic gynecomastia in eligible men following the careful discussion of its risks and benefits. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. 01/04/2023 PDF Breast Reduction Surgery and Gynecomastia Surgery - Aetna This trial included all male patients who presented to the authors breast clinic who were diagnosed with primary gynecomastia, and were treated with a trial of tamoxifen 10 mg daily therapy, over a 10-year period from October 2004 to October 2015.
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