Can Breast Lift Be Covered By Insurance?

Posted on May 30, 2017 by: Dr. Ronald DeMars


A breast lift operation, also known as a Mastopexy, is a common procedure performed by Dr. DeMars in his private surgical facility in Portland, Oregon. Pregnancy, weight gain and loss, and aging are all contributing factors in the loss of skin and breast tissue support leading to the condition of breast sag, known medically as ptosis (pronounced toe-sis).

The degree of sag is described as Grade I where the nipple is lower than the center of the breast, Grade 2 when the nipple is down to the level of the breast fold, and Grade 3 in which the location of the nipple falls below the fold.

Dr. DeMars and other breast specialists rarely find it necessary to do a breast lift on Grade 1 Ptosis, but when patients are in the Grade 2 or 3 Categories their breast contours can be rejuvenated through the mastopexy process. Many of Dr. DeMars’ patients will add breast implants at the time of the breast lifts but this is not always necessary.

It is normal for patients to worry about the resulting scars when trying to decide if a lift is appropriate for them, but then find over time the scars soften and fade and are not intrusive. Many of Dr. DeMars’ patients find the use of scar treatments to be helpful in speeding the softening and fading process.

There is another procedure that actually uses similar incisions that reduces the overall size of the breast while lifting it. Heavy breasts can often lead to chronic back, neck and shoulder pain and the combination of lifting and reducing these larger breasts can yield some dramatic improvement in symptoms. Because breast reduction leads to an improvement of symptoms it is considered medically necessary by insurance companies and if enough weight is removed from each breast (most insurance carriers will require at least 500 grams or slightly over 1 pound be removed from each side) the insurance companies pay for the procedure.

Unfortunately breast lift is not treated as medically necessary by insurance companies and it is not covered by them. The benefits of a well done breast lift by Dr. DeMars are significant in the sense of a more youthful and attractive appearance,  but the lift alone without a large reduction is not seen as an operation to improve physical health.

If you would like more information on the Breast Lift Procedure or a free evaluation to see if you are a candidate for the surgery you can make an appointment with Dr. DeMars by calling his office at 503-253-3458.