Cover for breast reduction: what are the conditions?

Dr Arie Azuelos' blog in Paris

Breast reduction, or reduction mammoplasty, is a surgical procedure designed to reduce the size of the breasts in women who suffer from various discomforts associated with overly large breasts. As well as improving aesthetics, this operation can relieve physical and psychological pain. Find out more about the conditions required for this operation to be covered by health insurance and other health bodies.

Breast reduction: criteria for reimbursement

Medical conditions

Coverage of breast reduction by the health insurance scheme is subject to strict conditions. It is approved for medical rather than aesthetic reasons.

The medical criteria assessed include :

Back and neck pain: breasts that are too heavy can lead to chronic back, shoulder and neck pain.
Dermatological problems: skin irritation under the breasts, particularly in the mammary folds, may justify an operation.
Breathing difficulties: excess breast weight can sometimes affect breathing, particularly when lying down.

Specific criteria for reimbursement

In France, Social Security may cover breast reduction if the surgeon removes at least 300 grams of breast tissue per breast (i.e. approximately one cup). However, each case is unique and must be assessed individually by a qualified surgeon, who will confirm the need for the operation.

Consultation and medical assessment

Initial consultation and medical file

During the initial consultation, Dr Arié Azuelos will assess the patient’s medical history and expectations and carry out a thorough physical examination. This consultation is also designed to ensure that there are no medical contraindications to the operation.

Administrative procedures

Is it necessary to apply for reimbursement?

In the case of a breast reduction, no application for reimbursement is necessary. The preoperative assessment and surgical plan must allow for a reduction of 300g per breast (i.e. approximately one cup).

Deadlines

The time between the first consultation and the operation may vary, but is on average one to two months.

This time allows you to confirm your willingness to undergo the operation, to prepare for the post-operative period (time off work, childcare, etc.), to undergo the necessary tests before the operation (mammogram and blood test) and to discuss with Dr. Arié Azuelos how best to perform the operation.

What is reimbursed and covered by Social Security?

Coverage is not synonymous with free treatment. It does, however, allow you to:

no operating theatre fees
drastically reduce the cost of hospital stays
benefit from sick leave/work
leavereimbursement of surgical, anaesthetic and nursing costs by your mutual insurance company.

Follow-up and post-operative care

Follow-up care after a breast reduction is crucial to ensure proper healing and to assess the results of the operation. Dr Arié Azuelos schedules several post-operative appointments to monitor healing progress and discuss any concerns the patient may have.

It is important for patients to have realistic expectations about the results of surgery. Although the benefits are often significant, each patient reacts differently and the final results may take several months to stabilise.

Conclusion

Breast reduction can significantly improve the quality of life of women suffering from the physical and psychological effects of overly large breasts. Dr Arié Azuelos is committed to providing personalised care and accompanying his patients every step of the way, from the initial consultation through to post-operative follow-up.