Does any health provider cover fat grafting?

7of9

I had a regional recurrence in axilla over 2 years ago. Radiation, which caused capsular contracture (bad), had the implant replaced last fall. It looks MUCH better but damn if it's not still rising up and getting tight again 2 years after rads, coming up on one year after replacement. I've been pretty good about massaging it most days but after swimming in the ocean (a nice problem to have) I can feel those tendons and muscles pulling and shrinking so bad.

I've been approved for nipples and tattoos, didn't get around to it first time but I think I'm finally ready to look normal especially after NED for over 2 years. I was denied by my "golden" Medical Mutual policy AGAIN for fat grafting to even out this closer, but still mismatching set of foobs. I'd like to do the nipple surgery and get some fat grafting to smooth out on the radiated side it looks odd, like where part of the muscles and tendons are tighter on one side...it kinda looks like an ace bandage holding in a water balloon with a gap here and there (sounds dumb).

Anyone have good results doing fat grafting and nipple surgery on radiated side (oh and minus axillary sac was totally removed). It looks 80%+ better than before the replacement surgery last year...would like to see if normal nips, tats and some fat grafting can help me forget about this crap - even once in a while when changing or getting in or out of the shower. My surgeon is confident with the low profile nipples the non radiated side will be fine and the radiated side should come through fine. I'm wondering too how much out of pocket this will cost me for the fat grafting. I've heard $1500? But that was a few years ago...

Meow13

It should be covered since you had a mastectomy for breast cancer. It is the law insurance companies must cover. Did you have your doctor's office contact them? They could have used a wrong code.

Lula73

Either your PSs office is using the wrong codes/descriptions or your insurance company is looking at it as cosmetic when it should be considered recon after mx. Believe it or not, lotsof PS offices do not know how to properly code for fat grafting and the lipo that needs to be done to get the fat. Odds are that is the problem.