Gynecomastia Surgery: Costs, Risks, and Insurance Coverage

Gynecomastia in males... complications, costs..?

I have gynecomastia.
However, I heard that the costs are quite high.
I would like to ask: 1.
Will there be any complications after the surgery, and is there a chance of recurrence? 2.
Is the cost of this surgery classified as a surgical fee or a procedural fee? 3.
Is this surgery included in the scope of procedures under Section 7, Chapter 2? My insurance needs this information for reimbursement.

jack, 30~39 year old female. Ask Date: 2016/03/09

Dr. Lu Daokuan reply Plastic Surgery

Male gynecomastia requires significant severity to qualify for breast reduction surgery (which is covered by insurance).
For milder cases, liposuction is used, but this procedure is not covered by national health insurance, nor is it reimbursed by insurance.

Reply Date: 2016/03/09

More Info

Gynecomastia, or male breast enlargement, is a condition that can cause significant psychological distress for those affected. Surgical intervention is often sought to correct this condition, and understanding the costs, risks, and insurance coverage associated with gynecomastia surgery is crucial for those considering the procedure.

1. Costs of Surgery: The cost of gynecomastia surgery can vary widely depending on several factors, including the surgeon's experience, the complexity of the case, and the geographical location of the surgery. On average, the cost can range from $3,000 to $8,000. This fee typically includes the surgeon's fee, anesthesia, facility costs, and post-operative care. It's important to note that this procedure is often classified as cosmetic surgery, which may affect insurance coverage.

2. Risks and Complications: Like any surgical procedure, gynecomastia surgery carries risks. Common complications include infection, bleeding, scarring, and changes in nipple sensation. While most patients do not experience significant long-term complications, there is a possibility of recurrence, especially if the underlying hormonal imbalance is not addressed. It is essential to discuss these risks with your surgeon to understand your specific situation better.

3. Insurance Coverage: Insurance coverage for gynecomastia surgery can be complex. Many insurance plans consider this procedure cosmetic, which means they may not cover the costs. However, if gynecomastia is causing significant physical discomfort or psychological distress, some insurance companies may provide coverage. It is crucial to check with your insurance provider about their specific policies regarding gynecomastia surgery. You may need to provide documentation from your healthcare provider to support your claim.

4. Post-operative Considerations: After surgery, patients can expect some swelling and discomfort, which usually subsides within a few weeks. Most individuals can return to normal activities within a week, but strenuous exercise should be avoided for several weeks to allow for proper healing. Follow-up appointments with your surgeon are essential to monitor recovery and address any concerns.

5. Classification of the Procedure: Regarding your question about whether this surgery falls under the second part of the seventh chapter, seventh section of your insurance policy, it is best to consult directly with your insurance provider or a healthcare professional familiar with your specific policy. They can provide clarity on how gynecomastia surgery is categorized and whether it qualifies for coverage under your plan.

In summary, gynecomastia surgery can be an effective solution for those struggling with this condition. While the costs can be significant and insurance coverage may vary, understanding the risks and potential for recurrence is essential. Always consult with a qualified surgeon to discuss your options and ensure that you have realistic expectations regarding the outcomes of the surgery.

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