Mastopexy (Item numbers 45556, 45558)
Mastopexy which is more commonly known as a breast lift is performed after the breasts have sagged due to either ageing or deflation after breast feeding.
Most people believe that this is a purely cosmetic procedure however it can be covered by private insurance if it is deemed by your surgeon to meet certain criteria. The criteria are set by medicare and are very strict.
The key points are:
- Item number 45556 is applicable without restriction if you are only having a lift on one side in order to match the other breast.
- Item number 45558 can be applied if you the following are met-
- You must have had at least one child and breastfed
- Your youngest child must be between 1 and 7 years of age
- The nipple must have sagged so that it is below the level of the crease under the breast (Infra-mammary fold). See photo below.
A medicare item number can be applicable in certain circumstances
Many women will also want to consider breast augmentation in order to replace the volume lost after breast feeding at the same time as the lift. The other interesting thing about the definition is that it specifies that the lift can be performed by any means which includes using implants. Although rare, implants can be used alone in order to produce a breast lift without the extra scarring associated with the traditional techniques although the cosmetic result is usually not as good.
So if you are contemplating a breast lift don’t leave it too late and contact firstname.lastname@example.org for an appointment well before your youngest child reaches 7 years of age.
The nipples are clearly below the level of the inframammary fold (IMF) and therefore meet the medicare criteria for an item number.
This opinion piece was brought to you by Dr Damien Grinsell.