When can fat grafting be covered by insurance?

By Dr. Kelly Killeen, MD FACS · Board-Certified Plastic Surgeon · Published June 19, 2023

Would fat grafting into the breast be covered at all?

Fat grafting to the breast is a surgical procedure that, under specific circumstances, may be covered by insurance. The context in which insurance coverage is often applicable for this procedure includes several scenarios.
Firstly, breast cancer patients or individuals with BRCA gene mutations who have undergone prophylactic mastectomies to reduce their risk of cancer are usually eligible for insurance coverage for fat grafting. In these instances, fat grafting is primarily used to reconstruct the breast after mastectomy.
Secondly, insurance may cover fat grafting for those who have experienced deformities in their chest due to previous surgeries or accidents. For instance, if an individual has undergone a lumpectomy for a benign mass and the result is significant asymmetry or a noticeable depression, insurance providers might provide coverage for fat grafting to rectify the irregularity. Similarly, fat grafting can be covered for chest trauma that has resulted in deformity or asymmetry.
Lastly, congenital breast deformities, like tuberous breasts, may also be a valid reason for insurance coverage of fat grafting. This procedure can be used to correct the asymmetry often associated with tuberous breasts and modify their shape. However, it's important to note that fat grafting alone is not typically the most effective treatment for tuberous breasts. More comprehensive procedures, such as a lift, reduction, or the insertion of an implant, are often more beneficial.
In summary, fat grafting for the breast can be covered under insurance in cases related to breast cancer, post-surgery or post-accident deformities, and congenital deformities like tuberous breasts.

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