Axillary breast tissue, often referred to as accessory breast tissue or polymastia, is glandular tissue that extends beyond the typical boundaries of the breast, usually presenting as a fullness or bulge in the armpit area. This tissue is anatomically identical to normal breast tissue, meaning it can swell, become tender with hormonal changes, and cause discomfort. People seek its removal for reasons ranging from aesthetic concerns to physical necessity, such as irritation from clothing or chronic pain. This article breaks down the average costs associated with axillary breast tissue removal and explores the factors that cause the final price to fluctuate.
Understanding Axillary Breast Tissue Removal
The diagnosis of accessory breast tissue typically begins with a physical examination, often followed by diagnostic imaging like an ultrasound. Imaging confirms the presence of glandular tissue rather than just fatty deposits. The surgeon uses this information to determine the most effective surgical technique, which directly influences the complexity and duration of the procedure.
For patients with tissue that is predominantly fat with minimal glandular component, liposuction is often the preferred and least invasive technique. This method uses small cannulas inserted through tiny incisions to suction out the excess tissue, resulting in minimal scarring and a quicker recovery period.
When the tissue is dense, glandular, or accompanied by significant excess skin, a surgical excision is required to remove the firm tissue directly. Excision involves making a longer incision, often hidden within the armpit crease, to fully remove the glandular mass and tighten the overlying skin.
Many cases involve a combined approach, where liposuction is used first to reduce volume, followed by a limited excision to remove residual dense glandular tissue. The choice of technique is important because excision requires more operating room time and greater surgical complexity than liposuction alone. This difference in technical demands translates directly into varying costs for the surgeon’s fee and facility time.
Detailed Breakdown of Average Costs
The total out-of-pocket cost for axillary breast tissue removal typically ranges between $3,500 and $7,000 for a bilateral procedure. This estimated cost encompasses the fees from all medical parties involved, not just the surgeon. The bill is composed of several distinct charges.
The Surgeon’s Fee is the largest component, often accounting for 40% to 60% of the overall cost. This fee covers the physician’s expertise, operating time, and pre-operative consultation fees, frequently ranging from $2,000 to $4,500. This amount varies based on the surgeon’s reputation and the complexity of the chosen surgical method.
The Anesthesia Fee covers the services of the anesthesiologist or CRNA and the cost of medications used. Since this fee is calculated based on the duration of the surgery, it usually ranges from $700 to $1,500. The final price depends on whether local anesthesia with sedation or general anesthesia is utilized.
The Facility Fee covers the costs associated with the operating room, supplies, equipment, and nursing staff support. Ranging from $800 to $2,000, this fee is determined by the type of location, such as an accredited outpatient surgical center or a hospital operating room.
Pre- and Post-Operative Expenses are frequently billed separately. These costs include mandatory pre-surgery blood work, diagnostic imaging, specialized compression garments, and prescription medications like pain relievers and antibiotics. These necessary expenses can add an additional $200 to $500 to the total cost.
Key Variables That Affect Pricing
The geographic location of the surgical practice significantly influences the final price, with major metropolitan and coastal areas often having notably higher costs than less urbanized regions. A plastic surgeon operating in a high-cost-of-living city, such as New York or Los Angeles, will naturally have higher overhead expenses that are reflected in their surgical fees. This cost difference can easily account for a fluctuation of several thousand dollars in the total bill.
The experience and reputation of the surgeon also play a determining role in pricing. Board-certified plastic surgeons with extensive experience frequently charge a premium for their expertise. A surgeon’s reputation and history of successful outcomes can warrant a higher fee compared to a less established practitioner. The specific complexity of the case is a factor, as a bilateral removal will cost substantially more than a unilateral procedure.
The volume of tissue being removed and the technique required directly impact the cost. A procedure involving extensive glandular tissue removal via surgical excision will be more expensive than a simple, fat-dominant correction using liposuction due to increased technical difficulty and time required. The type of facility also dictates a portion of the facility fee. Hospital operating rooms generally carry a higher facility fee than a private, accredited outpatient surgical center.
Navigating Insurance and Out-of-Pocket Expenses
Insurance coverage depends entirely on whether the procedure is classified as cosmetic or medically necessary. If the removal is sought purely for aesthetic purposes, it will be deemed cosmetic and will not be covered by health insurance, making it an entirely out-of-pocket expense. If the tissue causes documented symptoms, however, the procedure may qualify for coverage.
Criteria for medical necessity often include evidence of chronic pain, recurrent skin irritation or infections, or functional impairment, such as restricted arm movement. To pursue coverage, the patient and surgeon must typically submit documentation demonstrating failed attempts at conservative treatment methods, such as weight loss or supportive garments.
The submission to the insurance company requires the use of Current Procedural Terminology (CPT) codes, such as CPT code 19120 for the excision of a breast lesion. The insurer uses these codes to evaluate the claim.
Pre-authorization is mandatory to confirm coverage before the surgery is performed; without it, the patient risks full financial responsibility. For cases deemed cosmetic or for patients with high deductibles, alternative financing options are available. These options include specialized medical credit cards or structured payment plans offered through the surgical center.