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Breast reduction surgery, also known as reduction mammaplasty, is a procedure performed to reduce the size and weight of the breasts. For many women, large and heavy breasts can lead to persistent physical symptoms such as neck and shoulder discomfort, skin irritation beneath the breast fold, and difficulties with posture. Understandably, many people in Newcastle and the Hunter region ask whether Medicare can assist with covering the costs of this procedure.
Dr. Yezdi Mistry, Specialist Plastic & Reconstructive Surgeon in Newcastle, regularly assists patients in answering this question. His practice helps individuals understand Medicare’s requirements, assess their eligibility, and explore treatment options that support both function and wellbeing.
Medicare is Australia’s public health insurance system, designed to support patients by covering part of the cost of medically necessary procedures. Importantly, Medicare does not provide rebates for surgery that is performed for cosmetic purposes alone. However, in cases where breast reduction surgery is considered medically necessary, Medicare may provide a rebate under specific Medicare Benefits Schedule (MBS) item numbers (#45523 or #45520).
Medicare may contribute to the costs of breast reduction surgery when strict clinical criteria are met. These may include:
If these criteria are satisfied, your Specialist Plastic Surgeon can apply the relevant MBS item number (#45523 or #45520), making you eligible for a Medicare rebate. Learn more about the benefits of breast reduction beyond aesthetics.
Breast Reduction Surgery Before and After Photos
The outcomes shown are specific to those patients and may not reflect the results experienced by others, as individual outcomes can vary due to a range of factors.
While Medicare can provide partial rebates when the surgery is deemed medically necessary, it does not usually cover all associated costs. Additional expenses may include private hospital fees, anaesthetic fees, or any out-of-pocket surgeon’s fees. It is important to discuss these aspects in detail during your consultation so that you have a clear understanding of the potential costs involved.
When considering breast reduction surgery, it is important to consult with a fully qualified Specialist Plastic Surgeon. Dr Yezdi Mistry, based in Charlestown, Newcastle, holds FRACS (Plastic Surgery) and is a member of the Australian Society of Plastic Surgeons (ASPS). He provides patient-focused care, ensuring that individuals receive a thorough assessment and evidence-based guidance about their options.
Yes, if your back pain is directly related to the size of your breasts and you meet the Medicare clinical criteria, you may be eligible for a rebate.
No. Medicare does not cover procedures performed purely for cosmetic reasons without a medical necessity.
Yes. A GP referral is required to see a Specialist Plastic Surgeon under Medicare.
Private health insurance may contribute towards hospital or theatre costs if you are admitted as a private patient. However, coverage varies, and it is important to check with your health fund.
Your GP referral, along with medical records such as evidence of back or shoulder pain, skin rashes, and failed conservative treatments, may be required to support your eligibility for a Medicare rebate.
Yes, in certain cases. If a younger patient has significant symptoms and meets the Medicare clinical criteria, breast reduction may be considered. A thorough assessment by a Specialist Plastic Surgeon is essential before proceeding.
Breast reduction surgery can provide significant relief for those experiencing physical symptoms from large, heavy breasts. While Medicare may offer financial assistance when medical criteria are met, the process requires proper referral, assessment, and documentation. Dr Yezdi Mistry, Specialist Plastic & Reconstructive Surgeon in Charlestown, Newcastle, offers comprehensive consultations to determine eligibility and guide patients through their surgical options.
Dr Yezdi Mistry is a Specialist Plastic and Reconstructive Surgeon based in Newcastle, NSW. With extensive training and experience in both reconstructive and aesthetic surgery, Dr Mistry is committed to providing safe, evidence-based care that is tailored to each patient’s individual needs.
After completing his Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic Surgery in 2013, Dr Mistry relocated to Newcastle with his family in 2015. He began his work as a Visiting Medical Officer (VMO) in Plastic and Hand Surgery at John Hunter Hospital before establishing his private practice in 2017. His practice offers a comprehensive range of reconstructive and aesthetic procedures for the breast, body, face, and skin.
Dr Mistry’s approach to patient care is grounded in trust, respect, and open communication. From initial consultation to recovery, he aims to ensure patients feel informed, supported, and comfortable throughout their surgical journey. He is dedicated to maintaining the highest professional and ethical standards in all aspects of his work.
To remain at the forefront of modern surgical techniques, Dr Mistry continues to pursue ongoing professional development both in Australia and internationally. He was Australia’s first delegate at the Body Contouring Academy in Paris, where he received advanced training in body contouring and skin-tightening techniques, including VASER and RENUVION technologies.
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Please Note: Information provided on Dr Mistry’s website is provided as a basic guide, it does not constitute a diagnosis and should not be taken as medical advice. Any surgical or invasive procedure carries risks.
“I care because it’s my job as a surgeon, as a plastic surgeon, to do the appropriate thing and to give you a good outcome. I want to leave knowing that I can tell a patient, hand on heart, that I did the very best I could and that I looked after them, so when I see them post op later that day or the next morning, that they feel they were in good hands.”
– Dr Yezdi Mistry
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