Plastic Surgery

Medicare covers plastic surgery when it is reconstructive—i.e., to correct abnormal structures from congenital defects, trauma, disease, or to restore function—while purely cosmetic procedures are excluded. Specific covered services include medically necessary reduction mammoplasty (≥6 months of symptoms and ≥2 qualifying signs/symptoms refractory to non-surgical care), implant removal for defined complications, gynecomastia surgery for Grade III–IV disease, panniculectomy for refractory abdominal fold complications (≥3 months), lipoma removal by suction lipectomy when medically necessary, dermabrasion for trauma/burn/disease-related defects, rhytidectomy for functional impairment, and reconstructive nasal surgery; documentation of duration, prior conservative care, operative details, and sometimes photographs is required.

"Reconstructive plastic surgery to correct abnormal body structures caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease is covered when directed to impro..."