Do you miss your pre-baby body? Has pregnancy seemingly wrecked your breast skin, nipple location and abs? For many Mums, it’s not just a matter of getting back to Pilates or eating well. It’s often a matter of the body having undergone radical changes from having children. If you’re wanting surgery to repair your post-baby body, you’ll probably be asking us this important question: “Are there any Medicare REBATES for Mummy Makeover Surgery or combined Breast Surgery and Tummy Tuck surgery?”
Is Cosmetic Surgery after pregnancy covered by Medicare?
No. Corrective Plastic Surgery may be covered, but cosmetic surgery is not covered by Medicare.
The answer is that Cosmetic Surgery is never covered by Medicare (nor by most Health Funds).
Some surgery to correct for damage related to pregnancy MAY, however, be eligible for rebate support at the current time. Your GP will know more or visit MBS Online – Medicare Rebate Codes & Information for details.
Medicare Rebates | Mummy Makeover Surgery
What’s currently eligible for a Medicare Rebate after pregnancy?
Pregnancy and breast-feeding DOES alter most women’s breasts skin and abdominal areas. But it’s important to understand that every patient is unique – so each Mum’s surgery needs can vary significantly.
Plastic Surgery and rebates can be confusing, however. That’s because SOME of the surgery you may require after having babies MAY be eligible for by a rebate from Medicare (or hospital cover by your Health Fund).
- Breast Ptosis, for example, can be fixed with a Breast Lift & Nipple Lift to correct for sagging breast skin.
- That procedure may be eligible for a Medicare rebate if your youngest child is between 1 and 7 years of age.
But rebates can not only seem confusing, they can also be subjected to sudden changes. This happened a few years ago with Abdominoplasty rebate criteria changes.
The other aspect of Medicare Rebates for Post-Pregnancy Surgery that can be frustrating to many Mums, is the question of COMBINED procedures (such as breast AND tummy surgery).
Sometimes more than one surgery procedure is required.
Combined surgeries may be required because most Mums experience changes to multiple areas of their body after having babies. The areas most affected are the breast tissues, nipples and abdomen.
It’s not surprising, then, that Mummy Makeover surgery options are so appealing to Mums who want to get their ‘pre-baby’ bodies back. Whilst you can’t fully recover your pre-baby body, you can certainly get it to look more like it did before the children came along (or at least, get firmer skin in the areas impacted by pregnancy).
So a Mummy Makeover surgery generally means Breast & Tummy Surgery (Abdominoplasty), performed separately or combined. Vaginal laser treatments to remedy lax vaginal skin are also an option with the Mona Lisa Touch laser system (there’s also a Labiaplasty option).
Typically, Medicare & Health Fund rebate eligibility applies only for single surgery sessions.
This means that rebates from Medicare – and Private Heath Fund cover – will often NOT apply if you want to combine your breast surgery and tummy tuck surgery into one procedure.
The other reason you MAY or MAY NOT be eligible for a Rebate is the indication (reason) for having surgery.
- Medicare and Health Fund Rebates tend to only apply if the reasons for your surgery are medical in nature, rather than cosmetic.
- There are also stringent criteria that you’ll need to meet.
Ask your GP for details about your post-pregnancy conditions and if they meets the Medicare criteria for a rebate on your breast OR tummy surgery (but typically, not both, if you are combining them into one session).
“When it comes the post-pregnancy body, ‘Are there any Medicare rebates for combined Breast Surgery and Tummy Tuck (Abdominoplasty) surgery?’ is certainly a question we hear a lot, notes Patient Liaison Manager, Michelle, and her team.
“If the reason is cosmetic, the answer is always NO. But some women have conditions that impact their health and well being after pregnancy. These sometimes qualify for a rebate from Medicare and/or private health fund cover. You will need to check these directly with your GP or with your Health Fund.”
For example, a Breast Lift or Breast Reduction to remedy severe breast ptosis after pregnancy might leave you eligible for a rebate.
So, too, might a separate surgery to reduce excess skin folds around the abdomen, such as what you might experience after losing weight after having Gastric Weight Loss Surgery (but not pregnancy). But in general, the skin needs to be causing chronic health problems that were non-resolvable by other means.
Then there’s the problem of “Diastasis Recti” – damage to your core ab muscles – along with vaginal stretching. These can both contribute to problems with urinary incontinence.
These may be other medical reasons for needing beneficial surgery such as a Belt Lipectomy or Abdominoplasty with correction of Diastasis Recti conditions. Your GP should be able to help assess your eligibility.
That noted, any rebates or Private Health Fund cover for Plastic Surgery or hospital stays tends to involve a lot of paperwork and numerous forms (you might even need to send photos).
It can certainly be confusing for patients. And there are other ways to fund your surgery (ask us for a Guide by phoning 03 8849 1444).
The best thing to do is to see your GP with your complaints, and find out if your Plastic Surgery requirements means you qualify for a Medicare Code and a potential rebate.
The Post-Pregnancy Body: How to get your Belly Skin or Breasts “Back” to Where You Want Them To Be
Pregnant women undergo “significant anatomical and physiological changes in order to nurture and accommodate the developing foetus”, according to researcher A. K. Hoffman et al. (Read the science behind those changes here).
Essentially, having a baby – especially if you have more than one OR a big baby or TWINS or TRIPLETS – does a lot of damage to the skin and underlying structures.
You’ll find pregnancy:
- stretches the skin, resulting in loose, saggy skin after pregnancy (typically on the breast and belly area, but sometimes also on the upper arms and thighs)
- damages the surface of the skin; meaning you’ll have stretch marks
- loosens or splits the abdominal muscles to accommodate the size of the growing fetus (meaning you’ll have a belly bulge that is simply not fixable by exercise and diet alone, as your underlying ab muscles are ‘split’ or ‘broken’)
Fortunately, our team of Specialist Plastic Surgeons are highly adept at helping MUMS get their bodies firmer, tighter, smoother and more uplifted after pregnancy. Phone us today on (03) 8849 1444 to enquire about our Mummy Makeover Surgery options.
Pregnancy can change your body in significant ways.
You may LOVE being a Mum and love your kids, but NOT love having a bulkier, saggier body.
Fortunately, Plastic Cosmetic Surgery can help you get firmness back to your belly and breast areas, where lifestyle changes have failed to remedy the situation.
Contact our leading team of Surgeons for more information about Mummy Makeover surgery options.
There are many good reasons to have separate surgeries as well, rather than combining everything into a single surgery session when you’ve still got young children at home to care for.
Medicare Codes: A quick overview
Although Medicare codes and rebates are subject to sudden changes – these codes apply to selected patients who have severe Breast Ptosis, and/or damaged abdominal muscles after pregnancy OR after significant weight loss.
Abdominoplasty Surgery (Medicare Item 30177)
The Rebate is approximately $739 and may be subject to sudden changes.
New Tummy Tuck criteria as of 2016-2017:
- Significant weight loss, defined as greater than 5 BMI units
- Weight stability for > 6 months
- There is intertrigo or evidence of skin irritation that has failed 3 months of conservative treatment
- Skin folds are interfering with activities of daily living
According to the Plastic Surgery Hub, 5 BMI units translates as 10kg for 150cm tall, 12kg for 160cm tall, 14kg for 170cm tall, 16kg for 180cm tall.
Breast Surgery Medicare Rebates – Codes for Breast Reduction & Breast Lift Surgery
- Bilateral Breast Reduction (Item no. 45520) – Medicare Rebate is $675.35 (1 side)
- Breast Lift after pregnancy – Your youngest child must be between the age of 1 year and 7 years old (Item no. 45558) – Medicare Rebate $861.75 (both sides)
- Breast Augmentation for Asymmetry (Item no. 45524) – Medicare Rebate $556.25 (1 side)
- Breast Lift for Asymmetry (Item no. 45556) – Medicare Rebate $574.55 (1 side)
We hope this has cleared up some of the confusion you may have about rebates for Plastic Surgery.
To schedule a consultation, phone (03) 8849 1444 today or send an enquiry form.
We look forward to helping you get your body “back” with precision surgery, best-practice safety aims and patient care excellence.
Visit our Downloadable Guides pages
For more information about Cosmetic and Plastic Surgery options and research in Australia.