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Getting Insurance to Pay for Augmentation of Massively Asymmetrical Breasts

I'm not sure if this is the correct website for this question, but I was wondering how to get insurance to pay for some or all of the cost of breast augmentation surgery to correct massively asymmetrical breasts. My right breast is a large C-cup, possibly D, and my left breast is a small B-cup, possibly A. A visited a plastic surgeon who recommended breast augmentation surgery, but my insurance company will only pay for reconstructive cosmetic surgery. Thank you for your advice.

Asked 27 months ago by dolphinsfan in US
Sort 6 expert answers by:
+1

Insurance to cover breast asymmetry

In general insurance companies do not cover the correction of breast asymmetry. You might be able to get them to cover a unilateral breast reduction, but they will not cover augmentation. If you wanted to pursue a reduction, your plastic surgeon's office could advise you how to proceed. The patient usually needs to submit verification that the large breast is causing symptoms such as back pain. If you want to pursue this, ask your plastic surgeon who in his/her office helps with getting... more
Tracy Pfeifer, MD
Manhattan Plastic Surgeon
+1

Breast augmentation and symmetry correction won't be covered by insurance

 Unfortunately, serious asymmetry is still something you can survive and live with and as such, your insurance won't be willing to provide coverage.  Try to save for the necessary procedure to improve the situation but don't place your hope on getting coverage as it will just leave you frustrated.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+1

Breast augmentation insurance coverage

I do not know of any insurance companies that will pay for breast augmentation surgery. They may cover a breast deformity it a young adult who has Poland's syndrome or maybe a tuberous deformity. But most won't.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Augmentation for Asymmetric Breasts

Insurance companies will sometimes cover a unilateral augmentation when there is very significant asymmetry. They may consider it a birth defect, which in fact it is. There is no way to know without asking. Ask your plastic surgeon to write your insurance company to see if they will cover the procedure; then you will know for sure.
John Whitt, MD
Louisville Plastic Surgeon
+1

Insurance coverage for breast asymmetry

Typically insurances cover procedures that improve function or relieve pain or other medical issues. Reconstructive surgery is viewed as making something abnormal appear more normal. Cosmetic surgery is viewed as enhancing something that appears normal. Obviously insurance companies vary widely in how they interpret those definitions. If you have significant breast asymmetry, they will be unlikely to pay for augmentation. They may pay for a reduction of the larger breast if it is causing... more
Bahram Ghaderi, MD
Chicago Plastic Surgeon
+1

Congenital and asymmetric breasts

SEE VIDEO FOR EXAMPLES: It is highly unlikely that any insurance complan y will pay for placement of an implant for management of a congenital breast asymmetry in my experience. In some instances, they may perhaps be willing to reimburse a portion of performing a reduction on the larger side (D down to a B) but you would need to request that your plastic surgeon draft a letter with photographs to support your claim. It is not unusual for plastic surgeons to charge for this process.... more
Otto Joseph Placik, MD
Chicago Plastic Surgeon
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