. I have a extreme case of tubular breast deformity. I have extreme depression due to my deformity. I'm waiting to see if my insurance will cover it. The lady in the office of where I went to get my consultation says she thinks it will not be covered. I can't live like this anymore. I really don't know what to do. Please help me
What Do I Do? I Have a Extreme Case of Tubular Breast Deformity? (photo)
Doctor Answers (12)
Breast Augmentation with Mini Ultimate Breast Lift for Tubular Breast Deformity
The best technique to correct asymmetry is to operate on both breasts. The left breast will need augmentation with implant and areola aligned to match the opposite side. If you are happy with the right breast volume then you may not need augmentation but you need a circumareola approach to adust areola positioning. Insurance does not cover cosmetic deformity and it will be an out of pocket expense. I recommend you use CareCredit. It is possible to change the shape of your breasts using only a circumareola approach to correct the deformity and excise the excess skin. My preferred technique is Breast Augmentation with Mini Ultimate Breast Lift.
Gary Horndeski, M.D.
Unfortunately breast deformities aren't usually covered by insurance
Unfortunately, the breast surgery is not likely to be covered by insurance. However, there's no harm in pursuing it. There might be a chance that, with extensive documentation of the associated depression, the insurance company may reconsider as an appeal.
That being said, the surgical cost with silicone implants (preferred method of correction) would likely be under $7K and there are MANY financing options out there. The interest rates are not that high. It might be the best money you ever spend if it helps you feel good about your body.
While 'fixing' your physical appearance may ease your depression, there are never any guarantees that surgery cures all psychological trauma. Counseling may provide relief for you as well. And it might also help for documentation purposes.
I really hope these answers help.
Insurance coverage for breast deformity
Thank you for your question. Unfortunately medical insurance companies do not consider the repair of a breast deformity as medically necessary, unless there is breast cancer involved. I have had many patients with similar breast deformity, and none of the repairs were covered by medical insurance. There are many cosmetic financing companies to chose from. And some terms with no interest attached to the loan. Also some practices will set up a "layaway" account for you. That way the practice saves it for you. Good Luck To You.
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The abnormality/asymmetry is significant enough that in California state law would require coverage by your health insurance. I do not know about other states. Your posted photo shows a very small breast on the right with a small nipple to fold distance and a deflated drooping left breast. The left breast fold appears much higher than the right. The correction is difficult given the degree of asymmetry and the number of breast components involved. I do not think you will be able to raise the fold on the right given the small nipple to fold distance so you will have to lower the fold on the left. You will also need adjustment of the skin envelope on the left prior to filling it with an implant. The right might be better treated with a staged expansion of the envelope before filling it with an implant.
You should be prepared for staged surgical operations and need to make sure your surgeon has everything planned out before proceeding.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Tubular breast deformity is not covered by insurance
Unfortunately, tubular breast deformity does not fulfill insurance criteria for functional medical necessity. I sympathize and understand how this affects your mental health. You can have surgery but it will be cosmetic. You can save up for apply for Care Credit to see if you qualify for patient financing.
Tubular Breast Deformity?
I leave the question mark in the headline, as I am not sure that this is a tubular deformity or not. The photo is dark and not much detail can be discerned. Without a side view, I can't see some things that would help put a name to the diagnosis.
What is apparent is that there is marked asymmetry, with an underdeveloped right breast and a markedly sagging left breast. Surgery to enlarge the right breast and to lift the left breast will improve your appearance.
While insurers seldom cover the surgery you will need to correct the breasts, there may be some options, particularly a resident's clinic at an university hospital with plastic surgery trainees.
During the time you are sorting out your options, getting counselling can be very valuable and I couldn't make a stronger recommendation than to get a referral from you regular physician.
Thanks for your question, best wishes.
Yes, it appears that surgery is the right answer for you. The best result is usually a combination of breast implants and a lifting (mastopexy) procedure. The surgery would have to be customized to your body to achieve the best results. As for cost, this really is something that you would need to address with your insurance company and it may or may not be covered. Otherwise, there are options such as CareCredit for financing or going to a teaching facility where you may be able to have reduced price surgery with the understanding that the surgery would be performed by the plastic surgery residents in training.
What Do I Do? I Have a Extreme Case of Tubular Breast Deformity?
First of all, thanks for the photo as it makes answering your question much easier. The short answer is that you can have nearly normal looking and symmetrical breasts and be very pleased with the results. The long answer is that there are multiple ways to go about this and you would need to consult with a very experienced surgeon in that type of surgery, so be sure you interview several in your area. In my practice it would involve a lift of the left breast with an areola reduction, and then probably the use of bilateral adjustable implants.
I do a fair amount of that kind of surgery and have for many years and have had very little luck in getting any insurance coverage with the procedure.
A breast lift with or without implants is likely your best option.
Thank you for your question and the photo.
A breast lift with or without implants is likely your best option. If you want the smaller side bigger, then you will need breast implants.
To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.
Tuberous Breast Deformity
I am sorry to hear about your anguish. From the picture one can see you have a significant breast asymmetry. This can be improved by a bilateral breast augmentation and a mastopexy (lift) on the left. This will obviously leave more scarring on the left breast in comparison to the right but should help achieve fairly good symmetry. Make sure you consult with a board certified plastic surgeon who has experience in these kinds of cases.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.