Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition?

Question

I am trying to get my health insurance to cover SOME of my procedure, if possible. Because, why not? The language they use for cosmetic procedures is vague, and they do mention covering a "covered childs congenital deformation" so why wouldn't they want me to fix mine? I am only looking to make the left breast larger, to match he right as much as possible AFTER being lifted. [which I know insurance would not cover, ok with that.] I am curious about fat grafting as a work around to an implant.

Gary M. Horndeski, MD · Answer

It would be highly unlikely that insurance will cover any of your surgery.  The technique I recommend is a lift using The Bellesoma Method on the larger breast and a modified Benelli lift on the smaller breast with fat transfer.  I have done this on several patients with great results.  Also, this avoids the use of implants which are not lifetime devices.  These techniques avoid the vertical scar, maintain nipple sensation (in 95%) and the ability to breast feed.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear sugar_teeth,
based on your photos, it looks like you have a severe asymmetry but it is unlikely that insurance will cover the costs of your surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

James E. Chappell, MD · Answer

If one is under 18 insurance MIGHT cover it but I would make sure you get preauthorization. And you should be prepared with a full price quote either way so you know exactly what you might end up paying. Fat grafting may enhance left breast but it will take several sessions at least.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  I would not expect insurance to cover any aspect of surgery to improve symmetry.  The lift, as you mentioned, would not be covered and the only way to increase the size of the left would be through a lift or rounds of fat transfers, neither of which would be covered.

Camille Cash, MD · Answer

Plastic surgery is not deemed medically necessary and therefore it is unlikely that insurance will cover correction of your asymmetry. In order to improve the asymmetry you can consider a breast lift and implant to the smaller breast or both if you would like more volume overall.  See a board certified plastic surgeon near you to learn more.

Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition?

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Answer: Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition? (photos

Answer: Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition? (photos

Answer: Asymmetry

Answer: Asymmetry

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Everything you need to know about Breast Augmentation

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Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition?

Answers (6)

Answer: Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition? (photos

Answer: Is this asymmetry drastic enough that it would be potentially covered by insurance as a congenital breast condition? (photos

Answer: Asymmetry

Answer: Asymmetry

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Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.