Are There Any Grants for Breast Reduction Surgery?

Question

I am 48 years old. I had a Whilms Tumor at 3 mos. As a result of chemo and radiation have major scoliosis. I have indents in my shoulders that have caused pain in both my rotator cuffs, chronic pain in my lower left back. I am in college (almost graduated),on unemployment, and of course have no health insurance. I am small and short waisted which makes my breasts look like they are in the middle of my stomach! I am a 40DD. I often joke that if I cut my breasts off I would topple backward. HELP!

Tracy Pfeifer, MD · Answer

Hi Mary.Frank,

	You know your situation best re insurance.  When you start working, you may be able to obtain insurance.  That aside, I agree that if you do not have insurance or the funds to pay a private plastic surgeon, call the university hospitals in your area and find out if they have a plastic surgery residency training program.  Usually the programs will have clinics.  The residents will perform the procedure under the supervision of a board certified plastic surgeon.  When I was a resident we took care of many patients through the clinics for breast surgery, facelifts, etc. and the patients were very happy with the results.  Make sure you find out how much supervision the residents have-I prefer it if the attending is present the entire time and is present when the markings are made on the breast, which is basically the blueprint for the surgery.

	Tracy M. Pfeifer, MD

Darryl J. Blinski, MD · Answer

I think the previous poster is so correct about insurance coverage for breast reduction. But in my reading your question I believe you can not obtain insurance. Therefore Plastic Surgery residencies offer affordable surgeries by the PS residents. Otherwise, the costs to preform your surgery is a limiting factor, or out of pocket expenses for me. In my practice I can do a reduction as a charity case if my costs are covered. These costs for a reduction are $3,500. This will give you an idea of expenses. Regards Dr. Darryl j. Blinski, MIAMI

George Commons, MD (retired) · Answer

Soon we will all have health insurance via Obama in DC. We will all be forced to pay into this and that is also okay. I realize you are in a bind now but Obama is coming and that may take time but may help. You would definitely be covered by all insurance programs in view of what you describe. But you have no insurance. Can you get state assistance? Try going to your local university program. Often there are programs where surgery is significantly supported. This is an outpatient, non hospital procedure which helps contain costs. In training programs, you can get reduced costs when resident do your surgery. Residents are carefully assisted by attending staff so all gos well. Try these avenues. Check you local breast support groups. You will get good suggestions there. Good luck. Dr Commons

George J. Beraka, MD (retired) · Answer

Insurance Coverage for Breast Reduction

	80% of breast reduction questions on RealSelf are about insurance coverage. Here are some helpful points.

	1) Insurance companies try very hard not to pay for breast reduction, even though they should. Even small breast reductions relieve many symptoms such as back pain and shoulder pain, and even some types of headaches.

	2) Very big reductions (like from an F cup to a C cup) will usually be covered.

	3) Many policies will pay for breast reduction if 500 grams (a little more than a pound) or more are removed from each breast.

	4) Some policies take your height and weight into account. So that if you are tiny, smaller reductions will be covered. Find out the details of your policy.

	5) DON'T get too much of a reduction just to satisfy the insurance company. You will be unhappy with tiny breasts.

	6) Your surgeon needs to request pre-certification IN WRITING, and attach as much evidence as possible.

	7) Evidence includes letters from your internist, orthopedic surgeon, and/or chiropractor stating that breast reduction will relieve your symptoms.

	8) Some companies require that you try "alternative treatments" such as weight loss and physical therapy first.

	9) Don't give up. If the first request is denied, demand an appeal.

	10) If there is no insurance, and you cannot afford to pay a private surgeon, go to the plastic surgery clinic of a teaching hospital. There, residents do the surgery under supervision, and the cost is minimal. In New York City, we train residents and fellows at Lenox Hill Hospital, and they do good work.

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