Will OHIP cover breast asymmetry correction? (photos)

Question

Ever since puberty I have struggled with the sight of my breast, I dont want to look in the mirror, I am self concious of my boyfriend seeing them and we have been together for 3 years. My left side is just a little A cup where as my right is at least a full B cup. As well as on my right, my areola is huge compare to my left. Im not sure if any of this is "normal" I figured since I will be 20 and have suffered this for at least 7 year, Im ready to see my options!

Rodger Shortt, FRCSC · Answer

HiJust the other day I had a patient with the exact same concern.  It tried very hard to have OHIP cover both breast surgeries.  In the end they offered to pay for one breast.  Seeing as how the implants cost money I suggested that my patient have the more expensive side covered but will have to pay for the breast lift/ reduction to the other side.  What you choose to do may be a bit different but I would expect that your surgeon may be able to advocate for you to get one side covered at least.  Dr Rodger ShorttPlastic SurgeonAss't Clin ProfessorDirector of Cosmetic Surgery Training,McMaster University

Michael J. Weinberg, MD · Answer

Thanks for this question.OHIP has a rule that they will only cover a 2 cup size difference. That likely means that you won't be covered. That seems unfair. I would see a Plastic Surgeon and still ask them to apply to OHIP for you and maybe even send a picture. Sometimes they make exceptions.

Leila Kasrai, MD, FRCSC · Answer

OHIP may pay for part of the surgery but not all.  Your surgeon would have to request approval for the surgery from the Ministry of Health.  During the consultation your surgeon will explain the many possibilities to create symmetry.  The healing time would be two weeks but you won't see the final results for a few months.

William Andrade, MD · Answer

Thanks for your question.  It is very uncommon to get OHIP approval for asymmetry correction.  Their guidelines state there there must be a minimum difference of 2 cup sizes so most cases are not this severe.

Martin Jugenburg, MD · Answer

Breast asymmetry is not uncommon among women. OHIP will not cover this type of procedure. Please meet with a board certified plastic surgeon experienced with this type of surgery to discuss your concerns and expectations. Best of luck.

Jeffrey E. Schreiber, MD, FACS · Answer

It's very rare for insurance to cover any breast procedures requiring breast implants.  Call you insurance company first before getting a consultation.

Alexander Golger, MD · Answer

You're best course of action would be to have a consultation with a reputable, board certified plastic surgeon, first and foremost, to discuss the best options for you. Then, an application can be made to OHIP for coverage. Although they have certain criteria that need to be met, they also do look at each applicant on an individual basis. All the best.

Connie Hiers, MD, FACS · Answer

I would suggest meeting with a board certified plastic surgeon to discuss your options. Insurance companies will not cover elective cosmetic surgery.

John M. Weeter, MD (retired) · Answer

It is unfortunate that you have this breast asymmetry.  An experienced Board Certified Plastic Surgeon can do much get a better balance of features.  You would benefit with different sized implants with some lift on the right side. I find that use of external sizers can help determine the volume difference to balance out your breasts.  A modest lift and possibly reduction of the right areolar diameter will also help.  Even though this much breast asymmetry is not common, insurance will not cover the costs.  Good luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your email. You most likely will need a breast lift and areolar reduction on the larger side and breast implants on both sides to improve symmetry. Please see an experienced board certified plastic surgeon.

Will OHIP cover breast asymmetry correction? (photos)

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