Would OHIP cover my breast reduction (from 32DDD to 32B)? (Photo)

Question

I am currently around a 32DDD (my breasts are quite asymmetrical) and I am looking to be closer to a 32A or 32B (photo 2). I am 5'6" and about 135lbs. Though my body is technically "proportionate" (my hip and chest measurements are within an inch of eachother), my breasts cause me discomfort while doing most activities, it is difficult to find bras and clothes that fit me correctly, and I am emotionally uncomfortable with my chest the way it is. Is it likely that OHIP would cover my reduction?

Kenneth Hughes, MD · Answer

Request a predetermination from OHIP to ensure that they cover breast reduction.Then see a board certified plastic surgeon (BCPS) to evaluate you.  OHIP may try to deny you based upon a lot of things like weight, lack of enough tissue that should be removed, lack of symptoms, and lack of previous medical management.  Find a BCPS who deals with these things on a regular basis. 
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Reza Momeni, MD, FACS · Answer

Breast reduction eligibility and coverage by insurance varies from one insurance carrier to the next, and cannot be determined based on cup size, but only based on an in-person examination to figure out how much tissue the surgeon needs to remove.  You also often have to qualify for multiple other criteria from your insurance carrier, so be sure to request their breast reduction coverage policy ahead of time before your plastic surgery visit to ensure you meet all the other non-size related demands that they have.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

Would OHIP cover my breast reduction (from 32DDD to 32B)? (Photo)

Answers (2)