My breast are two different sizes. If I want surgery, can I cover this with insurance? (Photo)

I am 19 years old and while developing my breast have come out to be two different sizes one being an A cup while the other one coming to be a C. It is very noticeable. Could this be consider a defect and if so would my insurance cover it?

Doctor Answers 10

Different sizes

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Insurance companies in general are only concerned about solving functional problems (e.g back or breast pain, inability to wear clothes or exercise, etc). They are not concerned about cosmetic appearance and it his highly unlikely that they will cover any revisions for this purpose. You should consult with your surgeon and talk to your insurance and try however. 
Many surgeons have payment plans and you should talk to your surgeon regarding payment. 

Insurance Coverage

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Thank you for your question. You will have to contact your insurance provider to determine if this is something your plan covers.  

All the best.


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I really depends on your insurance company; you have a pretty significant degree of asymmetry.  In my experience, this would probably not be  covered as a medically necessary procedure by most third party payor.  Best to discuss with your insurance company and to see a plastic surgeon who can assess you and possibly submit a preauthorization to your insurance company.  Do not be surprised if it is denied, however.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 30 reviews

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My breast are two different sizes. If I want surgery, can I cover this with insurance? (Photo)

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It really depends on your particular insurer. It's best to call your insurance company to ask about your specific plan. Best of luck! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 40 reviews

#insurancecoverage of breast surgery

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The answer the like most healthcare in the US is complex. Coverage depends on the specifics of your health insurance policy i.e. its wording and the laws of the state where your reside and/or the state where the surgery is performed. Currently the most patient pro state laws for insurance coverage are California and New York. Your photo shows a right breast that is less developed than the left but nevertheless present and a visible pectoralis major muscle. In some states with some insurance policies this would not be covered because you do not have Polands and the breast deficiency is not deficient enough i.e. you have a nipple complex and visible breast tissue on the right. In some states, like California, the deficiency is sufficient to come under the state law requiring coverage of reconstructive surgery.

Your best bet is to read your policy with respect to its coverage of breast surgery and find out if your state has laws regarding coverage of reconstructive surgery. If these 2 avenues come out negative you will have to go to a favorable state but first find out how that state's laws apply to non-residents with out of state health insurance. If your health insurance has a base of operations in that state it will be an easier go. This is work on your part but could save you thousands of dollars. You are paying for the insurance and have a right to coverage when it is applicable. Just going to a surgeon and having him/her write a letter to insurance will only work if you are in a patient freindly state and the letter is worded appropriately. If the policy is prohibitive and the state is not patient friendly the letter will be a waste of time.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breasts are two different sizes, can I cover this with insurance.

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Insurance coverage is unlikely, though it still might be worth a review or predetermination from your insurance plan. No harm in trying.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast Asymmetry

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Thank you very much for your question.

It may be possible to have this covered.  I recommend visiting with a plastic surgeon who will evaluate you and discuss your options.

It is possible that you may have a variant of "Poland Syndrome", in which case your insurance company may cover part of the surgery.

Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon

Assymetry to breasts

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The best thing to do is to go to a plastic surgeon,be evaluated and then they can take photos and write to your insurance company to see if they will provide coverage.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Asymmetric breasts - will insurance cover surgery?

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Thank you for asking about your breast augmentation.

  • I know how bothersome this is -
  • Although every woman's breasts are asymmetric you are absolutely right that your asymmetry is more than usually seen.
  • Insurance however (unfortunately) is unlikely to pay for surgery -
  • The insurer's reasoning will be that defect or not, it does not affect your physical health.
  • To find out for sure, contact your insurer and ask - although often they  say 'yes' and in writing later on, say 'no.'
  • So you also need a plastic surgery consultation - with a surgeon in your insurance network who needs to submit a pre-determination report to your insurer. 
  • So when you call your insurance or go on line, find out who those surgeons are.
  • I have two patients for whom insurance did eventually pay for this surgery - both times, the parent was a lawyer who spend 3 years appealing the insurance decision after surgery was done.

Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Breast asymmetry

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Although your breast asymmetry is quite significant, unfortunately insurance companies do not cover this type of surgery.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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.