Do I Qualify for Free Breast Reduction Surgery?
I was 14 years old when I went from flat-chested girl to voluptuous woman—almost overnight. Every girls dream, right? Not really. Having a D cup in your teens and a DD in your 20s is not so much fun.
Besides being uncomfortable naked and in a bathing suit, my neck and shoulders were killing me. And my belief that I looked OK in clothes was shot to pieces one day in my late 20s when I reviewed a taped segment of myself (I was an on-air TV reporter) and saw that I looked like I had two huge grapefruits under my sweater. I was horrified and never appeared on-screen again in anything but a business suit.
Life could have gone on like this—with me enduring the pain in my neck and rib cage, being tired of the sweat that accumulated at night between the two mounds of heavy skin while I tried to sleep, and strapping on several sports bras before every jog—if my mother hadnt met a woman whod had breast-reduction surgery. Id considered reduction mammoplasty, sure, but I really couldnt afford it. (The average cost is $6,000-plus, according to plastic surgery organizations.) But the woman my mother told me about had the surgery and loved it, and her insurance paid for it.
I had no idea my top-heaviness was a medical condition that might be covered. But I was about to find that out. Heres my journey and what you need to know.
The approval process
Insurance companies need to be convinced that breast reduction is medically necessary. And convincing them requires more than just a doctors recommendation. You need real proof. To get it, I went to see an aesthetic-and-reconstructive plastic surgeon. After a quick examination, he told me what I already knew. My breasts were large for my frame, one was a good deal larger than the other, and I had the typical indentation marks on the top of each shoulder where bra straps had pressed into my skin for years. In his opinion, I was a good candidate.
The next step was harder. I had to be photographed from the neck down, and the pictures were sent to my insurer. A panel of doctors would determine if a reduction was appropriate and, most important, if my bill would be paid.
Insurance companies typically make the call by relying on a set of charts that consider height, weight, and the amount of removable tissue in each breast, according to Amy S. Colwell, MD, a specialist in aesthetic-and-reconstructive breast surgery at Massachusetts General Hospital in Boston. The surgery is covered 90 percent of the time when the tissue to be removed meets insurers standard criteria. (It weighs between 400 grams to 2,000 grams, or about 1 to 4 pounds.) Women with DD, DDD, and H cups usually qualify. But Dr. Colwell says the criteria of different insurers can be fuzzy, and a recent study in Plastic and Reconstructive Surgery found that insurers breast-reduction rules arent always based on medical science.
Weeks passed as I waited to hear what a panel of strangers had decided about my naked body. When the call finally came, I was shocked and thrilled all at the same time: The insurance company had approved my surgery, and I would probably go from an overflowing DD to a B. At 5-foot-4 and 130 pounds, I thought that sounded a little bit small, but I knew I needed the surgery. And now, finally, at 30 years old, I could afford it. The cost? My small deductible of $150.
There are several ways to perform a breast reduction. In my case, tissue was removed from the bottom of each breast, and my nipples were moved up without disconnecting them from the blood flow, allowing me to quickly regain sensation. “Nobodys leavin till theyre even,” was my surgeons motto in the operating room.
What about the risks? They include infection, wound breakdown, scarring, and the need for re-operating. Studies suggest that 10 to 50% of women undergoing a reduction may have some complications. But the healthier you are, experts say, the more likely surgery will be a success. Dr. Colwell says most women are extremely satisfied.
With mild pain medication and a full week of rest, recovery was easier than I had anticipated. Early on, I had feeling in one breast but not the other. With time, sensation returned to both, just as the doc said it would.
Two years later, the scars around my nipple and the lower-middle section
of each breast are barely visible. The scars underneath each breast are light-colored and hidden by the natural shape of perky boobs. Because theyre around and below the nipple, they dont show in bikini tops or plunging necklines. To be honest, I love the scars. They are a reminder that I took control of a part of my body that was out of control.
Although it takes months for breasts to take on their permanent shape after a reduction, I quickly looked and felt different. The weight on my neck and rib cage was gone, and, for the first time in a long time, I felt proportional. And my bra size? I turned out to be a perfect 34D. (Once in surgery, my doctor was able to meet the weight-removal requirements set by the insurance company and still leave me with breasts that felt right to me.)
Now that Im out of the Big Bra Club and feel great, Im on a mission to convert other women whose large breasts are a health issue. They need to know that feeling top-heavy, uncomfortable, and embarrassed isnt just a part of life that they need put up with. They need to know its not normal to have to search constantly for a bra that fits or to have backbreaking pain. And although a reduction can limit a womans ability to breast-feed, its unlikely to affect mammograms. Ultimately, these women need to know that big-breast problems can be fixed. For good.