the cost of a breast reduction
November 27, 2013 3:22 PM   Subscribe

I have health insurance, and the co-pay will be about 3150. Should I do it now, or wait?

I'm trying to decide if I should pursue getting a breast reduction. I'm a 31, non-smoking woman, with 40M breasts. I'm technically obese but honestly each one of my boobs is about 20 pounds each, so yeah. I initially pursued getting a breast reduction in my very early 20s, but it was not approved by my insurance company at that time because I had not tried physical therapy, and there was some concern on my PCP's part that I'd somehow be shortchanging my future husband's babies by not being able to breast-feed. I know, right?


I'm US-based, and living with family right now, so if I were to get one within the next year or so, I'd have an immediate support network available to help me. Here are my thoughts:

1. I'm paying about 400 a month for health insurance, so why not use it?

2. But isn't 3150 for a medically necessary procedure a lot? Should I wait until I'm employed and maybe have better health insurance through an employer? How much do people typically pay out of pocket for breast reductions?

3. But if I wait, I'll be moving to a new place, having major surgery, and all without knowing anyone in the area, since the odds of me getting a job in this area are v. slim... I've never had a surgery before, so kind of don't want to do this by myself.
posted by anonymous to Health & Fitness (14 answers total) 3 users marked this as a favorite
I can't speak to when (or if) you do this within your overall lifetime (i.e., waiting until you're employed, etc.) but what I will say is that you might want to consider the timing within your particular insurance plan's maximum yearly out-of-pocket costs. Will doing it now (before year end) vs. waiting until next year affect how much you have to pay?

I ask, because last year I unthinkingly waited to have a "cosmetic" procedure (mole removal) done until after the new year -- and I ended up having to pay more than I would've if I'd had it done in December. This will obviously vary depending on plan but you might want to check into it.
posted by hapax_legomenon at 3:34 PM on November 27, 2013 [1 favorite]

$3150 is a lot, but not necessarily a lot for a surgical procedure. It's not unusual for people with insurance and actual medical problems to have several thousand dollars a year in out-of-pocket costs, but that's usually compared to tens of thousands (or hundreds of thousands) of costs without the insurance. That said, this thread talks about some of the costs sans insurance, and it doesn't seem to be as much of a discount as many things are.

But, honestly, if you've got $3k to spend? I wouldn't necessarily want to spend another couple years hauling that much weight around like that, that's for sure. It does not sound so egregiously high that you'll kick yourself forever for not having gotten it cheaper.
posted by Sequence at 3:40 PM on November 27, 2013 [2 favorites]

I can't answer all your questions, but I just had a breast reduction six weeks ago.

1. With health insurance that already costs $400 a month, I would be very careful to make sure to check for any crappy extra charges or loopholes they could use to charge you more. Also, if there are complications afterwards, how much will follow-up care cost and will you have maxed out your coverage?

2. I have good insurance and my total cost was $35 for the initial surgery consultation and $50 for the surgery. All my routine visits to the surgeon post-surgery have had no cost to me. Now that I've had the surgery, if someone asked if I'd have paid $3150 out of pocket for it, my answer would be an enthusiastic yes.

3. For care after the surgery, you will need a ride home from the hospital and it's best if someone is with you for the remainder of that day. I had my husband to help but I could've taken care of myself after the first day if I had needed to. It would've been rough but possible.

Sorry that's not more decisive one way or the other. Because my experience has been so positive, I think I'd advise to do it within this year if you have a clear picture of how your insurance works and if you can swing the $3150.
posted by Squeak Attack at 3:46 PM on November 27, 2013

I've had a couple of friends (who have not yet had children) who've had breast reductions, for primarily cosmetic reasons. As you might have seen when researching breast reductions online, there is a long aftercare period during which your breasts will be very tender, you need to limit your movements, and you will not be able to engage in most exercise. However, my friends where all back to work only a couple days after surgery, so there is very little debilitating downtime, unless there are complications.

+$3000 does not sound out of the realm of normal for an elective procedure. Depending on your insurance, it can be perfectly reasonable.

Also consider:

1) Any surgery is more risky when you are overweight. It sucks to hear, but it is true. Healing times, risk for complications, all increase. I know weight loss can be extremely difficult, but any weight lost will help your chances of a successful outcome.

2) Given the risks of surgery, you may get more bang for your buck if you spend that money on weight loss/management initially. Check with your insurance company if there are any special programs they offer. They often have options, such as counseling, discounted gym memberships, and other options.

3) If you move after surgery, try to schedule the move for a couple of months after surgery. You're not going to be able to help in a lot of the moving efforts if its scheduled close to your surgery data. Getting help in this area might mean an extra cost.

4) Be prepared to spend money on new soft bras for right after your surgery. Its a smaller cost, but still something to think about.

5) If you do decide to move before surgery, maybe a family member or friend could come out and spend a few days with you, to help you?

You didn't mention if you'd already been to a doctor to discuss the surgery. Do schedule a consultation either way: your doctor or surgeon may have other considerations to bring up.

Good luck!
posted by troytroy at 3:52 PM on November 27, 2013

I guess I should further chime in that I'm fat and the surgery went fine. And no one, including my primary care doctor and the plastic surgeon, suggested I lose weight first for which I am eternally grateful. Seriously and sincerely.

I knew from experience that getting to a thin weight didn't bring my breasts down to a reasonable cup size and I was prepared to fight on that front but didn't have to. If you're an M cup, lowering your BMI likely won't reduce you to a B cup.

I was so happy to be treated as someone who could chose this surgery at whatever weight I'm comfortable at. I think you have the right to be treated the same.
posted by Squeak Attack at 4:02 PM on November 27, 2013 [6 favorites]

I'm in the if-you-have-the-money-and-want-the-procedure...DO IT. As soon as possible. It's a quality of life issue. /34G with back problems Honestly if I were in your shoes I would also be price checking rolling carts or perhaps butlers to carry them around on trays in the meantime. Not trying to snark. Boobs are hard.

For what it's worth I also shadowed a plastic surgeon for a short time in high school and stood in on a reduction surgery and met quite a few women post-op. Every single one of them was just SO HAPPY to not be lugging their extraneous breast mass around with them anymore.
posted by phunniemee at 4:13 PM on November 27, 2013 [2 favorites]

Have you been approved for it by your insurer or have you just learned the cost if approved? "Technically obese" was enough to have an insurer deny coverage for a friend of mine who had it done, and when I first consulted the surgeon who eventually did mine, he made clear that should my then-weight increase by more than X amount, they'd have to seek re-approval. If it's an issue with your insurer, your question may be moot until you meet their requirements. Good luck, it's so worth it.
posted by headnsouth at 4:15 PM on November 27, 2013

Do it now, while you have family to care for you post-op! I had my reduction mammoplasty in the Midwest in 1998 and it cost approximately $5000, so the price you've been quoted seems like a bargain to me. Honestly, having the surgery was one of the best decisions I've ever made for my health. Now I'm a runner, and I live back-pain-free! And I was able to breastfeed (had my first baby 9 years post-op so the milk ducts must have recanalized). Best wishes!
posted by hush at 4:46 PM on November 27, 2013

My deviated septum surgery was about $2200, so this sounds like a great deal. I say go for it! You can pay in installments, too, so don't be afraid to ask for a payment plan.
posted by vickyverky at 5:07 PM on November 27, 2013

I'd agree with those who say do it now. I was on enough pain medication for about a week after the surgery that the only thing I could really do for myself was visit the bathroom. Having family around to help out was amazingly helpful.
posted by kbuxton at 7:08 PM on November 27, 2013

Here's something to consider - look at your deductible and out of pocket costs under your plan. Have you spent a lot on health care this year, enough that you're going to hit your deductible? If yes, you might consider getting it done sooner rather than later so that you can maximize how much your insurance will pay. However, if you haven't, you may want to consider it for early next year. This way you'll have a head start on getting to your deductible and out of pocket costs, so that you can have anything else done that you need, or just have that extra room in case something happens that will run up some bills.
posted by azpenguin at 7:10 PM on November 27, 2013 [1 favorite]

I had a breast reduction and tummy tuck about six months ago. My insurance paid all but my deductible on the BR. Honestly, recovery from the reduction was pretty easy in comparison to the tummy tuck. You do have to wear sport or soft bras without underwires for the first six weeks. I bought a couple of fairly inexpensive ones.

My husband was there to help me the first few days but if it had been just the reduction, I think I would have been fine in a day or so on my own. I would say on a pain scale of 1-10, the reduction was about a 3-4 the first couple of days and hardly anything after that. I spent one night in the hospital. I went back to work at my desk job very carefully after two weeks but that was probably pushing it a little much with tummy tuck but would have been easy with just the reduction. YMMV but I am very pleased with the results and would do it again. No more neck/shoulder pain and headaches.

Be sure the price quoted includes the hospital or surgery center and the anesthesiologist. My insurance actually paid more than was expected and I ended up with a refund. If paying upfront is a problem, you might consider Care Credit.
posted by tamitang at 8:38 PM on November 27, 2013

I live in a different country to you so can't really comment on price and insurance etc. It all works differently here, with private insurance, Medicare, etc. However, after initially being horrified by the estimated out of pocket cost, I saw a couple of other surgeons and found one who treated me like a human being and whose costs weren't as high as the first one I saw. Went ahead with it, my only regret is I didn't push harder to have them be a bit smaller :) Seriously though, don't put it off. It's great. Also recovery in winter/cold weather is better than recovery in summer/hot weather - less icky to have to wear bandages without showering for a couple of days, not as much sweating in the post-surgery bra, etc.

FWIW I took panadol after the surgery (tylenol?). I was incredulous when the doc told me, but it was fine. The pain was minimal, really. I live by myself and didn't have anyone look after me, though did get a lift home from hospital. It was all fine. 6 months on and I have trouble remembering what they used to be like. Feel free to memail me with any other questions; I was a bit of a nervous nelly about it beforehand but it was honestly so straightforward and simple.
posted by Athanassiel at 9:41 PM on November 27, 2013

Even if you DO eventually get insurance that reduces the cost of the surgery--you're probably not going to save THAT much on the procedure. I mean, even if your new insurance saves you half, you are saving about $1,500. That looks like a lot of money, and paying it off might entail some sacrifices for a while, but it is not going to change your life. However, a bad or complicated post-surgical experience can change your life.

I would do the surgery now, with your support system around you, and consider the potentially higher cost of it an investment in peace of mind. (And you'll be all healed up and able to start your new life with happy new boobs and without this surgery hanging over your head.)
posted by elizeh at 5:48 AM on November 28, 2013 [1 favorite]

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