Can You Perform My Breast Augmentation for Free?

Q: Dear Dr. Eppley,  I’m 20 yrs old and currently in my junior year at college. I just found out earlier this year I have a breast deformity called ‘Constricted Breasts”. I knew something was wrong growing up when I wasn’t developing as I should. So I asked my doctors, at 18, about that, and he told me that when I get 20, my breasts should be fully developed. Well I’m 20 now, and they still look the same as they did in 7th grade. I have already tried to see if my insurance would cover a breast augmentation procedure, but they won’t, and my heart just sunk. It hurts so bad. It causes me mental, physical, and emotional pain. Just talking about it I burst into tears. My self-esteem is low, and I am not happy with the way they look and I also find myself cringing when I look down at them. I’m contacting you because I’ve seen your work here and I’m very impressed. I don’t want to seem as if I’m begging, but please, would you grant me with a free procedure? Being in a low-middle class family and in college, at times it’s really hard to make ends meet. I really don’t have anybody around me that understands the way I feel, or where I’m coming from, but you would make me smile from the inside out if you did this. I will be so blessed, and you can possibly change my life forever. From my heart, please consider this procedure for me. I can’t explain how happy I will be if you did this for me.

Thanks for your time, and I hope that for your kindness of your heart, you will make me happy.

A: I have great empathy for the concerns you have about your breasts, and wish that providing you with a free procedure were an easy choice.  Given the number of women who come into our office with similar concerns about their bodies, I can understand how connected self-esteem and a positive self-image are.   Providing surgery for free may seem like a simple and straightforward thing to do,  but there are many factors involved that make the concept of ‘donated’ surgery not exactly free. While any plastic surgeon can give away his time at no cost, a surgeon’s fee represents just a fraction of the total costs of surgery. The cost of the breast implants, use of the operating room, and the fee for the anesthesiologist expertise are other cost factors that must be accounted for and paid. The surgery center, implant company and anesthesiologist are under no obligation to provide services and materials at their expense for a cosmetic procedure. Often times, these costs make up more than that of the surgeon’s normal fee.

One obscure but significant cost of any surgery is the potential medical-legal responsibility that exists in every state. Unfortunately, donating surgery does not equal any waiver of responsibility  on the surgeon’s part.  Should any untoward events happen, such as a rare but possible complication,  the surgeon is still liable and responsible.  The possibility exists too, for the need for revisional surgery after the initial procedure and the question then becomes is the surgeon again expected to waive his or her fees?   There are no forms or waivers that a patient can sign that can legally hold harmless the physician for the services that he or she has provided.   

While a plastic surgeon may choose to donate his or her skill and experience for free, the rest of the costs of surgery remain, and are usually out of the surgeon’s control.

Dr. Barry Eppley

Indianapolis, Indiana