Q: Dr. Eppley, I have breast asymmetry and am interested in breast augmentation/lift surgery. I am 18 years old and have had two children. My breasts are significantly different by at least two cup sizes and have been so for six years. I have Tricare insurance. I am wondering if my being 18 years old is ok for breast surgery because I have already had two children so my body is done growing. I’ve spoken with my family doctor about wanting to have this done because its already done a lot of physiological damage to me.
A: Significant breast asymmetry is always a challenge in any form of cosmetic or reconstructive breast surgery. Having had two children and being two cup sizes different almost certainly speaks to the potential of needing some form of a breast lift on at least one the breasts (usually the larger one) and perhaps implants for both. Until I can see some pictures of your breasts I can not be any more helpful in recommending a specific plastic surgery treatment plan as there is great variability in many cases of breast asymmetry.
What is known now, however, is that insurance is not going to cover this type of breast surgery. Unless it is a case of reconstruction after breast cancer, breast reshaping surgery will be considered as a cosmetic procedure by any insurance provider today. The fact that you may have developed this through no fault of your own and it has a significant negative impact on your self-esteem is something that I have learned carries little weight with insurance companies.
Dr. Barry Eppley
Q: Dr. Eppley, I have breast asymmetry with two completely different sized breasts. One is like a B cup and the other one is more like a D cup. I’m a thick girl so I would probably want a lift, a smaller areola, and reduction in size on the bigger breast maybe down to a C cup. I know the other one will need an implant but my frame is too large for something like a B cup. I want both breast to be a C cup. I just want to finally be happy with my breasts and not hiding them all the time. Please let me know what you think this would take as far as cost and down time. Thanks.
A: The most difficult challenge in cosmetic breast surgery is management of the significantly asymmetric breasts. This is because one invariably will require some form a reduction/lift and the other one will need a breast implant. This also places scars on one breast and not the other and one breast will have an implant while the other one won’t. What this implies is two important concepts. First, breast symmetry can be improved and made a lot better but it is not attainable to have perfect or close symmetry between the breasts. Secondly, the difficult in trying to match the breasts with two different procedures indicates there is a high probability of the eventual need for a revision of the initial surgery for the best result possible. Expect to pay for total costs in the range of $ 7500 to $8500 for the initial surgery.
Dr. Barry Eppley