When I was informed I had BC and needed a Mx, I looked on the bright side, wohoo I thought, and I can have new breasts and a flat tummy. Sad I know, but it helped me get through the initial dx and surgery.
I decided to start looking into a recon. All the plastic surgeons I have found don’t fit into the price range that my medical insurance will pay; there is a shortfall of thousands. (I only have private though my company, I am not rich, I am very poor…(but happy))
So this leaves the NHS and I have just been told that the PS will do an augmentation, but not an enlargement on the remaining breast. I just rang a plastic surgeons secretary and she had never heard of it. She said on the NHS they wouldn’t do an enlargement as its cosmetic.
Anyone out there who can cheer me up and tell me that the nice NHS will do this? My other breast is so small after all the cysts have been drained. If I can’t have a decent pair of breasts then I am not sure I will have a recon. (I only want a B cup, not asking for a Jordan)
As far as I know the NHS will pay for surgery to even up your breasts if the reason they are wonky is due to breast cancer. I don’t think of it as cosmetic, it’s all about body image and that’s why they pay for reconstruction which strictly speaking is not medically necessary either
I just had a tram flap recon 2 weeks ago and went private. Same problem as you but my consultant rang up the insurance co (Medisure) and negotiated with them and came to an agreement. Maybe worth trying surgeons further afield?? THough I guess you won’t want visitors to travel too far. Mine was in Oxford, 1 hour away from home and family.
Re NHS, I was under that same impression as Mole, that the NHS will pay to get them to look the same. Maybe different NHS surgeons offer differing things - others may be willing to give you a bigger breast that you started out with on the Mastectomy side and then increase the other.
My recon has ended up bigger than I and my surgeon had anticipated so I am now wondering whether to get the other increased to match or to decrease the size of my new one at the next op. I have not had it confrimed yet whether he will increase the existing one yet, though. Check up next week so will ask then.
They frequently offer to reduce the nonaffected breast to match the reconstructed one - in NHS; cannot imagine why they would not enlarge it for the same reason unless there was a medical reason why not. They quite rightly don’t treat it as cosmetic to try to undo the damage from breast cancer. Actually, what is the difference between an augmentation and an enlargement? - sounds the same to me.
I think augmentation is where they take some skin away from the bottom and sort of push it up so it is more pert, but they have to move the nipple too. They don’t add to the size. But I could be wrong!
Hi Deb
There was a large shortfall when I started enquiries with my insurers. I’m on my husband’s work policy and there are limitations to where you go and who you see. I wanted to see the surgoen I’d been referred to as I trusted the team I’m with. My surgeon spoke to BUPA to explain exactly what he was going to do. They upped their allowance for the op although there was still a shortfall. When I got the paperwork it looked like I was having 3 ops! It mentioned the diep reconstruction, a hernia repair and resection of a rib!!! They are all part of the op but by listing them separately their computers recalculate the amount they’ll cover you for. Have a chat with the PS’s secretary because I think they face this all the time.
As far as the NHS is concerned my friend had a diep flap recon, then later she had a reduction on her good side. I see no reason why you shouldn’t have a matching pair if it means an enlargement. I think the only problem is the wait. A lot of women are having immediate reconstructions so they obviously have to be done first. For me I preferred to wait. But I am really pleased with the results. My recon is smaller than my good boob but I didn’t want an implant (not enough tummy fat!)
I think augmentation is where the boob is lifted to make it less droopy and enlargement is with an implant to make it bigger.
I have just scanned the above comments and I am a bit shocked that cost is even a factor.
I am in Edinburgh and am 2.5 years post dx, I am having my tram recon on left side in 3 weeks. At a later date if I want it the Plastic surgeon will get me a new nipple and make any adjustments if I want him to. This is standard procedure.
He wont do dieps as the fail rate is higher than in the tram so can be counter productive in the long run
Louise x
I was in the same position as you, my insurance WPA would only offer £2000 towards surgeons fees, his fee for DIEP recon was £5000, leaving me with a £3000 shortfall, I negoiated with my insurance company, they then agreed to pay £4000, I then went back to my surgeon and he dropped his fee by £500, so only had to pay £500 shortfall which I felt was worth it to get the surgeon I wanted.
Which insurance company are you with? - Like everything with bc, its a battle but it def is worth going back to your insurance comapny and asking to speak to a manager, all medial insurance companies work on operating codes for each medical procedure, it may be worth getting them to investsigate if the amount they are allowing for the DIEP is reasonable.
My mum had her “good breast” reduced to match the reconstruction of the other breast and they were pushed up and although smaller now (she is happy as thought there were too big before) they look marvellous.
Hi Deb. I have an implant in my right breast after mastectomy and am waiting for an operation to lift and augment my left one to match my lovely pert new breast they will do the nipple on the implanted breast at the same time. The service I have received from the NHS is wonderful nothing is too much trouble.
Hi had a full mastectomny four weeks ago. I also had my other breast reduced. I was always big breasted before and never liked it so really wanted to go a bit smaller. However I think I am a bit too small and wonder if any knows if they will put an implant in my natural breast to up the size slightly or is this considered just to much to expect? any ideas
I had a tram recon in April and the lady in the next bed had an LD recon on her affected breast. (she had been almost flat chested all her life) and the surgeon gave her an implant on the other side for cosmetic reasons only, this was done on the NHS at Whiston hospital. She was absolutely delighted with her new shape. Its worth checking with different hospitals to see if it is available to you.
Good luck
Julie
Just a thought sueg11 - as you were used to your size before, it may take a while to adjust to your new size as it is a contrast in size, but as time goes by you may get used to it and not think it is too small, and not need further surgery? Only a thought, because people say it takes time to adjust. On the other hand, if it is too small, I feel sure they would put an implant in because some people have numerous tweaks to get it right, so I can’t see that they wouldn’t do that for you. It is terribly important to feel happy with what you have, and I would say you have a right to be demanding - there is no need to settle for anything you are not happy with.
I wonder if it’s one of those NHS postcode lottery things. On the first visit to my plastic surgeon, I was asked if there was anything that I didn’t like about my shape. I could have anything I wanted, bigger, smaller, more pert - anything. I opted for a mastoplexy, where they lift the “good” breast and move the nipple and I’m slightly bigger, from a c cup to a dd.
I had a mastectomy last November. I am waiting for reduction on my other breast (it’s currently 36DD) before recon, hopefully, next year. As far as I can see it’s unfair to treat one and not another. At the end of the day the aim is to have breasts that match. I think you should ask around and push your point home. I do agree it can be a post code lottery. But it not right to reduce a breast and not augment another. At the end of the day we’ve all been diagnosed with breast cancer.
Hi dbusby,
I am going to see my plastic surgeon next week re the reconstruction. I saw him when I was first diagnosed and he actually suggested doing both boobs to ensure they looked the same. I thought this was typical of all practitioners and am quite shocked to read that some of you were told it was only for aesthetic reasons and would not be done on the NHS. Frankly that disgusts me, it’s hard enough going through the treatment after diagnosis and the effect it has on your self image without having to justify why you want 2 reasonably equal sized breasts - for god’s sake!! Obviously I am in an area (Newcastle upon Tyne) where the surgeons try to help you get back to feeling as normal as you can and try to restore as positive a body image as they can - I feel very lucky.
By the way when requesting to see a consultant now you can put down 3 choices, it’s called ‘chosen book’, maybe you could go back to your GP ask to go to a PCT that are more sympathetic such as Newcastle, if this would be an option for you to travel. I think it would be worth it. Anyways something to think about. Good luck, hope your successful and remember - those who shout the loudest get seen.
Love Halli xx
Well im just back home from St Johns (via Starbucks)
Op went very well PS is very pleased as I am. Felt horrendous for the 1st few days but by day 3 was moving about, got my last drain out this morning and have even en to the toilet whoo hoo