Breast Reduction Surgery for Macromastia

More than the struggle to find well-fitting clothing, the volume and weight of disproportionately large breasts cause a woman numerous physical problems that can have far-reaching psychological repercussions.

Macromastia or breast hypertrophy, as it is clinically known, is a medical condition that may occur due to over-development of glandular tissue during puberty, or as deposited fat in the breasts as women age or become overweight. It can also occur as a result of hormone sensitivity and can affect just one or both breasts.

While there is no hard and fast rule as to what constitutes macromastia, a fair indication is that breast weight is approximately 3% or more of an individual's total body weight and breast tissue exceeds 1,5kg.

Physical symptoms of breast hypertrophy

The sheer weight and size of abnormally-sized breasts can cause breast pain and severe physical disablement:

1. Muscular pain and discomfort – neck, shoulder, and back pain
2. Numbness – pins and needles in the fingers, hands, or arms
3. Posture – poor posture may compress nerve pathways
4. Rash – redness, itchiness, and moisture under the breast can cause skin infections
5. Breathing – the weight of the breasts can cause difficulty in breathing

Over and above these and other physical problems, the extreme burden of having to carry excessive weight makes normal day-to-day activities and exercise almost impossible. Emotional and social issues may arise, such as depression and lack of interaction with others.

Breast reduction surgery

Reduction mammoplasty is performed by a plastic surgeon that involves removing breast tissue and excess skin, and repositioning the nipple. To alleviate pain, infection, and other complications, over-the-counter medication is often the first port of call.

Medical aid schemes standpoint

Medical aids do not cover 'cosmetically-driven' procedures, but some may provide some cover only if it's considered medically necessary and the clinical outcomes meet the medical aid's ex-gratia requirements. They will consider the medical motivation from a specialist such as a physical therapist, chiropractor, dermatologist, or orthopaedist – and evaluate the appeal. Determining what guides their decision is tricky because protocols are not standard and differ across medical aid schemes and product options.

Other medical aids may provide "medical support for the conservative management of macromastia", as in the case of Discovery. Momentum has also committed to reviewing their policy on breast reductions following the case of Juliet Harding earlier in February this year. Momentum has acknowledged the issue and their benefits need to be reviewed with this in mind.

In Summary

What does this mean for a member suffering from macromastia? Some medical aid schemes agree that macromastia is a medical condition that needs consideration. However, sufferers will need to meet certain clinical criteria before their case is considered. Remember that medical aids review their products annually, so make sure you keep yourself updated. Every medical aid is different and so will their criteria be. If you're considering breast reduction surgery ask them to provide you with the criteria in writing.

Disclaimer:
This article is for informational purposes only and should not be construed as financial, legal, or medical advice. The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of Hippo.co.za