Breast reduction covered by CPAM

Do you have large breasts and would like to undergo breast reduction surgery? Complexity, back pain, difficulty exercising, the weight of other people's gaze... There are many reasons why a woman might decide to undergo surgery.
But what about Social Security coverage for breast reduction? Can you get financial help to feel more comfortable with your body? Most of the time, the answer is yes!

WHEN IS BREAST REDUCTION SURGERY RECOMMENDED?

Breast reduction surgery is intended for people with breast hypertrophy. Breast enlargement is generally congenital or hormonal in origin. It can cause physical and psychological discomfort for a woman.

People considered to suffer from breast hypertrophy have breasts whose volume is equal to or greater than 300 cm³, or 300 grams.

To give you an idea, this corresponds to an E or even F cup. Generally speaking, a breast reduction patient will go from an E/F cup to a C/D cup.

A breast reduction can help :

• Treating breast ptosis : sagging breasts, «sagging breasts» - a kind of breast lift.
• Treating breast asymmetry: non-harmonious breasts and uncomfortable bra wear; ;
• Treating skin irritation caused by perspiration under the breasts and rubbing of the skin of the breasts on the upper abdomen; ;
• Reduce back and lumbar pain related to breast weight: after bilateral mastoplasty, 71.8 % of patients report a reduction in pain ;
• Reduce symptoms of skeletal deformities and breathing difficulties linked to breast size.

Since breast enlargement can lead to serious back problems, breast reduction surgery is available from the age of 16.

HOW MUCH DOES BREAST REDUCTION SURGERY COST?

On average, the price of a breast reduction is between €3,000 and €5,000. This price includes:

• Preoperative consultations and preliminary examinations ;
• Clinic fees: vary according to the time spent on site;
• Surgery: operating room fees, general anesthesia, surgery and analgesics;
• Post-operative follow-up appointments; ;
• Optional: the bra ideal for promoting healing.

Certain price elements, such as the duration of the operation, depend on your morphology and your wishes. The surgical technique is planned and performed differently for each patient.

Although the procedure is covered by the French Social Security system, there are still some excess fees for surgery and anesthesia, partly covered by mutual insurance companies.

If your clinic doesn't offer a support bra, you can buy one at a pharmacy.

WHAT ARE THE CONDITIONS FOR A REIMBURSED BREAST REDUCTION?

The main condition for reimbursement by the Social Security is a volume reduction of more than 300 grams of mammary gland per breast.

In this case, the act is not considered to be a plastic surgery, It's a surgery that's necessary for the patient's well-being. Only patients who are ready to cut back 300 grams from mammary gland to each breast can be supported at 100 % by the Assurance Maladie.

A reduction of 300 grams corresponds to a reduction of 2 cup sizes. This means that women with a cup size larger than D are automatically covered by Social Security.

If you have asymmetrical breasts, You will be interviewed by specialists and by the Health Insurance medical service. These professionals will determine whether you are suffering from serious psychological problems (depression, social isolation) related to the size of your breasts. Your treatment will depend in part on their conclusions.

In addition, most mutual insurance companies reimburse unilateral breast reduction in cases of significant asymmetry. Whether this asymmetry is natural or caused by cancer surgery is irrelevant.

If your breasts are causing you neck pain and/or back, it is very likely that your breast reduction will be covered by Social Security.

If during the intervention, your surgeon removes less than 300 g, the act will be considered an act of plastic surgery. It will therefore not be covered by Social Security.

To cover certain surgical procedures, you need the’prior agreement from Consulting Physician from Assurance Maladie. This surgery entitles the patient to time off work.

On the other hand, an act of bilateral mastoplasty reduction (code QEMAO13 on the CCAM website - classification commune des actes médicaux) is not subject to prior agreement. All that's required is for your surgeon to stipulate that he or she has removed more than 300 grams of mammary gland per breast to the Social Security.

This lasts about 1H30 in the operating room under general anaesthetic. You will need to wear a support bra for 6 weeks.

Even if this procedure is covered by the health insurance system, the plastic surgeon's fees may be higher in private clinics.

EXCEPTIONS TO TREATMENT FOR BILATERAL MASTOPLASTY

There are two reasons why you may be denied breast reduction reimbursement:

• The estimated reduction weight is less than 300 grams.
• You are significantly overweight: you will need to lose weight before considering any operation.

IS IT POSSIBLE TO BREASTFEED AFTER BREAST REDUCTION SURGERY?

In principle, breast reduction surgery does not prevent a woman from breastfeeding her child afterwards. However, it is important to note that this procedure can complicate breastfeeding and, in some cases, make it impossible.

Breast milk production depends on :

• The ability of the mammary gland to produce ;
• The presence of galactophore ducts intact ;
• Nipple sensitivity;
• The nervous system, which produces the hormones needed for breastfeeding.

In case of breast hypertrophy your surgeon will remove part of the mammary gland. If breast reduction has not necessitated nipple displacement, the milk ducts will be preserved.

On the other hand, if the nipple has been repositioned, the milk ducts will have been severed. It will therefore no longer be possible to breastfeed a child. In some cases, the connections between the skin around the areola, The nipple and ducts rebuild, but this is not always the case.

To make sure you make the right decision, make an appointment with your plastic surgeon.