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Breast reduction?

on 9/2/09 8:22 pm - Canada

How do you qualify for OHIP to pay for a breast reduction?  Is there a certain size you need to be?  I know my husband would be sad, but I like people looking at my eyes...

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

on 9/2/09 9:27 pm - toronto, Canada
thats one thing I kind of miss , when I lost my weght I lost my breast I I use to be a 44 dd now I'm on a 40 d , check with your doctor but I think you have to have rash , and other problem .

jude G.
on 9/2/09 9:41 pm - Canada
i had the girls lopped off in 1999. back then, the criteria was that you had to be a DD or bigger, that's it.  go to your family doc and get a referal to a plastics guy who specializes in tits.  he should take care of the rest.
in the depth of winter, i finally learned that within me there lay an invincible summer.  ~albert camus.

20 lbs lost pre-op  Image and video hosting by TinyPic

on 9/3/09 5:45 am - Canada

I wonder if, when a child is growing up and deciding what to do, the say to themselves "When I grow up, I want to be a guy who specializes in tits"!!

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

jude G.
on 9/3/09 6:14 am - Canada
oh i've known plenty of men who have had the life-long dream of tit-specialist! most of them weren't doctors, though.
in the depth of winter, i finally learned that within me there lay an invincible summer.  ~albert camus.

20 lbs lost pre-op  Image and video hosting by TinyPic

on 9/3/09 7:44 am - Canada
I've known a few of those as well, lol!!

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

Mr. Incredible
on 9/3/09 7:37 am - Canada
Bonnie ABC
on 9/2/09 10:57 pm - Smiths Falls, Canada
RNY on 09/16/08 with
I thought the criteria was so many cm's from shoulder to nipple as well as shoulder indents and pain.  .. hmm... gee.. think I qualify now lol..  I've got from a 54H to a 42D... sigh...  but it's all good.


   I can do hard things, life is teaching me that I can.
             Lost 222lbs with rny, 20 lbs regain.
                        Plastics, July 2010 with Dr. Sauceda in Monterrey, Mexico
on 9/3/09 2:04 am - Canada

I had it done by Dr. Wayne Carmen in Scarborough (he was "the" breast man back then) in 1996.  I was a DD, pushing on an E cup, but my problem was also that, since the "birth" of my breasties, they had NEVER been perky. I used to call them "goat tits" b/c they literally pointed DIWN, and it hugely affected my self-esteem. He took one look and said, OHIP will cover this, no worries. And they did :)

I went to C cup (which had progressed to a D a whiel back), but am back to a C again, now. Yea!

Good luck!

VSG- consult March 10th, OOC faxed to OHIP March 24th, Sleep study March 26th, CPAP autotritation April 9th thru the 14th, OHIP APPROVAL: March 31st!! PATS- June 30th VSG July 15th!!!!!!

(weight loss includes 8 lbs lost the week before surgery)

5' 6"  (at surgery, wearing 2x-3x, 20/22)
Goal 175 lbs

on 9/3/09 4:21 am - Canada
A friend of mine not a WLS person, was a 38D and she complained of back pain and had it covered.  In the end she only went to a 38 C.  but everything is back where it needs to be; once she had approval he did not care if they stayed the same he said , he did'nt even ask her how small until she was on the table she replied a half size smaller and alot higher LOL.
Diane  - Dave's wife
Jennie M.
on 9/3/09 5:49 am - Ottawa, Canada
Following along because if I had to pick between boobs and panni, the boobs are GOING. I'm still a G cup even after losing 100 lbs and now that I want to start doing more aerobic/jogging exercises, I just can't without injury. LOL

I'd love to be a full C when done... as a former boyfriend once told me (er... when I was that size - probably when I was 17-18??) "a nice handful". I think DH would be crushed though but he's not the one hauling them around 24/7.

Urban Poling Instructor, 5K runner & soon to be CanFit Pro Personal Trainer
HW339/Lowest Wt 175/CW210/GW175  Plastics done (TT & BR) 8/31/10

on 9/3/09 5:54 am - Canada
Yeah, it sucks to be the one hauling them for sure!!!

I don't know if I would qualify at a small D or large C.  Maybe it's leftover trauma from my teenage years (when I was nothing but a stick with boobs) that makes me want to lop them off, lol!!

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

on 9/3/09 6:00 am
I also had reduction in 1999 - went from a big D to a small C -second best thing I have done for myself.
I had the indents in the shoulders and rashes in the summer under my bra - Ohip covered it all

                                                                                                                                                       RE-GAIN TO LOSE:  Lost 20 - "10 to go"




on 9/3/09 6:24 am - Canada

I posted this post I found on another website before on this forum but thought this thread could use it reposted for information purposes. I found the post quite informative and valuable so I'll share it again. Good Luck! -Annie


I am placing this in the TT board because many people from Ontario Canada don't know what to ask for when they go to the PS for a TT consult. There is also mention of breast reduction in this post so if any mod feels like I haven't placed it in the right forum, please feel free to move it as the need may be.
The section on Panniculectomy follows after the section on Breast Reduction...


In the province of Ontario Canada, there are indeed some situations in which PS is covered. One such situation is BREAST REDUCTION.

In order to be considered for a breast reduction on the OHIP plan, you must present with significant symptomatology.
This is some of what OHIP considers significant symptomatology in regards to breast reduction.

Firstly be aware that pitosis (sagging) of the breasts is NOT enough to have OHIP cover your reduction surgery. It should be a contributing factor, but as well there should be documented pain in the shoulder or neck regions, bra strap indentations of the shoulder area, skin fissuring in the creases and folds and intertrigo (rashes) associated with excessive and uncontrollable moisture in the folds and cleavage of the breasts.

If you are experiencing ANY of the above symptomatology, MAKE SURE you take yourself to your regular family doctor or in absence of a family doctor to a walk in clinic and report the symptoms to a medical professional and ask for his/her advice on the best way to deal with them.

One of the things that finally pushed me over the edge to surgery was the fact that a year ago I ended up in the ER thinking that I was having some kind of stroke due to numbness in the arm and face, only to find out that I was healthy as a horse, but the nerve compression in my shoulders from lugging around my huge breasts was the problem. It was embarrassing for about 2 seconds until the cardiologist suggested breast reduction to alleviate the symptoms and actually wrote it in her discharge notes for OHIP.

One thing my PS told me is that if you are over a D cup in Ontario the chances are good that you will be approved; having the other symptomatology is like the icing on the cake. So if you are over a D cup, with strap indentations, the chances are good that OHIP will eventually approve your request.

Another situation that may be covered by the OHIP plan is PANNICULECTOMY.

It is important that you know your terminology when you enter into a consult with a plastic surgeon. If you go in asking for a tummy tuck consult that is exactly what you are going to get a cosmetic tummy tuck consultation.

If you go in asking for an OHIP insured panniculectomy consult then that is what you are going to get.

MAKE SURE that you are refferred to your plastic surgeon through your family doctor and that the plastic surgeon works out of a provincially funded hospital. OHIP WILL NOTcover surgeries done in private surgical centers for ANY reason. The surgery and aftercare MUST be in a provincially funded and regulated hospital in order for coverage to be considered.

In researching the procedure it is easy to become confused because the term abdominoplasty and panniculectomy are quite often interchangeable when you are searching online.

In a lot of cases and with a lot of insurance companies they carry the exact same billing code therefore making it very difficult for the companies to determine exactly what procedure you are asking for. Since OHIP never covers a cosmetic tummy tuck, the proper term is panniculectomy for insurance purposes.

Once again, symptomatology is KEY when asking for OHIP to cover a panniculectomy. Rashes, skin fissures, back pain, lower body pain restricted movement, all of these fall under symptomatology for panniculectomy. It is paramount that your symptomatology be recorded.

Do not be ashamed or fearful in going to a general practitioner (family doctor) and asking for ways to manage pain brought on by the weight of the pannus. Don’t be afraid to go week after week, month after month or for every rash, odor or anything “abnormal” all of these visits are recorded and then OHIP has a basis in which to judge your claim.

What is an OHIP insured panniculectomy? The definition of panniculectomy says that it’s the excision of redundant fat and skin below the navel for functional purposes sometimes with and sometimes without preservation of the umbilicus (belly button.)

When I went for my consult I was fully expecting to hear that there would be no muscle repair involved and that I basically would get what I got on the other side of surgery, but that is not what I heard from my PS, instead I heard that there will lipo around my rib cage and there will be a hip to hip incision, and in some cases an inverted T from the belly button to the pubic mound (this will be the case for me as I have an extra paunch there that needs extra work to deal with) there will be placation of the fascia (tightening of the abdominal muscles) and there will be repositioning of the umbilicus ( belly button)….

Now if that doesn’t scream TUMMY TUCK, I don’t know what does. It’s not in what you say to OHIP, but how you say it that makes all the difference.

I was also informed by my PS that OHIP has a habit of denying at least 50% of requests for panniculectomy and they basically do it to see who is serious enough to fight with them over it, so if you receive a denial don’t think it’s the end of the world; it’s just OHIP saying “convince me.”

I was lucky and got my approvals without having to appeal, but when dealing with provincial health insurance remember that it’s not personal, it is their job to make sure that you know what it is you are doing, that you meet the criteria for them to fund the operation and that you are serious about your health and the maintenance of it post operatively.

I have read what I think might be a million messages all over the internet by people saying that OHIP doesn’t cover a TUMMY TUCK… this is true, they don’t cover a TUMMY TUCK because TUMMY TUCKS are believed to be strictly cosmetic, what they do cover is PANNICULECTOMY that is considered medically necessary and reconstructive and if you have all your ducks in a row you should have no problem getting one.

LeahFlameRain Posted: Thu Mar 20, 2008 4:56 am    Post subject: Dealing with OHIP - The Ontario Health Insurance Plan

HW:519 W@C:476 SW: 448 CW:373  103lbs Lost so far.

"How old would you be if you didn't know how old you are?"

on 9/3/09 7:48 am - Canada
Thanks for posting that!!  Very informative.

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

on 9/3/09 8:02 am - Canada

You're quite welcome :) Thought it may help some.

HW:519 W@C:476 SW: 448 CW:373  103lbs Lost so far.

"How old would you be if you didn't know how old you are?"

Erin A.
on 9/3/09 8:38 am, edited 9/3/09 8:39 am - Burlington, Canada
CBC news story:

Breast reduction surgery

This common procedure eases women's discomfort caused by large breasts; here's what you need to know about it

Having a breast reduction can be an emotional experience. Sandra (who didn't want her real name used), a 32-year-old health-care worker for the Forensic Psychiatric Institute and a mother of two, experienced mixed feelings after the breast-reduction procedure. She says that after the surgery, she was a little sad. "Something that was a part of me for so long were so small compared to before. I felt small-chested and a little afraid of whether I would grow to love them."

Despite her initial mixed feelings about the procedure, Sandra has grown to accept her new breasts.

"I have really grown to love them. They don't shake, I don't need to wear a bra if I don't want to. I have a lot more freedom than before. My shoulders are stress-free. I sleep really well. I look much better in clothes and I am now wearing bras that fit really nicely. I am getting compliments all the time."

Large breasts may seem like an asset to some, but for women who have them, they can be uncomfortable, awkward and even embarrassing.

Women have breast reductions to change their proportions and reduce discomfort such as back pain. According to the Canadian Institute for Health Information, 5,181 women had breast reduction surgery in 2006 at in-patient facilities in Canada.

The procedure, technically known as reduction mammoplasty, involves removing fat from the breast to make it smaller, more firm and lighter. Breast reductions are covered by all provincial health plans, but must be approved based on criteria that vary from province to province. (For example, in Ontario, size is not sufficient grounds for coverage, there must be associated back or neck pain. In Nova Scotia, at least 500 grams per breast must be removed.) If the breast reduction is not covered by a provincial health plan, costs range from $4,500 to $6,500.

"Breast reduction is a very common operation for plastic surgeons around the world," says Dr. Nasim Huq, a Niagara Falls, Ont.-based doctor who has performed the procedure on more than 80 women. "With the increased prevalence of obesity, people are a little heavier. The surgery has become more safe and more popular."

Tatum Rusak, a 30-year-old mother of two and owner of a home-based business, says the procedure appealed to her because she had trouble wearing nice clothes and finding bras to fit her 38H breasts.

"I had to go to specialty stores to find bras, they all cost over $100 — it was crazy to have to spend that much," she says. "They would only last a few weeks and would then be garbage - they just don't support that big a breast."

The procedure

Breast reduction is a medical procedure that requires consultation with a surgical expert. Patients usually find a plastic surgeon to perform the procedure through referrals. To check on the specialty of a doctor and to verify certification, Canadians can contact The Royal College of Physicians and Surgeons at 613-730-8177, 1-800-668-3740, or through

The patient then discusses the details of the surgery with the surgeon, going over issues such as where the nipples and scars will be positioned, and how much weight will be removed. A typical procedure sees 1-3 cup sizes reduced from the breast. Rusak, for example, went from a 38 H to a 36 DD, while Leslie Holland, a Campbellford, Ont.-based homemaker with three kids went from a 48DD to a 40 C, losing nearly 7 kilograms (15 pounds).

The procedure typically takes about two hours, and is performed under general anesthetic.

The most common way of performing breast reduction surgery is the "Inverted T," where one incision travels along the bottom of the breast, and another goes upward to the nipple.

For smaller breasts, only a vertical incision is used, with no transverse cut along the breast. This technique is often used with liposuction, but is more difficult to do when a larger volume of the breast needs to be removed, says Dr. Huq.

Things to consider

The downside of the operation can include issues such as scarring and possible reactions to anesthetic, which can happen with any operation.

Having adequate support before and after the operation helps women to deal with its emotional and physical after-effects.

"Before the surgery I had some friends who went through it and coached me. I relied a lot on that. After the surgery, my mother took the kids for one week so that I can just relax and take care of myself. My surgery was on a Friday so my husband was home for two days with me ... mostly just reaching for things and lifting things and just helping me around the house .... After that I was home by myself. I was fine," says Sandra.

Rusak is pleased with the results of her breast reduction, but she experienced complications following the surgery. Her husband took her to the emergency room, who then referred her to the plastic surgeon who performed the procedure.

"The incisions opened up, where the T meets," she says. "There was a triangle under each breast that was opened, that was bleeding, yucky and painful. I went to [the plastic surgeon] the next day. They said it is fairly normal."

The recovery time is also something women considering the procedure should take into account. Most people are back to their jobs (if they are desk jobs) within two weeks, but they are not able to do heavy lifting for four to six weeks after the procedure.

Due to the nature of her work, which involves running and lifting, Sandra says she took six weeks off of work after her procedure in February.

Many women, like Holland, experience minimal pain after the procedure. "Advil and Tylenol took care of the pain for me. I was still able to play with my kids, drive, but I couldn't lift things."

Some women who have had the procedure have trouble breastfeeding. Dr. Huq recommends that women do the surgery after having and breastfeeding their children, if they wish to breastfeed rather than bottle-feed.

"It depends on the techniques that are used. The traditional ways of doing the surgery usually cuts your breastfeeding ability in half," says Dr. Huq.


"I'm not embarrassed to be out in public. I don't feel bad when people look at me. I'm more confident in myself," says Holland about her experiences after the procedure.

Most women are pleased with the results of the procedure and the decrease in discomfort. Dr. Huq says he has a 95- to 97-per-cent satisfaction rate for breast reductions.

"I would recommend the surgery to anybody," says Rusak. "I love it, it is absolutely the best thing that I have ever done."

Kim Edwards is a Toronto-based freelance writer and editor. Contact her at

I had my BR done this past Feb.  Went from a huge 52E pre WLS, to a 46D long post WLS, to a perfect 40C and I am very pleased.  It was covered by OHIP.  I had enough issues (shoulder indents, rashes under breasts, yeast infections, the large sag and severe back, shoulder and neck pain - all documented through the family doctor).


Erin ~ "Nothing tastes as good as thin feels!"
Hamilton & Area Support:  


on 9/3/09 9:05 am - Thornhill, Canada
For all that is good and holy, DON'T DO IT!!

            HW-373 / SW-352 / CW-160 / GW-185                     

on 9/3/09 9:26 am - Canada

Start weight - 287
Lowest - 123
Current - 130's
Height 5'7"

on 9/3/09 9:54 am - Canada
RNY on 01/06/09 with
I'm also curious to see if OHIP would cover me for a reduction.  Up until 2 months ago, I hadn't lost any weight there at all.  Now that I have, I'm concerned that they will say: just deal with them.  I'm waiting for the plastics doctor to call to arrange an appointement, so I should know in the New Year. 


jeanetta2.gif picture by lynnca1972