breast reduction and ohip??

on 4/2/10 11:09 pm - Canada
Hello there

I was wondering if OHIP will cover breast reduction? I had my surgery and have been living outside Canada for almost three years and am moving back home in the spring. I still have about 40 pounds to lose.

My poor boobs are hanging pretty low. Are there steps I need to take once I get home to build my case?
Anyone have any luck with getting an arm lift. I am finding with all the extra skin in my underarms is making me crazy itchy all the time. 


Jaime :)
on 4/2/10 11:23 pm - Ottawa, Canada
RNY on 10/02/09 with
 I'm no expert but it sounds to me like you have a case to have it covered.
“The miracle isn’t that I finished. The miracle is that I had the courage to start.? --John “the Penguin? Bingham 
There is no passion to be found playing small - in settling for a life that is less than the one you are capable of living. ~ Nelson Mandela

 HW: 247.5/SW: 228.5/CW:135/ My GW: 140/SGW: 151
on 4/3/10 12:05 am - St Catharines, Canada

hi Jaime

  I just had a reduction last year, prior to surgery (who knows when that is lol)  Anyhow, I would find a family doctor if you don't have one now in Canada.  Then start the process and get a referal to a plastic surgeon.  It sounds like you would qualify being that you have itchy spots  all the time.  I know I had to wait 2yrs to see the plastic sureon for the referal appointment and another 2 yrs for the actual surgeon.  But it all depens on the surgeon you get refered to.

  Also being that you have been out of country the last 3 yrs Ohip may have you wait 3 months prior to an referal appointment. Best check with your doctor.

Good Luck !

on 4/3/10 12:09 am - Canada
The breast reductions seem to be hit and miss these days.  I had a reduction a couple years ago and got it approved due to rashes, sores under the breast as well as lower back pain.

OHIP will not cover an arm lift under any cir****tances, that is my understanding anyway.

Proud Member of the Cambridge Crew!

Jennie M.
on 4/3/10 12:36 am - Ottawa, Canada
Yes - there is definitely a waiting period when you come back to the country.

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 4/3/10 2:25 am - Canada

I have been told it is 3 months before I get any coverage let alone anything else. Just checking so I can be prepared. I imagine that it would take forever to get even close to a surgery date if I am even approved.

thanks for the insight


Molly G.
on 4/3/10 2:42 am, edited 4/3/10 2:43 am - Canada
I had breast reduction almost 3 years ago and OHIP paid for it.  I decided to do it because even though my breast were not that BIG but was long, they were almost to my navel and that is no exaggeration, I had a pulling sensation in front when ever I took my bra off. I was suprised that ti was paid for because i didn't really have any other issues with them. My surgeon was Dr. Graig Fielding in Ontario and he did an amazing job.
on 4/3/10 9:45 pm - Newmarket, ON, Canada
Hi Jaime,

OHIP does cover breast reductions if they're deemed to be medically required. I had mine done in 11/09. I'm so happy with it. If you have large breasts (with at least 1/2 lb to lose from each breast) with a history of back/shoulder problems, you should be covered.

You will want to have more than one consult with plastic surgeons to find the one that best suits you. I have put together a list of questions I took into account when I was researching my own plastic surgery:

1) Are they a member of the American Society of Aesthetic & Plastic Surgery? Although I wouldn't rule them out if they're not, I would definately want more experience if they're not.
2) How many years have they been the primary surgeon, performing Plastic & Reconstructive surgery? If they're really young, be afraid! You're looking for someone with at least 10 years of experience. Check them out on If they don't rate at all, this is a red flag - too inexperienced.
3) Find out what your end result will be (what size?) Have it written in your file.
4) Do they explain the details of your incision lines? Diagrams are good. There should be no surprises. For a breast reduction, you should have an incision around the nipple - where they make the nipple smaller & lift it. There should also be an vertical incision from the base of the nipple to the bottom of the breast. But, if there's no implant there should be no horizontal incision along the base of the breast. If your surgeon suggests this last incision (called an anchor cut) for a breast reduction, he's old school. Find another surgeon. Your goal is to have fewer incisions. This helps reduce the risk of infection & scarring.
5) Do they treat you professionally? Assume that they'll treat you in the OR the same way as they did in their office. Look for someone who's respectful & professional. So, if they have you strip in front of them, that's not professional. If they have you go to a seperate room to change & respectfully leave the room until you're ready, that's appropriate. 
6) Of course, compare costs - all costs, including hospital costs for self-pay procedures. Do they offer financing?
7) If you're only having an OHIP-covered procedure, find out up front, if they're willing to work with OHIP. 
8) Is the surgery performed in hospital or clinic? There's pros & cons to both. If in hospital, this is good if there's any complications. But, you're exposed to more germs & anti-biotic resistent infections like MRSA. If you have no pre-existing health conditions, either should be OK.
9) How long will you be in hospital? You should be in overnight. Some surgeons perform TT's & Breast work as day surgery. Be concerned.
10) How many drains will you have? How long will they be in? Will you get home help for drains, bandage changes? I didn't require this personally as I didn't have drains & I was able to change dressings fine, but ask the question. Some surgeons ALWAYS leave drains & other surgeons RARELY leave drains. They are a pain during recovery. If they're not necessary, try to avoid them. But, they do serve a purpose, so if all your consulting surgeons recommend them, then you probably need them.
11) Will there be any exterior stitches or staples? How long will they be in? In my experience, there will be dissolvable inner stitches & any exterior work should be glued. So, there shouldn't be any need to remove stitches or staples later. Exterior staples & stitches leave more scars, cause more pain during recovery & have a higher tendency towards infection. If the surgeon will not use glue, he's old-school. Move on to another surgeon.
12) When does the surgeon start anti-biotics? They should start it on the table/in hospital & send you home with a prescription for it. If they don't, move on to another consult.
13) How much time will I need to be off work? Are they OK to complete Short-Term Disability forms? They shouldn't mind.
14) How many procedures will they do at the same time? If they say more than 2, be careful. It's dangerous. This may suggest that they're more greedy than careful. What would you prefer?
15) Do they include lipo? If so, is there an additional cost? Lipo is more painful to recover from & causes a lot of initial swelling. There's pros & cons to it. The surgeon should be able to explain this.
16) Don't be surprised if they ask to take pictures. Just ask that they'll remain private & not show up in their photo gallery in their waiting room!

I can't speak to the issue regarding waiting periods for Canadians who've been out of country & OHIP - sorry.

Take care,


OH Certified Support Group Leader for the York Region/GTA Support Group.
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