07 July 2025 | 4 minute read
I recognise that any form of plastic surgery undertaken privately has financial implications, and sometimes the cost can be very high. Expenses include the surgery itself, hospital or facility fees, potential breast implants, specialist equipment like fat grafting tools, and anaesthetist fees.
These costs vary depending on the complexity of the procedure, especially when multiple stages are required. Many insurance companies remain unwilling to cover these costs—even though tuberous breast correction is reconstructive rather than purely aesthetic surgery.
This is understandably frustrating. In my previous NHS work, a significant portion of my breast surgeries involved developmental conditions like tuberous breasts or asymmetry. Sadly, NHS rationing led to the discontinuation of all non-cancer breast reconstruction surgeries, despite their psychological and physical importance.
What Are Tuberous Breasts?
Tuberous breasts are a congenital breast deformity with specific physical features. These may include underdevelopment, herniation of breast tissue through the nipple-areola complex, and a constricted lower pole—often described as a high and tight breast crease. The term “Snoopy Dog” is sometimes used, albeit uncomfortably, to illustrate the appearance.
Emotional and Functional Impact
This condition has profound emotional and physical effects. Many patients avoid holidays or intimate relationships due to self-consciousness. Clothing rarely fits properly due to asymmetry or breast placement. It’s not uncommon for patients to feel isolated or even abnormal before seeking help.
Often, patients realise something is different during puberty. They compare themselves to peers or images in media and start to feel something is wrong. During our first consultation, many express relief when shown similar cases I’ve treated—realising they are not alone.
Understanding each patient’s unique concerns is essential. It helps guide us in planning treatment that restores normalcy and boosts confidence.
Is Tuberous Breast Surgery Cosmetic or Reconstructive?
This is a complex question. While insurers aim to draw a firm line between cosmetic and reconstructive surgery, tuberous breast correction straddles both. It addresses form and function—improving appearance and correcting developmental deformities.
Much like reconstruction after cancer surgery, this procedure can restore physical balance and psychological well-being. Despite this, insurers often classify it as cosmetic, and therefore not covered. This perspective frequently ignores the medical and emotional necessity.
What Determines Insurance Coverage?
Some insurers may consider covering tuberous breast correction, but they require extensive documentation. This may include medical records, a general practitioner’s input, surgeon’s evaluation, psychological assessments, and more.
Pre-authorization is crucial, along with proper coding (CPT and ICD codes) to classify the condition appropriately. Every insurance provider and policy differs—there’s no universal standard, and the approval process can be deliberately difficult.
What Insurance Might Cover (And What It Won’t)
Insurance may partially cover the procedure in cases involving severe asymmetry or clearly defined congenital deformity. However, coverage typically excludes implants, fat grafting, or changes considered purely aesthetic.
Attempting to separate and submit only part of the surgery for insurance consideration often leads to denials and may not be clinically advisable.
Steps to Improve Approval Odds
To improve the chances of insurance approval:
- Obtain a comprehensive evaluation and medical documentation from your plastic surgeon.
- Submit supporting materials: photos, letters of medical necessity, and referral notes.
- If initially denied, engage in the appeals process—persistence can sometimes lead to success.
Costs Without Insurance
If insurance does not provide cover, patients can expect to invest between £10,000 and £15,000 depending on the type and extent of surgery. Financing options may include Health Savings Accounts (HSA), Flexible Spending Accounts (FSA), or clinic-offered payment plans.
Choosing a qualified, experienced surgeon is critical to achieving safe and satisfying results—this is not a procedure to bargain-hunt.
Common Questions
Q: Will insurance cover one-sided tuberous breast correction?
A: Rarely. While asymmetry can support a medical claim, most policies exclude partial procedures.
Q: Is areola or nipple correction ever covered?
A: Only if it’s part of a broader medically necessary procedure.
Q: Can I start without a referral?
A: Yes, many private practices accept self-referrals, but having GP input may strengthen insurance claims.
Conclusion & Next Steps
If you’re considering tuberous breast correction and are unsure about what your health insurance may cover, you’re not alone. We understand how important this decision is—emotionally and financially.
With extensive experience correcting congenital breast conditions, we’re here to support you. From your first consultation through documentation and treatment planning, our goal is to help you feel confident, balanced, and free in your own skin.
Book a confidential consultation today to find out whether your procedure may be eligible for insurance cover and explore your personalised options.