Woman calls on Nova Scotia to update rules on breast reduction surgery

A Halifax-area woman is calling for the province to update its rules governing who can and can't get breast reduction surgery covered by Nova Scotia's health care system. 

Melody Harding says she experiences back and shoulder problems and wants to get the surgery. But Nova Scotia will only pay for the operation if a person has a body mass index of 27 or less, and Harding said the province should make decisions on a case-by-case basis, like the system in neighbouring New Brunswick.

"I think they should look at changing the criteria," she said.

"If you have a higher BMI but you have co-morbidity like back problems or just other risk factors, then they will consider your case even if your BMI is over 27 [in New Brunswick]."

"BMI is an antiquated measurement anyway, but that's still what the health department uses."

Multiple bras needed

Harding is close to six feet tall and wears a 36N to a 36O size bra.

She estimates her breasts weigh 15 lbs. When she tries to be physically active, she said it's difficult because she has to wear two to three sports bras at a time just so she can move her arms.

"I can't run, I can't do sports. I'm unable to move my body properly or without pain in order to aid in losing weight," Harding said.

Different provinces, different rules

Harding said she doesn't understand why different provinces have such different guidelines for who qualifies for breast reduction surgery.

"I have a good friend that I was in school with who also had the same issues. She moved to Ontario after high school and she had it done and she said it was the best thing that has ever happened. She was able to lose weight, she's been able to live a healthier lifestyle.

"I look at her and I think why is she able to do something like this, you know, better her quality of life as an Ontario resident but I'm not allowed to in Nova Scotia?"

Costly to pay out-of-pocket

When she contacted a private surgical centre about costs for a breast reduction, she was told it could be approximately $8,600 to $10,200.

If the surgeon needed her to stay for observation after the surgery, it would add on another $600 plus tax.

To get a better idea of how much it would cost to have the surgery, she was told she would need to pay $100 plus tax for a full consultation.

Harding said she doesn't have that kind of cash.

'It's really heartbreaking'

"I'm going to be 30 in September and I've been carrying this weight around for years and the thought of going another 10 years with this weight on me both physically, mentally, emotionally — you know it's heartbreaking really."

Harding said she contacted Nova Scotia Health Minister Leo Glavine about her situation as well as her MLA, Keith Colwell. She said she has yet to hear back from either.

"I'm not getting anything from them, not even a 'No-can-do,'" she said.

Province won't make changes

At this point, the province said there are no plans to make any changes to its criteria regarding breast reduction surgery.

Nova Scotia's health department said it will cover the cost of breast reduction surgery when a patient meets three criteria and a surgeon has received approval from MSI to have the procedure covered:

• The patient must have a body mass index of 27 or less
• 400 grams or more of tissue need to be removed from each breast
• There are documented physical symptoms attributed to the size of the breasts — this may include neck or back pain or other symptoms.

In an email to CBC News, the province said it goes by this criteria because it's based on "the best available evidence regarding medical necessity, surgical and post-surgery risks."

"This is to ensure that when a patient requires this, or any other surgery, they have the best potential for surgical success."

The province said it regularly reviews the criteria as the evidence changes to see if there needs to be any adjustments. It says it also monitors what other provinces are doing and what's happening in the medical field.

"Patients may also seek this service through a private provider."

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