When does surgery cross the line to quasi cosmetic, or de facto cosmetic/elective surgery, and who should ultimately pay for it?

There is a difference between fixing a disfigurement and just trying to beautify. Cosmetic surgery for significant congenital abnormalities, from injury, or from illness are either considered necessary or in a grey area depending on who you are talking too.

Some insurance companies might consider fixing a cleft palate covered, but not cover reconstructive breast surgery after mastectomy. You never know with insurance.

If we had socialized medicine that was salary based at least some of the purely cosmetic work could be covered.

Tough question. I don’t see a clear line between them. The problem comes in when talking about quality of life. A simple nose job maybe not. Plastic surgery to fix major disfigurement, I’d say yes. I think breast augmentation has societal benefits, breast reduction, not so much. ;->

Yet, @Jaxk, breast reduction surgery is occasionally recommended to ease back strain and back problems, while outside of reconstructive surgery following a mastectomy, I can’t see a justification for breast augmentation.

@Jaxk really hit at the central question – quality of life.

@Jaxk The problem comes in when talking about quality of life.
How would you quantify ”quality of life”? Some might have a nasty burn on most of their upper body and up their neck and be OK with it; other would not be even if clothing covered most of it. How would a standard be set? Is it arbitrary and who pays for arbitrary if at all?

@zenvelo […breast reduction surgery is occasionally recommended to ease back strain and back problems,…]
More and more evidence is showing breast size has little to do with back pain, having no greater or less effect than carrying a “spare tire” gut in front of you.

[…I can’t see a justification for breast augmentation.
I use to think that 100% but over the years soften that position a might. I believe it is more psychological since we are in a nation that doesn’t even know itself. As with breast reconstruction after a mastectomy, the female breast is psychologically an intricate part that makes a woman a woman even if no one is supposed to notice, look at, or even speak of them, a woman who is flat-chested by the preponderance of evidence I have seen, feels missing of something. Even after that bra they wore all their life with the idea it would prevent them from sagging and it fails them miserably, they opt to go under the knife to have them made perky and full again, as when they were young. Should they be comfortable in their own skin as they often say, maybe? People are very caught up on appearances even while lying to themselves saying they don’t care that much.

When Barbie receives a skin graft from Ken?

@Hypocrisy_Central people are very caught up with appearances, that’s true. We are bombarded with images of perfection and it’s no wonder when we look in the mirror we can be deeply distressed by what we see. Mostly, people suck it up – “that’s the card that life dealt me” – or they make non-surgical changes like diet and make up. But some people have a different psychological makeup and the quality of their life is affected by their appearance. These are the people who are candidates for surgical treatment on insurance.

I knew someone who was allergic to the sun. She would puff up terribly if she got exposed. Her appearance was affected by this as it left her with loose skin around her eyes and chin. She found it difficult to interact with people because she couldn’t deal with them staring at her and asking about her appearance. She conveyed this to her GP and he recommended a face lift on the NHS. Afterwards, she was a changed woman and could enjoy her life again.

The decision on whether the treatment is necessary is difficult to make in the borderline cases. (Obviously someone who has e.g. been burned horrendously is a different category). Someone who goes on about it a lot to their doctor is more likely to get it, especially of they know the right things to say. But in the UK there are a lot of psychological tests you have to go through before the NHS will pay for cosmetic treatments.

Since hair serves a functional purpose this Flutherista believes hair replacement procedures should not be considered cosmetic.

Vision restoring surgeries that are often “corrected” with glasses should also be covered.

As clever as corrective eyewear systems are they should be considered no more than sticking plasters in this day and age.

Insurance should cover adult orthodontia as standard:

One’s need for well aligned teeth does not diminish with age.

@HC ”More and more evidence is showing breast size has little to do with back pain, having no greater or less effect than carrying a “spare tire” gut in front of you.” Bullshit. People with a gut put a strain on their lower back.

Large breasts put a strain on the upper back. I know this from experience. I went in complaining of a never-ending upper back ache. My MD ran some tests, etc., and referred me for breast reduction surgery.

However the surgeon refused to do it because, due to insurance rules about the minimum amount that has to be removed for it to be covered, it would not leave a socially acceptable amount of breast left. Nevermind what was acceptable to me. Fucking bullshit.

@SecondHandStoke Vision restoring surgeries that are often “corrected” with glasses should also be covered.
Restoring or improving eyesight due to birth defect or an injury or simply alleviating the person of the need to wear glasses? If they can wear glasses would not the surgery to correct or enhance sight so they can avoid glasses (which some believes makes one more attractive) closer to elective and not truly needed?

@Dutchess_III Large breasts put a strain on the upper back. I know this from experience. I went in complaining of a never-ending upper back ache. My MD ran some tests, etc., and referred me for breast reduction surgery.
Sorry you had that experience, what I have read over the years from various sources, that is not true with all women, however if I read something (and enough of it to have a majority voice) that there is truth to it for women in general, I would give it a good look, have not seen it yet though.

And if carrying a beer gut around will cause back problems, I guess a lot of Americans are popping Doan’s pills like breath mints.

Of course it’s not true of all women, HC. That was a ridiculous comment. Not all women have large breasts. And of the ones who do, most don’t have a relatively slender body, like I do. My muscles (including back muscles) aren’t as strong as they once were, but my breasts still just as heavy as they always were. They’re causing trouble they didn’t cause 5 years ago.

It pisses me off that society has more of a say over the bags of fat on my chest than I do.

It’s ridiculous to think that this isn’t going to put a serious strain on lower back muscles. Look at it. Look at it! (His gut. Not his non-existent penis, silly.)

Trump is beginning to appear just like Hitler comments. If you wait long enough all issues will revert to Trump. Incredible how much influence he has over everything.

I was using his stomach fat to bring home a point. It had nothing to do with politics. He set him self up to be a laughing stock.

Alright, I’ll find a different example: @Hypocrisy_Central do you honestly think this guy doesn’t have back problems.

@Dutchess_III Of course it’s not true of all women, HC. That was a ridiculous comment.
It sounded as if you were dismissing any truth in it as bullshit because of our experience by it.

It pisses me off that society has more of a say over the bags of fat on my chest than I do.
When the fat hits the skillet, that goes for more than ”bags of fat” on the chest, it goes to shaving of legs, pits, faces, putting on unnatural scents to keep one from smelling human, etc. It is what it is…..

It’s ridiculous to think that this isn’t going to put a serious strain on lower back muscles.
It is sad for people to allow themselves to become that way, and silly not to think it will affect them in a negative way, yeah….

@Hypocrisy_Central do you honestly think this guy doesn’t have back problems.
I would bet my dollars to anyone’s donuts he has that and hip and knee problems to boot, however, some as big as him swear they are as fit as an Olympic swimmer, that they are ”fat but fit”, then hit the same old cliché of the skinny person who is suffers malnutrition.

I was speaking the obvious.

Yes, it’s sad that people allow that to happen. That’s the difference. They allow it to happen and they can do something about it. Women with large breasts can’t, not without surgery. My point is, is that if there is research out there saying that large breasts don’t cause back problems, that’s bull shit.

I don’t understand this comparison: ”... that goes for more than ”bags of fat” on the chest, it goes to shaving of legs, pits, faces, putting on unnatural scents to keep one from smelling human, etc. It is what it is…..”
All of those examples are choices women make. What does that have to do with breast size?

^ I don’t understand this comparison: ”... that goes for more than ”bags of fat” on the chest, it goes to shaving of legs, pits, faces, putting on unnatural scents to keep one from smelling human, etc. It is what it is…..”
You alluded to the displeasure of society having more to say over your breast than you do, I am just saying other things you do are more dictated by society than you do as well.

But I have a choice whether to do those things to please society. Ultimately, they don’t have control over whether I shave my legs or not. It’s not comparable.

^ But I have a choice whether to do those things to please society.
Do you? It has been alluded time again here that society mandates people do certain things as there is no real choice not to do them. Sure, if you felt like bathing only 2 a week and not using scents and deodorants, you could, but the negative consequences for not falling in line with societal norms would make it so you had no true choice. That was pointed out many times in threads dealing with the wearing of bras even when one did not need to wear one. One might have the choice of shaving their legs or not where as they cannot remove, or add breast or make them larger but as one can shave, they either stuff them in some manner of bras, let them go free, or disguise them with some manner of garments; they can be influenced in some ways even if small.

Yes, I do. Do I choose to shave? Yes. I am a member of this society and it has been programmed into me that unshaven legs and arm pits are unattractive.

However if shaving caused me sometimes excruciating pain, and the cure was to simply stop shaving, then you damn strait I’d quit shaving. To hell with society.

^ However if shaving caused me sometimes excruciating pain, and the cure was to simply stop shaving, then you damn strait I’d quit shaving.
Of course, pain or severe discomfort will make anyone change from going with the herd. If shaving was severely damaging my skin and I could not find a way to do it otherwise, call me ”fur face”, because my personal health comes 1st.

But I don’t have that option with my breasts. To keep society happy, I just get to live with the back pain.

@Dutchess_III To keep society happy, I just get to live with the back pain.
No you don’t, you can liquidate whatever assets you have or borrow against others and deflate the ”twins”, it comes down to if you are willing to make that deep of a sacrifice out of your own pocket if the insurance, the government, or some wealthy person doesn’t decide to gift you to pay to have it done.

Yes, I could. I could head into retirement with absolutely nothing.

Where did this “government or wealthy person” shit come in? Insurance, which we pay $400 a month into, won’t pay for it. I’m done.

Yes, I could. I could head into retirement with absolutely nothing.
That is the rub, huh? You have basically three options:
• Spend a great amount of money and have nothing for retirement but no back pain hopefully.
• Go into retirement with some funds, but maybe not enjoy it as much because of the back pain.
• Find a way to amass some capital to go into retirement and not have back pain.
I think you need to focus on option three. Just saying……….

Yep. All because society says a certain boob size is not acceptable.

^ Yep. All because society says a certain boob size is not acceptable.
Those are usually the ones who do not need a bra and have zero worry of back pain or sag.

Yep. Or men.

I don’t see how some men with “moobs” don’t, larger than what many women have.

That’s fat caused by excessive eating. If it bothered them enough they could just quit eating so damn much. They could claim some sort of obesity-related health issues and get lap band surgery or something.

@Hypocrisy_Central

Because it isn’t a true fix to the problem.

@Hypocrisy_Central having no greater or less effect than carrying a “spare tire” gut in front of you.

Carrying 20, 30, 40 pounds of extra weight in front of you, whether we’re talking boobs, moobs, spare tire, or infant, will put extra stress on the back. Just ask any woman who has carried a child to term. Or better yet, try carrying a snuggly filled with a 10 lb bag of flour or sugar all day everyday for a week.

There you go @Yetanotheruser. Or bags of water.

Apparently big tits are a mixed blessing. Those that have them want to make them smaller, those that don’t want them bigger. Personally I enjoy the variety. I’m not sure we need the government to determine the appropriate size and fund any discrepancies.

@Jaxk You missed the point. Completely. My breast concerns are about me, not about what you, and the rest of society “enjoy” about them.

@Dutchess_III Bags of water would probably better illustrate what we could refer to as the “jiggle factor”

Well, the “jiggle factor” puts other stresses on the muscles too, by yanking them side to side. I also know I couldn’t jump as high with them, as I could have without them. :( :( :(
How much water volume does it take to equal a pound of flour? I think water would be a better indicator than something relatively solid. Or maybe oil. Lots and lots and lots of oil.

@Dutchess_III – Actually I think you missed the point. Once you move the payment for those changes to the public realm (taxpayer funding) then it does matter what I and the rest of society think.

@Jaxk I don’t even know how the government or welfare even entered into the subtopic of my personal experience.

My INSURANCE won’t pay for the procedure, because my INSURANCE PROVIDER has determined that a certain breast size is not socially acceptable. Never mind the fact that my doctor determined that the source of my upper back pain is most likely due to the strain my breasts put on the muscles.

@Jaxk and @Dutchess: In @Dutchess’ case, it makes no sense that they’d pay for back pain treatment and management but not breast reduction.

I know. I mean, the doctor is the one who noticed that it affects my posture as well, and causes my shoulders to slump forward. I try to remember to stand up straight….but it’s exhausting!