Almost half a thousand women in Lithuania underwent free breast reduction operations last year. Not everyone knows that health insurance funds cover the costs of such operations, but specialists say that in order to reduce breasts at the expense of the state, medical indications are also necessary. Some come and have to be disappointed, and the clinic managers say that there is no system and very clear criteria, the patients are evaluated individually.
Breast implants are routine in private clinics. Most of the time, healthy women, but dissatisfied with their appearance, lie on the operating table.
In the past, fashion prevailed - as big as possible, now the desire is for a natural, unoperated image.
However, what to do if nature naturally rewards in such a way that female beauties begin to interfere and complicate life due to their size.
"Crushes, skin infections, breathing problems begin, breathing stops when sleeping on the back. I had the largest breasts in my practice, we removed 5 kg during both, and they remained proportionally large, and losing 5 kg from such a place is a lot," said Jonas Tutkus, a plastic surgeon at the Baltic-American Clinic.
In this case, the woman paid for the operation out of her own pocket.
Perhaps the patient did not know, like some women, it is surprising that the state lends a helping hand in similar cases. For owners of extremely large breasts, reduction can be performed free of charge, from the mandatory health insurance.
"In 2023, more than 500 women underwent breast reduction surgery due to medical indications," said VLK Service Expertise and Control Division. advisor Žydrūnė Baigienė.
Such reduction procedures, which are paid for by the state, are performed only in Santara and Kaunas clinics.
"Patients bring a number of 30 cm, the distance from the neck to the nipple, but one parameter does not always show what the situation is, because you have to decide according to their size and severity," explained Nerijus Jakutis, head of the Plastic and Reconstructive Surgery Center of Santaras Clinics.
In the clinics of Santari alone, there is already a queue until next year.
N. Jakutis singles out a group of women from the age of 40, who gave birth normally, but he says they have had large breasts since adolescence. Teenage girls also come, accompanied by their mothers.
"They come with the hope that they will be compensated, but that doesn't always happen," said Loreta Pilipaitytė, head of Kaunas Clinic's Plastic and Reconstructive Surgery Clinic.
A woman may hear a negative answer after evaluating the criteria, which are so precise and undefined.
"I can say unequivocally that we do not have guidelines, we follow international guidelines and evaluate patients individually," said L. Pilipaitytė.
"There is no system that decides in which cases compensation is given. This is left to the competence of the plastic surgeon", said N. Jakutis.
"The operation is performed by plastic surgeons, but the decision is made either by a neurologist or an orthopedist-traumatologist, if something is wrong with the spine," explained VLK Service Expertise and Control Division. advisor Žydrūnė Baigienė.
"This area has a very thin line between health and aesthetics. If you behaved absolutely correctly, after the operation, after weighing and measuring, it could be said that you had aesthetics because of it, but that would be immoral", said J. Tutkus.
However, this is the case in other countries, for example the weight of the removed part of the breast is measured in Denmark.
"There are many measurements, special tables, according to which we select," said L. Pilipaitytė.
"It seems like it would be easier for everyone. Maybe it would be possible to think about it, so that there would be more objective criteria", N. Jakutis thought.
Breast operations are also reimbursed in the event of cancer.
Aušra Bružienė constantly communicates with women whose breasts are removed due to illness. Some of them decide to reconstruct with implants, they are covered by the state, but not so long ago, from 2022.
"Not everyone wants to talk about it, but there are many more women who take the plunge," said Aušra Bružienė, president of the National Association of Breast Diseases.
Health insurance companies provide figures on how many operations were performed last year and the year before, how much money was allocated for operations, including reductions and implants.
Unfortunately, implants are still not compensated in cases where the symbol of femininity has to be removed for prevention, when there is cancer in the family.
"In my case, I have a gene mutation and my daughters have inherited it. They are not compensated, they had to pay themselves. This is very painful", said A. Bružienė.
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