'Short 10 grams': Alberta breast reduction candidate impacted by funding changes

WATCH: A Calgary woman is facing an uncomfortable change in how Alberta Health deals with breast reductions. Coverage adjustments made a few years ago mean she no longer qualifies for the elective surgery, at least not fully. Sarah Offin explains.

Everyday, Marleigh Goulet takes a cocktail of medications seeking relief from a uniquely female problem.

“I really thought that my migraines and my bulging disc, the torture of my bra straps — how they dig in and my shoulder pain — how I’m always getting dragged down, I thought that was enough,” said Goulet. “And the size!”

Goulet wears a G-cup bra and has been going through the process of getting breast reduction for several years. She was previously approved by Alberta Health for fully-funded surgical procedure.

But then, the rules changed.

“‘You’re short 10 grams on your left breast,'” Goulet said she was told. “‘Your right breast is approved. Your left breast is not.'”

Traditionally, breast reductions are covered by provincial health care nationwide. But which cases qualify as “medically necessary” varies by province.

Until recently in Alberta, the decision was at the discretion of surgeons.

“If we felt like the patient would improve or benefit from it, we would ask Alberta Health to cover it,” said Dr. Justin Yeung, one of about 25 plastic surgeons in Calgary.

But in 2020 the rules changed, mandating a minimum tissue removal threshold for coverage. It can be difficult determination for physicians to navigate.

“Knowing how many grams that is prior to surgery is an incredibly difficult thing to do,” said Yeung.

“It’s like almost going to a grocery store and guessing how many oranges you need to make 300 grams.”

Removing too much tissue is not only an aesthetic issue, but a safety one.

And for Goulet, the change means either paying $7,000 to $12,000 out of pocket or — more likely — continuing to suffer.

“Who is deciding on female health? And why did they change it?”

As part of a statement to Global News, Alberta Health made no mention of any tissue weight restrictions for breast reduction.

“The government relies on the physician’s clinical expertise to determine whether a service is medically required. If a patient is not satisfied they may seek a second opinion,” said spokesperson Andrew Livingstone.

“It is recommended that the patient speak with their primary care physician, as they are best suited to provide alternate care or provider options.”

Yueng suggests breast reductions can improve quality of life for patients, much like other publicly covered surgeries, like hip replacements. But the two surgeries don’t seem to be prioritized in the same way.

“I just don’t think there’s enough money,” said Yeung. “So where that line needs to be drawn is very difficult.”

As it stands, the line for Goulet seems to be somewhere between her left and right breast.

© 2023 Global News, a division of Corus Entertainment Inc.

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