Plastic Surgery: Where Do You Draw The Line Between Deformity And Vanity?

Americans are spending a reported $13.2 billion on cosmetic surgery (more than the GDP of Bolivia!), but should health insurers be reimbursing at least a few of these procedures? Over on the New York Times "Freakonomics" blog, plastic surgeon Dr. Michael Zenn points out: "Insurance companies often insist that surgery should treat a functional problem, not a cosmetic one. However, the distinction is not as black and white as they would like and there is a large gray area between the two." Zenn uses the following as an example: "We might all agree that a woman who is a C cup and wants to be a D cup should not be covered by insurance, but what about an 18-year-old girl who has one B cup breast and one D cup breast? Many would argue that this scenario creates a functional problem that is hard to describe as only cosmetic. What about a woman who has had a mastectomy and wants a reconstruction? Cosmetic?"

Zenn also talks about how difficult it was to get breast cancer patients covered by insurance for reconstruction — same thing for children born with congenital deformities. So where should insurance companies draw the line? When Is a "deviated septum" an actual deviated septum and not just what people claim when covering up their frivolous rhinoplasties?

Your Plastic Surgery Questions, Answered [Freakonomics — NYT]

Americans Putting Up The Dough For Plastic Surgery [Houston Chronicle]