Patients who are concerned about how they will pay for breast explant surgery often want to know, “Will insurance cover breast implant removal?” In this article, we will explore the answer to this question and help you navigate the breast implant removal process.
What Is Breast Implant Removal Surgery?
Breast implant removal surgery is a procedure in which a surgeon removes silicone or saline breast implants from a patient’s body. This surgery may be performed for various reasons, ranging from complications to personal preference. During the procedure, your plastic surgeon may also remove the scar tissue surrounding the patient’s implants (capsulectomy).
Breast implant removal recovery varies depending on the complexity of the surgery and whether any additional procedures are simultaneously performed. Many women seek this surgery for relief from illness symptoms, to enhance their breast size, or to return to a more natural breast appearance.
Why Might Someone Want Their Implants Removed?
As stated above, patients may wish to have their breast implants removed for several reasons. These reasons range from medical concerns to lifestyle changes. Some common reasons include:
- Capsular contracture (scar tissue hardening around the implant)
- Implant rupture
- Breast implant illness (BII) or concerns about implant safety
- Personal preference
- Changes in body image or lifestyle
- Discomfort or chronic pain
- Complications from a previous breast augmentation
Will Insurance Cover My Breast Implant Removal?
It’s important to understand that not all health insurance companies will cover breast implant removal surgery. Coverage depends on why the procedure is needed, the type of implants, and the patient’s health plan. Below are situations in which some insurance plans may offer coverage.
Capsular Contracture
Capsular contracture occurs when the scar tissue around the breast implants hardens and causes pain or distortion of the breast shape. If this condition is severe enough to affect your health or quality of life, your insurance company may consider covering the removal surgery.
Implant Rupture
If an implant ruptures or leaks, it may be deemed medically necessary to remove the breast implants. In cases of silicone breast implants, the rupture might not always be noticeable (known as a “silent rupture”), which can lead to health concerns. Insurance may cover implant removal if rupture is detected and poses a health risk.
Severe and Chronic Breast Pain
Breast implants can sometimes cause chronic pain, whether from nerve damage, muscle strain, or other complications. If this pain becomes debilitating and affects your daily life, insurance coverage may be granted, particularly if the pain stems from implant-related issues like capsular contracture or rupture.
Illness
Health conditions like breast implant illness (BII) or a rare cancer known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) may prompt insurance companies to cover implant removal.
BIA-ALCL is a cancer of the immune system linked to textured breast implants, while BII refers to a collection of symptoms (like fatigue, joint pain, and cognitive issues) that some women believe are caused by their breast implants. Though BII is not yet officially recognized as a medical condition, some insurance companies are beginning to offer coverage in cases where patients are suffering severe symptoms.
When Won’t Insurance Cover Breast Implant Removal?
Most insurance companies won’t cover breast implant removal surgery if there is no medical necessity for removal. For example, if you are no longer satisfied with the appearance of your implants or prefer to return to a more natural look, this would typically be classified as elective surgery.
Health insurance companies often exclude coverage for cosmetic surgeries such as breast augmentation and breast lift surgery and any revisions related to them, even if the patient experiences some discomfort post op. Of course, always review your personal health insurance plan and speak with your provider to understand the specific terms of coverage.
FAQ: Breast Implant Removal
What will I look like after breast implant removal?
The best way to know what you may look like after this surgery is to browse breast implant removal before and after photos online. This will give you a good idea of what you may look like following surgery.
Will my insurance cover breast implant removal due to capsular contracture?
If capsular contracture is severe enough to cause pain or deformity, your insurance company may cover breast implant removal surgery. It’s important to check with your insurer and have your surgeon provide documentation of the medical necessity.
Will medical insurance cover breast implant removal after a mastectomy?
In many cases, if you had breast implants placed after a mastectomy (reconstructive surgery), insurance may cover the removal of those implants. Since this is considered reconstructive rather than cosmetic, most insurance plans offer better coverage.
Can I have my breast implants removed if I don’t like them anymore?
Yes, you can have your breast implants removed as a cosmetic surgery. But if the reason is purely cosmetic and you have otherwise healthy breasts, health insurance typically won’t cover the surgery.
Does health insurance cover breast implant illness (BII)?
Some insurance companies are beginning to recognize breast implant illness as a legitimate reason for implant removal, especially when the symptoms are severe. Coverage will depend on your insurance provider and the details of your plan.
Request a Consultation Appointment with Dr. Mason
Board-certified plastic surgeon Dr. Rachel Mason is one of the leading breast explant surgeons in the Las Vegas area. If you would like to learn more about this surgery and whether you may be a good candidate, please contact Perspectives Plastic Surgery today to book a consultation appointment.
We can also help you navigate insurance coverage if this is something you may qualify for. Call today to schedule your consultation. We look forward to hearing from you!