Will Insurance Cover Breast Implant Revision?

Breast implant revision can remedy many issues that arise after a primary augmentation, some cosmetic, some functional. This blog discusses when and to what extent insurance companies may cover this procedure.

Table of Contents

• Will Insurance Pay for My Breast Surgery?
• What If Insurance Won’t Cover My Breast Revision?
• What Are the Benefits of Breast Implant Revision?
• Who Is a Candidate for Breast Implant Revision?
• See How Breast Implant Revision in Tampa, FL Can Change Your Look and Increase Comfort

Will Insurance Pay for My Breast Surgery?

Insurance companies only cover procedures that are deemed medically necessary. When you have a cosmetic procedure, like a primary breast augmentation, it’s not considered necessary for your health, so insurance won’t cover it. 

But what about when complications arise after a cosmetic procedure? That’s what a breast revision can address, depending on the issue. If you need a breast implant revision procedure due to medically necessary complications, it may be covered in part by your insurance. Possible complications that are deemed medical issues include: 

• Capsular contracture (Baker III or IV)
• Implant rupture
• Severe pain
• Breast deformity

But breast implant revision surgery is very complex and unique to the needs of the patient. The level to which your insurance will cover your surgery depends on your specific needs and the details of your procedure. For example, if you have major capsular contracture that is causing your implants to be painful and necessitates their removal, that aspect of your surgery may be covered. But if you also want to replace your implants with new ones, you’d have to pay for that out of pocket because it is considered an elective procedure.

What Causes Breast Augmentation Issues?

In some cases, improper primary surgery may be the cause. Some surgeons may not perform the procedure adequately, making minor mistakes that cause issues for the patients down the line. Poor healing during the recovery process can sometimes lead to issues. 

However, in many cases, things just happen. Capsular contracture is a common issue with breast augmentation, and unfortunately, there’s no way to avoid it. Rupture is another unfortunate issue. It can happen from acute trauma or injury, but the likelihood of it occurring also increases as the implants age. 

Aesthetic issues can also occur. Some patients are ill-advised about the end result of their procedure, such as being convinced that large implants are the way to go when they end up being more of a burden. Additionally, weight gain, pregnancies, and hormone fluctuations can all impact the breast appearance in surprising ways, which can make breast implants less attractive than the patient initially thought.  

How Can I Get My Insurance to Pay for Part of My Breast Implant Revision?

The first step is to discuss your concerns and end goals with your surgeon. Most patients need a medical assessment to determine what exactly is happening with their breast implants via ultrasound or manual exam. 

If your surgeon determines that, yes, you have a severe case of capsular contracture or breast deformity, and that removal is necessary, you may have a case. 

Next, you’ll need to obtain a pre-authorization and inquire with your provider to see what your policy says about complications from cosmetic procedures. If you are awarded some coverage, you’ll have to see if your surgeon accepts your insurance or find one that does. This may pose another challenge, as some cosmetic surgeons don’t take insurance. 

What If Insurance Won’t Cover My Breast Revision?

If your insurance won’t cover your breast implant revision, you’ll need to explore other options like financing. You can also discuss your options with your cosmetic surgeon to determine your next steps. 

However, if you are suffering due to your prior breast augmentation, it’s important that you get help for your concerns. Breast implant revision does more than enhance the appearance of the breasts; it can be an extreme relief to have painful, hard, and misshapen breast implants removed with this procedure. It’s important to explore every option when it comes to this procedure and improving your quality of life.

What Are the Benefits of Breast Implant Revision? 

Breast implant revision is as empowering as it is necessary for many women. If you are living with breast implants that are painful, unappealing, misshapen, or dissatisfying for any reason, you deserve another chance to have the look you want! 

A breast revision procedure is like an all-in-one makeover for your breasts. It can: 

• Remove unsatisfactory breast implants
• Remove painful scarring (capsular contracture)
• Replace or upgrade old implants
• Change the size, shape, or type of implant

It can also be combined with a breast lift for patients who have had their breasts stretched by age, pregnancy, or large implants. 

Who Is a Candidate for Breast Implant Revision?

Breast implant revision isn’t just for women who have pain or issues with their implants. Many candidates simply want to upgrade their look. While breast implants are long-lasting, they are not considered lifetime devices. Many women get breast implants early in life, with a certain aesthetic or lifestyle in mind. Then they get older, have children, change jobs, etc., and find that their old look or aesthetic isn’t who they are anymore—and that’s fine!

Breast implant revision gives women a chance to restart, refresh their breasts, and live the way they want. So in addition to cases where breast implant revision is necessary, candidates may also: 

• Desire smaller or larger implants
• Want to swap silicone for saline, or vice versa
• Want a more anatomically-shaped, or rounded implant
• Want to remove their implants altogether 
• Remove implants and have a lift, instead

That’s the beauty of this procedure: it allows patients to work with their surgeon to enhance their appearance and boost their self-confidence with a breast enhancement that’s best suited for them.

See How Breast Implant Revision in Tampa, FL Can Change Your Look and Increase Comfort

Call Dr. Pasquale Tolomeo, board-certified cosmetic surgeon and expert breast and body contouring artist. Dr. Tolomeo employs advanced techniques for all of his breast enhancement procedures, including breast implant revision surgery. Call Dr. Tolomeo today at (516) 350-8168 or complete our online form to see how breast implant revision can change your life.