Romanelli Cosmetic

Does Insurance Cover Breast Implant Removal?

When a woman gets breast implants, chances are that the thought of having them removed is the furthest thing from her mind. No one ever intends to undergo breast augmentation only to have it reversed at a later date, but there are certainly situations when this is the case. For women facing breast implant removal, it is only natural to wonder whether or not the procedure may be covered by insurance. The caring and knowledgeable team at Romanelli Cosmetic Surgery, under the direction of board-certified plastic surgeons Dr. James N. Romanelli and Dr. John Layliev, is dedicated to helping guide Long Island, NY patients through the often complicated process of determining whether or not their breast implant removal may or may not be covered by surgery and, ultimately, providing the most exceptional level of patient care. 

Why would I need my breast implants removed? 

There are a number of reasons why women choose to have their breast implants removed, as well as some cases when implant removal is more or less required. Some of the most common scenarios leading to breast implant removal surgery include:

  • Change in personal preference
  • Change in lifestyle, such as the desire to become pregnant or breastfeed without implants
  • Damage, malfunction, or rupture of the implant
  • Chronic breast pain
  • Breast implant-associated illness

Whether the reason you are considering removal of your breast implants is cosmetic or medical, the experienced surgeons at Romanelli Cosmetic Surgery can help you. During your initial one-on-one consultation, Dr. Romanelli or Dr. Layliev will discuss your concerns and goals with you at length, explain your options in detail, and recommend a surgical plan that will best meet your needs. At this time, it may also be appropriate to discuss whether or not insurance might cover your procedure.

Is breast implant removal covered by insurance?

The key to determining whether or not breast implant removal, or almost any surgery, is covered by insurance is to establish whether or not the procedure is medically necessary. Unfortunately, this decision ultimately lies with the insurance provider, regardless of whether or not the patient and surgeon believe a procedure to be medically necessary. While most insurance companies will not cover any cosmetic procedure or subsequent procedures due to complications from the original cosmetic surgery, there are a few conditions in which explant surgery may be considered for coverage. These include:

  • Rupture of silicone gel implants
  • Chronic breast pain
  • Chronic or recurrent infection
  • Severe capsular contracture 
  • BIA-ALCL (a form of lymphoma associated with breast implants)

If you think that you may have any of these conditions and are interested in having your breast implants removed, the first step is to consult with a qualified, experienced, and board-certified plastic surgeon in Long Island. Following your initial consultation, the team at Romanelli Cosmetic Surgery will advise you on how to get in touch with your insurance company to discuss potential coverage for your surgery.

How can I get my explant covered by insurance? 

While the final decision on whether or not a breast implant removal can be deemed medically necessary is made by the insurance company, there are some steps you can take to help strengthen your case for coverage. These include:

  • Obtain written statements from your doctor expressing his or her professional opinion that your breast implant removal is, indeed, medically necessary
  • Keep detailed records of all doctor’s appointments, hospital visits, treatments, and other things that pertain to your condition 
  • Document your condition with photographs and written logs
  • Provide evidence that you have pursued all other available treatments for your condition, with surgery being a last resort
  • Choose a highly reputable surgeon and surgical facility

How do I find out if my insurance provider covers breast implant removal?

A good place to start in your search to find out whether or not your breast implant removal may be covered by insurance is to read through your EOC documentation. This document outlines the details and benefits of your specific plan and typically lists specific procedures that are – and are not – covered under your plan. You can also call your insurance company directly and speak with a representative to get further details about your coverage plan. 

How do I go about getting a breast implant removal in Long Island? 

The first step toward having your breast implants removed, regardless of the reason, is to be evaluated by a certified and experienced surgeon. As part of this evaluation, you may find out that your symptoms are in line with a condition that could result in your surgery being covered by insurance. Again, though, this will be determined by the insurance company. Call the convenient Huntington, NY office of Romanelli Cosmetic Surgery to schedule your consultation today, and learn more about how a breast implant removal can give you relief from your symptoms and help you regain your life! 

*Individual results are not guaranteed and may vary from person to person. Images may contain models.