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Insurance and Breast Implant or Explant Surgery



Plastic surgery comes with high costs - high costs financially and high costs for potential health risks or complications.


If you have elected to get breast implant surgery, be aware that at some point in your life you will also need to budget for the breast implant removal surgery (explant surgery) or replacement. Many women tend to focus on the initial cost of the implants and inadvertently neglect additional related costs such as MRIs, ultrasounds, mammograms, blood work, possible explant surgery, and any other health-related costs due to complications or subsequent breast implant illness type expenses. In addition, quite often the breast explant surgery costs more than the original breast implant surgery, especially if you elect for a breast lift at the time of explant.


Insurance

As one would expect, not many women have the amount of money needed set aside for elective surgery. One option, if you have an insurance plan, is to check to see if your insurance will cover a portion, if not all, of your surgery. It is important to note that typically insurance plans do not cover breast implants unless it's medically necessary. A medical reason for implants may be the need for implant reconstruction after a mastectomy for breast cancer. In Canada, as of August 2019, four provinces actually now cover the costs of breast augmentation surgery for transgender women.


Some countries also have medical coverage available for partial breast implant removal (explant) surgery. If you are a resident in Canada, be sure to ask your plastic surgeon if your government insurance (e.g. OHIP in Ontario) will cover part of the costs. We have seen that health coverage in each province varies greatly combined with the plastic surgeon's evaluation as well. Some private insurance companies will also cover a portion of the costs if the removal of the implant is deemed 'medically necessary' by your physician; sometimes even if the initial implants were not classified as such. Examples of medical conditions that could result in the explant surgery being considered medically necessary are: ruptured silicone gel breast implants, Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), severe capsular contracture and chronic breast pain.


If your government-issued or private healthcare will not cover the cost of your surgery, it is also possible to set up financing with your surgeon, depending on their practice and payment policies.


No matter your healthcare coverage or location, it is worth your while to research the available options as it relates directly to you.



All posts are intended strictly for educational purposes. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough in-person consultation with a medical professional. If you have questions about your personal medical situation, please call your healthcare provider.

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