I got saline breast implants in March 2019 & then got pregnant in May of 2020, sometime between pregnancy & delivery, one of my implants ruptured. It's been over a year since the rupture & I contacted my PS & they said that insurance will not cover the removal since there is no sign of infection. I am having pain & have a knot the size of a golf ball where the implant capsule is. What do I do?
I am not sure what is the exact problem you are having without a complete history and physical examination and possibly radiology exams.
Deflated saline implants are NOT covered by insurance. You are fully responsible for all the cost of surgery.
Insurance does not cover complications from cosmetic surgery.
May be under certain circumstances the Implant company may replace the implants but the rest of the surgery cost is yours.
Removing a ruptured implant may be covered by insurance. Replacement or mastopexy would be cosmetic and not covered by insurance.
The implant manufacturer “warranties” your implants. If an implant deflates, the manufacturer will reimburse you for the cost of a new implant(s). If the deflation occurs early, as in your case, they will also provide monetary assistance to cover the OR expenses. Your surgeon’s office should be able to let you know what the cost to replace would be, how much the manufacturer will reimburse you, etc. You may need to consider taking out a short term no interest loan from one of the financing agencies, like CareCredit or Alphaeon, to pay for the surgery, and then get reimbursed from the breast implant company once your failed implant is evaluated by them. You can also contact the breast implant company directly to see what kind of help they will provide. The deflated implant is not “dangerous” to your health, but can be uncomfortable if it folds into a firm knot. You may need to have the surrounding capsule removed as well, to provide enough “room” for a new implant. Good luck!
Typically insurance companies do not cover ruptured implants, but the manufacturers do. The two main companies that sell saline implants (Mentor & Allergan) offer a 10-year product warranty. There is also coverage for surgeon and hospital fees, but recently they required extended warranty coverage at an additional cost.
Also, you are not required to utilize the same surgeon to take advantage of the warranty. However, you would need to obtain the product cards and contact the manufacturer if your initial surgeon does not.