Will Health Insurance Pay for Breast Revision Surgery? (Part 2)

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Will Health Insurance Pay for My Breast Revision Surgery? (Part 2)

In part one of this article we discussed how some (not all) insurance companies may cover breast removal / revision surgery if the surgery meets their definition of “medically necessary.” In part two we discuss how a patient typically must “prove” medical necessity in order to obtain insurance coverage for breast revision surgery.

They type of medical evidence that the health insurance company will need to allow coverage based on medical necessity will depend upon the reason for seeking the breast implant removal and replacement.

Health Insurance Coverage for Breast Rupture Revision Surgery

If a woman’s saline or silicone breast implants are ruptured, the insurance company will need proof.

Generally MRIs are the best way to prove breast implant ruptures to the insurance company. However, the insurance company may also accept ultrasounds or mammograms. Remember, though, mammograms should be avoided whenever possible, as the pressure from them can also cause ruptures or leaks.

Health Insurance Coverage for Breast Capsular Contracture

Capsular contracture occurs when scar tissue tightens or hardens around breast implants, causing pain as well as a less natural appearance and feel. Capsular contracture can be mild and fell slightly uncomfortable – or be severe and cause debilitating pain.

Capsular contracture is rated on a scale of “Baker I” to “Baker IV.” While Baker I & Baker 2 are mild, Baker III or Baker IV causes breasts to be hard and/or painful.

Typically the insurance companies only consider Baker III and Baker IV level capsular contracture to be a medically necessary reason for breast implant removal or replacement.

Additionally, if a woman’s implants are causing extensive pain resulting from nerve damage and/or the weight of the breast implants, insurance companies will sometimes consider the breast revision surgery medically necessary.

What Breast Revision Surgery is NOT Considered “Medically Necessary”?

Sadly, many insurance companies do not consider autoimmune diseases or reactions to breast implants to be medically necessary. Similarly, physiological symptoms such as anxiety related to breast implants is generally not going to be considered a medically necessary reason for revision surgery.

And – just as with an original breast augmentation that is cosmetic in nature – insurance companies do not cover breast revision surgery for changing the size, shape or positioning of the breasts if the reasons are purely cosmetic.

How Do I Know if an Insurance Plan Covers Breast Revision?

To start understanding what revision surgery your health insurance covers, you can read through a copy of your actual insurance policy. Be careful not to rely on the short summary that is called a Summary of Benefits and Coverage. This will not be complete information.

Specific policy coverage regarding breast implants or breast revision will be in the “contract” that you signed when you signed up for health insurance coverage. Customers are entitled by law to receive a copy of their contract online or in the mail. So call the phone number on your insurance card and ask for a copy of your contract.

Remember, if your insurer does not cover the surgery you need, you can always consider switching to an insurer with better coverage during the next enrollment period. We also offer financing options for any procedures not covered by health insurance.

Troy Area’s Top Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Top Troy, MI Area Breast Revision Surgeon: 248-335-7200

Breast Revision Surgery to Change Implant Size

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Breast Revision Surgery to Change Implant Size–

The goal of skilled and experienced breast enhancement surgeon is to give women breasts that they want now, and that will also continue to be ideal for them over the course of their lifetime.

In our Detroit area medical office  we spend a great deal of time with every woman helping her choose the best size breast implant for her frame, her proportions and her lifestyle. Unfortunately, not all breast surgeons do this – and women may find that they are dissatisfied with the size or shape of their breast implants.

When this happens, breast revision surgery performed by a skilled, caring and experienced breast revision surgeon can correct the “wrong size” so that the patient is satisfied and comfortable with the size of their breast implants.

Breast Revision Surgery to Reduce Implant Size

While a full breast is attractive, for many women going any larger than a D or DD cup may make their breasts look out of proportion with their body. Additionally, implants that are too large can make a women so much broader in the chest that it can actually make a women look heavier, which is the opposite of what most women want.

Breast implants that are too large can also cause pain and misalignment in the neck and back, as well as significant stretching and sagging of the skin and soft tissues around the breasts.

Additionally, some women find that their oversized breasts cause too much negative attention and/or make it hard to find clothes that fit properly.  Breasts that are too large can also interfere with an active lifestyle (such as running). Finally, as some women mature into roles as mothers or professionals in their career they no longer desire the look of enormous breasts.

In most cases of breast revision surgery, a skilled surgeon is able to exchange too large breast implants for smaller implants. Keep in mind that during the initial breasts augmentation surgery, the skin was stretched and the breast pockets were created to conform to the large implants.  So breast revision surgery to “go smaller” may require additional procedures such as a breast lift, skin tightening, etc.

Breast Revision Surgery to Increase Implant Size

Some women may have been conservative about choosing their initial breast implant size out of concern about going too big – then find that they actually like being bigger and would like to go up in size.

Increasing breast size with a second breast revision surgery is possible in the hands of a skilled breast revision surgeon. The degree to which breast can be enlarged will depend upon the size and shape of the original implant “pocket”- as well as the amount of skin and degree of skin elasticity (“stretch”) that is available to cover a bigger implant.

Again, as with initial breast implant surgery, going bigger is only a good idea if the implant size will fit the woman’s proportions – and not cause pain or health problems down the road.  Making the breasts beautiful, natural-looking and healthy means selecting a size of implant that is not too large for the size and shape of the patient’s frame, natural breasts and the chest itself.

The goal of breast revision surgery is to adjust previous breast implant surgery to give women the breasts they want – that will look beautiful and fit their proportions and their lifestyle – without creating a problem later in life where the weight of the implants and the size of the chest are too much.

Detroit Area’s Top Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Detroit Area Breast Revision Surgeon: 248-335-7200

What to Expect During Breast Revision Surgery

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What to Expect During Breast Revision Surgery–

There are many reasons a woman may desire – or require – breast implant revision surgery. The underlying reason or cause of the revision will determine the exact revision procedure that her surgeon will use.

In this two part article we explain the general steps that are typically involved in breast revision surgery and recovery. However, the best way to understand exactly what breast revision surgery would be like in your situation is to schedule an appointment with an experienced and caring board certified breast revision specialist like Dr. Ali.

Breast Revision Surgery Anesthesia

Medications will be administered by an anesthesiologist for your rest and comfort during the breast revision surgery. These may include intravenous sedation (an anesthetic “drip” or injection) as well as general anesthesia.

In the majority of cases, general anesthetic is used to “knock out” the patient or “put them to sleep” – so they are not awake during the surgery.

Your breast surgeon will discuss your options and recommend the best choice for you during your breast revision consultation.

Breast Revision Surgery Incision

The type of incision used in breast implant revision surgery will also vary depending upon the type of procedures that need to be performed.

Whenever possible, most surgeons will try to use the same incisions used for the initial breast augmentation surgery – in order to avoid an additional second set of scarring.

However, using the same incision may not be possible in all cases. For example, if the patient previously had a transaxillary incision – and/or if a breast lift is now required – new incisions made need to be made.

Dr. Ali is a skilled, experienced and artistic surgeon who takes every step to minimize the size and visibility of any scars – while still achieving the best surgical results.

As with the initial breast implant surgery, incisions can include:

  • Inframammary incision made in the crease under the breast(s)
  • Peri-areolar incisions around the bottom of the areola
  • Vertical incision or Wise pattern incision for breast lifts

Stitches (sutures), skin adhesive, tape and/or clips will be used to close the incisions, depending on their size and location.

Breast Revision Surgery Process

The actual surgical technique(s) used during breast revision surgery depend upon why the surgery is being done. For example, simply replacing a ruptured implant is less complicated and may be a quick “in and out”. While breast revision surgery because of capsular contracture is more involved as it requires the removal of painful, thickened scar tissue around the implant.

Click Here for Part 2: What to Expect After Breast Revision Surgery

Detroit Area’s Top Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Detroit Area Breast Revision Surgeon: 248-335-7200

What to Expect After Breast Revision Surgery

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What to Expect After Breast Revision Surgery

There are many reasons a woman may desire – or require – breast implant revision surgery. The underlying reason or cause of the revision will determine the exact revision procedure that her surgeon will use, as well as what to expect during recovery

In this two part article we explain the general steps that are typically involved in breast revision surgery and recovery. However, the best way to understand exactly what breast revision surgery would be like in your situation is to schedule an appointment with an experienced and caring board certified breast revision specialist like Dr. Ali.

Recovery after Breast Implant Revision Surgery

The final results of breast implant revision surgery will be initially obscured by swelling. Get more information about breast implant revision results.

Following breast implant revision surgery, gauze dressings or bandages will be applied to the incisions. In many cases the patient will also be required to wear special compression garment or a support bra for a prescribed length of time.

Some patients will also require the insertion of a small, thin tube temporarily placed under the skin to drain any excess blood or fluid after surgery.

Patients will be given specific instructions by their surgeon regarding caring for their surgical site(s) following surgery. Pain medications, as well as antibiotics to reduce the risk of infection, will also be prescribed.

Seeing Results after Breast Implant Revision Surgery

Because of the post-surgical swelling, it can take up to six weeks to see the results of breast revision surgery.  After six weeks the swelling should subside, at which time the breasts to feel softer and more natural and appear close to their final size.

Healing time is different for every person – and some revisions are more complicated or “invasive” than others. So it can sometimes take longer for the breasts to soften-up, and for normal sensation to return.

Scars will fade in much the same way they did after the initial breast implant surgery. This will depend upon each patient’s hereditary predisposition to scarring, as well as the location of the scars.

A caring and experienced breast revisions surgeon like Dr. Ali will discuss realistic expectations regarding recovery, healing and scarring in your unique situation.

Following your breast revision surgeon’s instructions is key to avoiding complications and the long term success of your surgery. Breast massage may be recommended in some cases to help prevent capsular contracture. In all cases, it is important that the implants and the surgical incisions are not subjected to excessive force, abrasion or motion during the recovery period.

Most patients are able to resume normal, non-strenuous activities of daily living within a week – and can typically return to work in two weeks or less. Your breast revision surgeon will let you know what is best for your unique situation.

Detroit Area’s Top Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Detroit Area Breast Revision Surgeon: 248-335-7200

Breast Revision Surgery: Breast Implants Size Change FAQs

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Breast Revision Surgery: Breast Implants Size Change

The vast majority of women are highly satisfied with the size of their breast implants. However, some women may wish to have their implants exchanged for larger or smaller ones. Reasons for a change in implant size may be purely cosmetic – or may be for medical reasons.

The process of changing the size of breast implants is called breast revision surgery. When performed by performed by a skilled, caring and experienced surgeon, breast revision surgery can correct the “wrong size” so that the patient is satisfied and comfortable with the size of their breast implants.

How Many Women Get Breast Revisions for Implant Size Change?

Statistics indicate that only about 12 percent of women with breast implants decide to change the size of their implants at some point.

Younger women are typically more likely to want to increase their breast implant size. While women who are in their 40s or 50s are generally more likely to want to reduce the size of their implants.

Why do Women Get Breast Implant Size Change Surgery?

Some women may have been conservative about choosing their initial breast implant size out of concern about going “too big”. Then find that they actually like being bigger and would like to go up in size to achieve a more curvy and voluptuous look.

Other women may have had limited natural breast tissue and had go with smaller implants than they wanted. Then, once the breast tissue has stretched for a year or two, the woman can safely exchange their implants for larger ones.

On the opposite end of the spectrum, breast implants that are too large can cause pain and misalignment in the neck and back, as well as significant stretching and sagging of the skin around the breasts. For women with these problems, reducing the size of their implants may be necessary.

Additionally, some women find that their oversized breasts cause too much negative attention and/or make it hard to find clothes that fit properly.  Breasts that are too large can also interfere with certain activities such as running.

Finally, as some women mature into roles as mothers or professionals in their career they no longer desire the look of large breasts.

How do Women End Up with the “Wrong” Size Breasts?

In our Detroit area medical office we spend a great deal of time with every woman helping her choose the best size breast implant for her frame, her proportions and her lifestyle. Unfortunately, not all breast surgeons do this – and women may find that they are dissatisfied with the size or shape of their breast implants.

In some cases, women may also give in to pressure from partners or friends to choose a bigger size than is optimal for their body – ultimately resulting in a less than desirable outcome.

But in many other cases, women were initially satisfied dissatisfied with their implant size after surgery, but as they aged, their preferences change.

Is Breast Revision Surgery More Complicated than the First Implant Surgery?

In some cases, breast revision surgery to change implant size is more complicated than the first surgery. This is because the surgeon is now operating where there are previous incisions, scar tissue, and stretched skin and muscles, from the initial surgery.

For this reason it is important to choose a plastic surgeon who has more advanced, specialized skills and experience than typical breast augmentation surgeons.  It is very important for patients to select a breast revision specialist for their surgery, like Dr. Ali.

Keep in mind that during the initial breasts augmentation surgery, the skin was stretched and the breast pockets were created to specifically conform to the initial implants.  So breast revision surgery to “go smaller” may require additional procedures such as a breast lift or skin tightening, to make the pocket smaller and the skin not sag. And surgery to “go bigger” will involve additional stretching to increase the pocket size.

Top Breast Revision Surgeon Oakland County

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Top Oakland County Breast Revision Surgeon: 248-335-7200

Breast Revision Surgery FAQs (Part 1)

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Breast Revision Surgery FAQs (Part 1)

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How is Breast Revision Surgery Different from Initial Breast Enhancement?

Breast revision surgery – which replaces implants or corrects problems from initial breast implant surgery – is often more complicated than the first surgery. Scar tissue, and already stretched skin and muscles, are just two of the reasons the second surgery takes more skill than the first.

For this reason it is important to choose a plastic surgeon who has more advanced, specialized skills and experience than typical breast augmentation surgeons.  It is very important for patients to select a breast revision specialist for their surgery, like Dr. Ali.

Who Is a Candidate for Breast Revision Surgery?

Breast revision surgery can be performed for a variety of reasons, including: ruptured or leaking implants; a desired change in the size, shape or position of the implants; or relief from pain and hardness caused by “capsular contracture” scars.

If you have had previous breast enhancement surgery you may be a good candidate for breast revision surgery for any of these reasons, as long as are in in good health both physically and mentally.

What Conditions Can Breast Revision Surgeons Help?

Breast revision surgery can correct a number of problems related to a previous breast implant surgery.  Removing hard, painful, excess scar tissue around the implants due to capsular contracture is one of the primary reasons for breast revision surgery.

Uneven or asymmetrical breasts can also be made to more evenly match with breast revision surgery. Breast implant positioning – too high, too low, too far apart or too close together – can also be corrected with breast revision surgery. Breast implant size can also be made larger or smaller with revision surgery.

And, of course, ruptured or leaking implants can be replaced during breast revision surgery.

What is Capsular Contracture?

When any type of foreign object – including breast implants – is placed in the body, a “capsule” of fibrous scar tissue forms around it. While this is a normal biological process, in some cases, this layer of scar tissue may thicken and contract. This contracting may change the shape and feel of the breast, sometimes causing it to feel hard. The adhering of the scar tissue can also result in pulling and pain

Because of improvements in modern breast implant materials and technologies, capsular contracture is much less common today than it was previously. However, some women’s heredity makes them more prone to scarring than others. In some cases, capsular contracture can be prevented or treated with procedures such as massage or medications.

But in cases of advanced capsular contracture, breast revision surgery is typically required.

CLICK HERE for More Breast Revision Surgery FAQs

Top Birmingham, MI Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Top Birmingham, MI Breast Revision Surgeon: 248-335-7200

Breast Revision Surgery FAQs (Part 2)

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Breast Revision Surgery FAQs (Part 2)

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In Breast Revisions, will my Implants be Placed Over or Under the Muscle?

Breast surgeons generally agree that implants placed under the pectoralis major muscle is better, because it provides thicker coverage over the implants making ripples less likely – and because there is a lower capsular contracture rate under the muscle.

However, during breast implant surgery, the surgeon is dealing with the added concern of scar tissue, tissue damage and/or stretching from the first surgery. So in some cases the surgeon may find it best to insert the new implants in the already established “pocket”.  In other cases breast revision surgery may requires placing the implant in a different plane than the first surgery in order to achieve the best results.

For example, the old implants may have been placed over the muscle – while new ones need to be places under the muscle (or vice-versa) – to enable the surgeon to place the replacement implants in an area where there is less scar tissue and less tissue damage or stretching from the first surgery.

Will Health Insurance Pay for My Breast Revision Surgery?

The Women’s Health and Cancer Rights Act of 1998, protects woman who have undergone mastectomies. If a woman’s implants were put in after a mastectomy, and the doctor shows that removing the implants is now “medically necessary,” then the health insurance company must cover your breast implant revision surgery.

However, for breast implants not related to cancer, everybody’s insurance is different. In some cases health insurance companies will cover breast revision surgeries necessary because of capsular contracture, scarring problems and wound healing issues. Less commonly, but in some cases, insurance may cover surgery for uneven breasts or ruptured breast implants. (Note that breast implants also have certain limited warranties.)

If the reason for your revision surgery is simply cosmetic – because you changed your mind about size or shape – your health insurance will typically not cover your procedure.

Our caring office staff will work with you to verify any insurance coverage of your revision procedure. We also offer financing options for women’s whose procedure is not covered by insurance.

Read More About Health Insurance for Breast Revision Surgery HERE

What Happens during Breast Revision Surgery?

Since every woman’s needs are different, there is not one single approach or technique that is best for breast revision surgery. If there is capsular contracture, for example, the surgery will include removing the scar tissue around the original breast implants.

Breast reduction revision could also include a breast lift, if necessary to reshape and reposition the natural breast tissue. This is often the case when the original implants were too big, causing gravity to stretch the surrounding skin downward.

In some cases the surgeon may find it best to insert the new implants in the already established “pocket”.  In other cases breast revision surgery may require placing the implant in a different location than the first surgery (e.g. under the muscle rather than over it) in order to achieve the best results.

In most cases, the breast surgeons will make every effort to use the existing scars from the first surgery, in order to minimize any additional scarring.

What Can I Expect During Breast Revision Surgery Recovery?

The recovery from breast revision surgery will vary with type of revisions you required. In many cases the recovery will be much like your first surgery. However, if your first surgery was performed a long time ago, you should find that advancements in breast implant techniques has shortened the recovery time from what it was years ago.

The level of discomfort varies according to which procedures were done. But you will be given pain medication to manage the soreness after your procedure, just like before.  Most patients are well-enough to resume most regular activities after a week, as well as resume working after a week or two.

CLICK HERE for More Breast Revision Surgery FAQs

Top Birmingham, MI Breast Revision Surgeon

Top plastic surgeon Dr. Ali has provided breast revision surgery for thousands of patients across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Consultation with Top Birmingham, MI Breast Revision Surgeon: 248-335-7200