How Much Does It Cost to Have Breast Implants Removed and Replaced?

Breast implant removal and replacement is a procedure many individuals consider for various reasons, ranging from health concerns to aesthetic preferences. Understanding the financial implications is important, as costs fluctuate significantly. This article explores the financial aspects to help individuals prepare.

Factors Influencing the Overall Cost

The total cost for breast implant removal and replacement is influenced by several components, with surgical fees often forming a substantial part. A surgeon’s expertise and geographic location impact their fees. Removal alone can range from $2,000 to $5,000, averaging around $3,979. When replacement is included, the average cost for breast implant revision is approximately $10,247, ranging from $8,000 to $16,000.

Anesthesia fees are another significant expense, covering the anesthesiologist’s services and medications. These fees typically range from $600 to $800, but can extend from $500 to $2,000 for general anesthesia. Cost depends on surgery duration and anesthesia type, with general anesthesia generally being more expensive. Anesthesia can be billed hourly, often around $300 to $400.

Facility fees cover the use of the surgical facility, including the operating room, equipment, and nursing staff. These costs typically range from $800 to $1,200 but can add between $1,000 and $5,000. Hospitals generally have higher facility fees than ambulatory surgical centers (ASCs). ASCs often present a more cost-effective option for outpatient procedures due to their specialized focus.

The cost of new implants, if chosen for replacement, also contributes considerably. Saline implants average around $1,000 per pair, while silicone implants are about $2,000 per pair. Newer “gummy bear” implants are the most expensive, starting at $2,000 and potentially reaching up to $6,000 per pair. The choice of implant type, brand, and size directly affects this cost.

Geographical location plays a substantial role, as costs vary widely across cities, states, and regions. Differences in living expenses, demand, and competition contribute to these price variations. Procedures in major metropolitan areas may be more expensive than those in smaller towns.

The complexity of the surgical procedure also influences the total cost. Procedures requiring more extensive work, such as an en bloc capsulectomy, are typically more time-consuming and expensive. Combining removal and replacement with additional procedures, like a breast lift (mastopexy), can add approximately $6,000 due to increased time and skill.

Additional Expenses to Consider

Beyond core surgical fees, several other expenses typically arise. These additional costs are not usually included in the primary surgical quote but are necessary for a complete procedure.

Pre-operative consultations and diagnostic tests represent initial expenses. These include fees for consultations with the surgeon, diagnostic imaging, and blood tests. Patients may require blood work, mammograms, or MRI scans, especially for silicone implants. The necessity and cost of these tests vary based on individual health and surgeon’s requirements.

Post-operative care and supplies also contribute to the financial burden. This includes follow-up appointments with the surgeon. Patients will likely need prescription medications, such as pain relievers and antibiotics. Specialized items like compression garments and bandages are often required to support healing.

Long-term financial planning should consider future revision surgeries. Breast implants typically have a lifespan, often 10 to 20 years, after which they may need removal or replacement. Complications can also arise, potentially necessitating further surgical intervention.

Understanding Insurance Coverage

Navigating insurance coverage for breast implant removal and replacement can be complex, as coverage depends on the reason for the procedure. A clear distinction exists between medically necessary and cosmetic procedures.

If breast implant removal is for medical reasons, such as a rupture, severe capsular contracture (Baker Class III or IV), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), infection, or chronic pain, insurance may cover a portion or all costs.

However, if removal is for purely cosmetic reasons or personal preference, insurance typically does not offer coverage. The original reason for implant placement can also influence coverage; implants placed for reconstruction after a mastectomy may have different rules. The Women’s Health and Cancer Rights Act of 1998 (WHCRA) mandates coverage for reconstructive surgery following a mastectomy.

Regarding replacement, insurance coverage is usually limited to cases where it is part of medically necessary reconstruction, such as after a mastectomy or to correct a severe deformity. If replacement is solely for aesthetic enhancement, it is typically classified as cosmetic and not covered. Even when medically necessary, patients are responsible for standard insurance costs like deductibles, co-pays, and any expenses before reaching their out-of-pocket maximum.

It is important to obtain prior authorization from the insurance company before surgery. This involves submitting medical documentation, such as a Letter of Medical Necessity from the doctor, to demonstrate the procedure meets the insurer’s criteria. While prior authorization indicates likely coverage, it is not a guarantee. Patients should confirm policy details directly with their provider.

Payment and Financing Options

When insurance coverage is limited or unavailable, individuals have several avenues to finance breast implant removal and replacement.

One common approach is to self-pay; some practices may offer discounts for upfront cash payments. Patients should inquire about potential self-pay discounts during their initial consultation.

Many surgical centers and practices provide in-house payment plans or collaborate with third-party medical financing companies. These plans allow patients to pay in installments over a set period. Terms and interest rates vary, so review them carefully.

Medical credit cards, such as CareCredit, are designed for healthcare expenses and are widely accepted. These cards often offer promotional financing periods, typically six to 24 months, with no interest if the full balance is paid by the term’s end. If not paid in full, deferred interest may apply from the original purchase date, resulting in substantial charges.

Personal loans from banks or credit unions offer another financing route. These loans provide a lump sum for medical expenses, with repayment structured over a fixed period at a set interest rate. Eligibility and interest rates depend on the borrower’s creditworthiness.

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) provide tax-advantaged ways to pay for qualified medical expenses. Funds contributed are pre-tax, reducing taxable income. For breast implant removal to be eligible for HSA or FSA reimbursement, it must be medically necessary and supported by a Letter of Medical Necessity. These accounts cannot be used for purely cosmetic procedures.