Will insurance cover breast implant removal?

Author: Noelia Smitham  |  Last update: Friday, July 11, 2025

Implant removal may be covered only if it's necessary treatment of a complication which represents a separate medical condition. Implant damage, hardening, leakage, and autoimmune disorder don't qualify as separate medical conditions.

How to get insurance to pay for removal of breast implants?

The easiest way to get pre-authorization is to have your plastic surgeon sign and submit a letter that lists your symptoms and explains why removal is medically necessary based on your insurance policy language. (Usually one or more of health problems listed on the bullets earlier in this article).

What makes breast implant removal medically necessary?

In some cases, breast implant removal or replacement is medically necessary. The most common reason to remove implants is that scar tissue hardens around the implants. This hardening is known as capsular contracture. It can cause pain, discomfort or breasts that look different than they once did.

How much does it cost to have old breast implants removed?

The average cost of breast implant removal surgery is $3,979, according to the latest statistics from the American Society of Plastic Surgeons. This average cost is only part of the total price – it does not include anesthesia, operating room facilities or other related expenses.

Do you have to pay to remove breast implants?

Understanding the costs involved in breast implant removal is essential. The average price of explant surgery varies based on location and surgeon expertise. On average, patients can expect to pay between $2,000 and $5,000. Additional costs may arise from anesthesia and facility fees.

7 day update| Healing after Breast Explant Q and A

What happens when breast implants are removed and not replaced?

After removal, some women do not choose to replace their implants. These women may have cosmetically undesirable dimpling, chest wall concavity, puckering, or sagging of their natural breasts.

What is the explant assistance program?

The Explant Assistance Program (EAP) is an option available to claimants who need financial help to have their implants removed. This program is designed for direct payment to the doctor and/or hospital that provides your explant service.

At what age should breast implants be removed?

Eventually, the implants will have to be removed. Breast implants generally last 10 to 15 years. It is not unheard of for them to last longer, but the longer you have them, there is an increased risk of rupture and other complications.

What do breasts look like after implant removal?

Following an implant removal, breast volume decreases significantly. Depending on the implant size and natural breast tissue remaining, this lack of volume can create several negative aesthetic effects: Breasts may appear deflated, saggy, or misshapen. Skin may be loose and will likely have severe wrinkles.

Can you keep breast implants for 30 years?

For many people, their breast implants last their entire lives. While these devices can lose some of their strength over time, there is no rule that says breast implants are only ever good for 10 years.

Will I lose weight after breast implant removal?

Some patients may experience weight loss and change in their breast volume after implant removal and wish to replace them. Although it is not that common, some patients miss the fuller volume they had with implants.

Does insurance cover breast lifts?

A surgeon's fee for breast lift surgery will be based on his or her experience, the type of procedure used and the geographic office location. Most health insurance plans do not cover breast lift surgery or its complications, but many plastic surgeons offer patient financing plans, so be sure to ask.

What happens if you never take breast implants out?

Over time, the implants can experience changes such as ruptures or leaks, hardening, or shifting within the breast pocket. These changes can lead to discomfort, changes in breast appearance, or even health problems like infection or migration of the implant.

What is a medical necessity for breast implant removal?

Medical Necessity

Breast cancer in the implanted breast or remnant, or in the contralateral breast, where implant removal is necessary to excise the breast cancer; or. Breast implant-associated anaplastic large cell lymphoma; or. Extrusion of implant through skin, or. Implants complicated by recurrent infections, or.

Are your breasts flat after implant removal and lift?

While initially, most patients will appear “flat” in the chest after explant surgery, this does not always last.

What are the symptoms of breast implant illness?

Breast implant illness symptoms and signs
  • chronic fatigue.
  • joint and muscle pain.
  • memory and concentration problems.
  • breathing problems.
  • sleep disturbance.
  • rashes and other skin problems.
  • dry mouth and dry eyes.
  • anxiety.

What happens to the pocket after breast implant removal?

The pocket that once held your implant will naturally heal and shrink after removal, and with drainless breast procedures, this process can occur more comfortably and with less risk of complications. If you're considering breast implant removal and are interested in drainless breast procedures, Dr.

How long does it take to fully recover from breast implant removal?

Whether you want to remove or replace breast implants because you want a more natural look or because your current breast implants are too old, breast implant removal is a simple procedure with a short recovery time. Most people are fully recovered from this procedure in about six weeks.

Is removing breast implants a major surgery?

Anesthesia Complications

As we mentioned, breast implant removal is a major surgery. As such, you'll likely have to be put under either a local or general anesthesia. With anesthesia, there come potential complications.

How much weight did you gain after breast implants?

In most instances, only 3-5 pounds are gained after your procedure. While some of this weight gain is caused by the presence of breast implants in your body, there are other factors that account for the rest of the weight. Fortunately, this is usually temporary.

Is it OK to have breast implants for 20 years?

On average, today's implants are designed to last more than a decade, with the chance of rupture increasing by one percent each year. So, the older your implants are, the greater your risk of rupture or other complications. In many cases, breast implants can remain in good shape for 20 years or more.

How to get insurance to cover implant removal?

Implant removal may be covered only if it's necessary treatment of a complication which represents a separate medical condition. Implant damage, hardening, leakage, and autoimmune disorder don't qualify as separate medical conditions.

Can you get breast implants removed for free?

Medicare does provide a rebate for breast implant removal/explant surgery. That doesn't mean that your surgery is "totally covered" by Medicare and private insurance. It doesn't entitle you to "free" surgery.

How painful is explant surgery?

Like any surgery, you should expect post-operative pain, but in general, breast explantation surgery is well-tolerated with over-the-counter pain medications and a short course of prescription pain medications.

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