Post to Forum

So excited!! Having my 35 year old implants removed in June....I'm DONE with them & just want to be 'me' again. I'm 66.

  • verana
  • 1 year ago

They were fine for years, no problems at all since 1978,  but years of mammograms probably contributed to both being ruptured now, although you can't tell visually.  Besides, I'm tired of not being able to do yoga correctly, or some exercises.  I'll be small again, but am soooooo looking forward to this.  Found a fabulous surgeon in Ft. Lauderdale, supremely qualified & also reccommended by friends who have used him.   No desire to have implants again, & my husband always wondered why I got them in the first place, although I thought I looked like a boy....(I didn't)....so he's happy for me.  I always regretted having them, even though I looked great.  I don't wear the same clothes I wore in my 30's & 40's either, & bras are so pretty now, am looking forward to shopping.  Explantation is less than I feared, so it's going on my credit card. 

Comments (72)

Sort by

Ladies, your conversation has been so interesting. I'm 68; have 32 yr implants; know one has been ruptured for at least 2+ yrs.....I hope you don't mind if I check with you later.....I'm so concerned about explanting;....and I have Medicare/supplement....but the Main Center for Breast in one of our hospitals told me they were not getting any reimburse from Medicare even though they are on the Medicare list??? I've been to two PS that are on the medicare list on the website and in the book; but was told they are not doing medicare anymore???? Why doesn't Medicare keep their list of Doctors updated?. I've call everyone on the list and was told No every time.Please keep those of us waiting in the wings as to the outcome from MedCare Y'all are like the pioneer women! Go get them!!!! and blaze the trial for us waiting. lol .
  • Reply
Medicare just hopes the plastic surgeons join up, but most of them work on "cash" only...I put mine on my Visa and am just trying to get reimbursed as Medicare said if the implants are ruptured, they will cover some costs. So far no luck, but now that I got the codes to put on the form Medicare sent me (it's just one page) I'm going to resubmit, as both of mine were ruptured, and it states such in the doctor's notes I attached. I think they will cover it partially, but they make you jump through hoops to get it. Will keep you posted. You may have to get them out first & then hope, as I do, for reimbursement. It's still worth it, even making the Visa payments....my boobs now are little, but real & squishy as they should be, not the gorgeous knockers I had for 35 years, but I'm 67 almost, so I don't care anymore, health is much more important. I still have a couple of issues in the nipple area, but they can be easily corrected when I want. Good luck!
  • Reply
I will try to keep you all updated if I find a way for Medicare to cover my expenses.
  • Reply
I found the billing code for Medicare and other insurance. Its 996.54. I am still trying to find the diagnostic codes. Will keep in touch and update when I have the info.
  • Reply
996.54 is the diagnostic code--it's from the ICD-9.  The surgeon should have the CPT code which is the procedure code.
  • Reply
Thanks, amanclay & explanting Texan! Now all I need is the procedure code. I'll try resubmitting the form. My PS doesn't have it, since he doesn't use Medicare. Maybe you guys can find it on your forms? Even if I got half back, it would help a lot. Thanks so much!! :)
  • Reply
Thank your for the information. I will pass it on to my doctor so she can refer me and also she is going to check out the codes. I don't know anything about billing or insurance codes, I just know that without Medicare's help in paying for it, I am going to be stuck with these 39 year old implants for the rest of my life. Fortunately, I have a voucher from the McGann (I am not sure that is spelled right) settlement that is worth $5,000 and I called the number on the form and they said it is still good as the funds to pay it are in a trust.The last time I tried to have them removed (about 10 years ago) no one wanted to do it just for the value of the voucher alone. Every doctor I saw wanted cash up to another $5,000 in advance.
  • Reply
Amanaclay, how did you get that voucher? I tried to get one from McGhan, too, but they said the implants had to have been put in after 1985 (89?) and I got mine in '79, so I gave up. Wish I'd had the advice you did! Good luck. Let us know if your surgeon concurs with the codes. Both of mine were ruptured, so I'm going to go with the 19330 code and print it in the Medicare form myself. Thanks!
  • Reply
I got the voucher back when the class action suits were going. Probably in the 70s or early 80s. In order to get the voucher, you had to be a part of the suit before the settlement.
  • Reply
Ah, ok. Back then, I had no problems with them & looked good, so I didn't even think about it! I resubmitted my forms for the third time....it this doesn't work, with the codes, then I'll give up!
  • Reply
I found the billing code for Medicare. Its 996.54. I am still trying to find out what the diagnostic codes are.
  • Reply
Maybe the diagnostic/procedure code is the same? My 1490-S reimbursement form asks for the "diagnosis code" and the "procedure code." I hope you find it. I don't have any physician friends or I'd ask them!! Thanks for the billing code...I'm going to put it into the diagnosis code box, & see if anyone comes up with the procedure code (i.e. explant, heart attack, colonoscopy, etc...each procedure has a corresponding code, my husband's retina specialist told us. One shot (for his eye) has one code, and the medicine used in another shot has a different code! It's confusing. The doc said the paper crunchers just look at the numbers - if they see the code, they approve it, if not, they question it. We'll keep plugging!
  • Reply
Verana--the CPT codes used are 19328 if the implant is intact and 19330 if it is ruptured.
  • Reply
Thanks! Is CPT the procedure code? I think the diagnosis code is 996.54? Or Billing code....the CMS form asks only for procedure & diagnosis codes...you guys are a great help :)
  • Reply
Thanks, I will send that to my doctor who will be referring me. She ask me for the codes. She is a Gynecologist but thinks removal is medically necessary.
  • Reply
Yes,  the CPT code (Current Procedural Terminology) is the procedure code.
  • Reply
Thank you! I'm going to resubmit the paperwork for the 3rd time. Will let you know if it works...they say the doctor is supposed to submit it, but, oh well. We'll see! :)
  • Reply
Good luck, Verana!  My fingers are crossed that you get some reimbursement!
  • Reply
Thanks. I hope that the codes I have are right.
  • Reply
They are - I looked on the net for medicare codes & they matched what you said :)
  • Reply
Thanks!
  • Reply
Hi Verana, I just read your post and was wondering how you were doing after explant? I also would like to know the name of your surgeon if you don't mind sharing that with me. I live in South Florida and would like a referral.
  • Reply
Sure Sophie, his name is Don Revis (SouthFloridaPlasticSurgery.com), and he's double-board certified. I got my stitches out on Tuesday, at 2 weeks. I feel great, my poor boobs are recovering from the 35 years I had the implants in there. One boob is great, the other may be a little weird on the bottom, but that's because he had to kind of dig out the implant that had started to grow into my tissues!! Both were ruptured....I posted the explant pics...yuck, I'm so glad they're out. I'm really happy, and he & his staff are just super nice. They gave me all the doc notes & even pics of the explant so I can submit to Medicare & hopefully get reimbursed! They do not take insurance, so I just put it on my Visa. He's on Fed. Hwy, in Ft. Lauderdale. Good luck! Private msg me if you want anything else...oh, I even gave him a quote off this site that had been written about him - someone read that he was known as the Boob God Master Surgeon....he laughed when I showed it to him. Of course, he does all kinds of plastic surgery, including implants, but even he agreed I shouldn't get re-implanted after this explant. Probably I'm too ancient!!
  • Reply
I totally understand your excitement! I had mine removed after 20 years and I am SO HAPPY about it! Yay for you and good luck! Mary
  • Reply
If your implants are ruptured insurance should cover the removal. I would definatley check into it. My surgery is April 12th and at 56 after 28 years of implants I too am looking forward to being natural again. Good luck to you.
  • Reply