​ Financial Issues, Part 2

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Several fees contribute to the overall cost of cosmetic surgery. Be certain you understand which fees are included in your quote for the procedure. An office employee may quote only the surgeon's fee when giving you an estimate. This may not include the anesthesiologist's or the operating room fees. If this is the case, you may believe that the cost of your procedure is much lower than it actually is.

Fees are surprisingly uniform throughout the United States, with the exception of the New York area, where fees are consistently 50 percent higher than the rest of the country.

Surgeon's Fee

This fee is applied toward your surgeon's overhead expenses such as employee salaries, rent, and malpractice insurance. After taxes, only about 30 percent of this fee lands in your surgeon's pocket.

Anesthesiologist's Fee

The anesthesiologist's fee usually depends on the length of the procedure. If your surgeon administers your sedation, or if only local anesthesia is used, there should be no anesthesiologist's fee.

Facility (Operating Room) Fee

If surgery is performed in the hospital, there will be a separate operating room fee. If it is performed in the office, there may be a facility fee.

Implant Fee

This fee applies to the cost of medical materials such as breast implants, facial implants, and collagen. The price of your implants may be marked up as little as 10 percent or more than 100 percent. For example, breast implants cost an average of $1,000 per pair from the manufacturer, but you may be charged up to $2,000 for a pair. Your surgeon or the surgery center may profit from the sale of implants.

Financing Your Cosmetic Surgery

Cosmetic surgery, with rare exceptions, is paid in full before surgery. If you lack the liquid assets, you may be able to obtain financing through credit cards or bank cards, payment plans, bank loans, and mortgage plans (which offer the advantage of tax-deductible interest).

But bear in mind that plastic surgery is a luxury item. Few people would borrow money or mortgage their homes to pay for a vacation. So, why consider this for plastic surgery? Think about it.

Insurance Coverage

Cosmetic surgery is not covered by insurance. Exceptions to this rule exist when the surgery corrects a functional problem or deformity. To give some examples, excess upper eyelid skin that interferes with eye opening can be corrected with eyelid surgery. Severely asymmetric breasts can be made symmetric by augmenting the smaller breast with an implant. Paralysis of one side of the face can be improved by a one-sided facelift or forehead lift. A severe hollow of the chin or cheek resulting from trauma or cancer surgery can be restored by placement of an implant or bone graft.

A surgeon who agrees that your anticipated procedure is aimed at improving a deformity or solving a problem may write a letter to your insurance company on your behalf explaining that the surgery should be covered. However, health insurance often will not cover treatment for these medical conditions. Do not rely on coverage from your insurance company, even if you have a legitimate medical need.

Combining with Medically Necessary Operations

If you are in need of a medically indicated procedure and would also like to have a cosmetic procedure, then you may be able to combine them. A common example is combining tummy tuck with hysterectomy. If you would like to pursue this option, discuss it with the surgeon who will perform the medically necessary procedure first. If she agrees that combining operations is appropriate, then she will refer you to a plastic surgeon with whom she has worked. Insurance companies may cover the cost of medically necessary operations, but you will be financially responsible for the portion of fees related to cosmetic surgery. By combining procedures, you may save on the hospital and anesthesia fees.

Article by
Fresno Plastic Surgeon