Is pain classified as medically necessary plastic surgery?

Question

13 weeks post op. At 2 months i had a fluid noise with sqeaking of the implant on movement. Was told the implant is moving in its pocket. Always in pain daily. Unable to wear a soft bra. Muscle spasms and pins and needles on a daily bases since 12 weeks. Also very restricted to certain physical lifting or activities still. When i have an active day. My left implant with rise high then drop again after a few days. It also goes from bigger to small every few days. Would my issues be medically necessary?

Ellis Choy, FRACS(Plast) · Answer

Hi there,
Sorry to learn about your concern and persistent pain & discomfort after your recent breast implant surgery.
It is not uncommon sometimes it can take up to 3-6 months for the final result to eventuate and mature with resolution of pain or discomfort. It'll be best to seek further advice from your surgeon for further assessment & management.
Best wishes
Ellis Choy

Robert Drielsma, MBBS, BSc, FRACS · Answer

Sorry to read that you are experiencing concerns after your surgery.  Its important to note that you are still in the relatively early stages of your post operative recovery and its important to be patient.  Creaking noises and strange sensations are usually all normal.  Its essential to ease gently back into you regular routines and its usually normal to have some limitations as you ease back into things.  You should not be in constant pain and if it doesn’t resolve than its best to undergo further investigation such as imaging to rule out any concerns. Keep your surgeon advised about your progress and discuss your concerns.  You surgeon will determine if revision surgery is medically necessary and allocate Medicare numbers for claiming rebates.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

I am sorry that you are having issues about your procedure and thanks for sharing your question. I can appreciate your concern.
It is difficult to determine the source of your problems without proper examination and testing. The revision surgery would be difficult to have it covered by insurance. however, if you have an infection or bleeding, you may have coverage of the threatening condition but not the replacing implant. 
If you adquired implants extra insurance, sometimes there is coverage of surgery with implant replacement when experiencing capsular contracture.
Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.
Wishing you the best in your journey

Chien C. Kat, MD · Answer

Thank you for your question.It is important that you see your plastic surgeon for advice especially if you are experiencing pain and swelling.Your surgeon will be able to advise you best with regards to insurance cover.

Terrence Higgins, MD · Answer

Thank you for your questions.
The period of time that it takes each individual to "adopt" implants and become pain free can vary from a few days to several months.
Occasionally there are individuals that never get comfortable with having implants in place.
You need to follow up with your board certified plastic surgeon who performed your surgery.
He/she can evaluate what's going on  and further recommend treatment.

Sometimes physical therapy can be helpful.
Best of luck to you.

Marc J. Salzman, MD, FACS (retired) · Answer

The term "medically necessary" is a term that is meaningful to insurance companies and will vary from company to company and certainly from from country to country.. With pain and fluid after surgery,  you will need  tro be evaluated by your operating plastic surgeon. Best of luck.

Michael Hueneke, MD (retired) · Answer

You would need to be seen in person to determine if a procedure or revision is necessary. I think you are asking if the procedure is considered medically necessary for insurance purposes. This would be considered a revision or complication of an elective procedure. This is not something most companies would pay for. It still may be too soon to tell if you need surgery. I recommend continuing to follow up with your plastic surgeon.

Is pain classified as medically necessary plastic surgery?

Answers (7)

More Breast Augmentation Questions

WE SEND PRETTY
EMAILS

Answers (7)

More Breast Augmentation Questions

Can someone pls tell me what's wrong with my implants? 18 months post-op. (photos)

Taking the tape off my incisions and the scab coming off with, is the scar going to be worse because of that?

How can I fix bottoming out due to skin stretching without it happening again? What is the best option for my goals?

MDMA 14 days before Breast Augmentation?

How long after a Breast Augmentation can I get back to playing tennis / lifting weights?

How soon can I return to work after Breast Augmentation? I work as a dancer/pole dance instructor.

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS