Are capsule implant removals covered by ohip?

Question

I was in an accident 3 yrs ago and insurance will not cover the removal of the implants and my original surgeon wants to charge me $5000 to have it done. It is very painful in my chest and armpit. What are my options? I don't want other implants put in.

Martin Jugenburg, MD · Answer

Removing breast implants is a procedure covered by OHIP when performed for medical reasons.  Given the brief description you provided here, you should qualify.  Understand that OHIP covers removal only.  If you need any work done to improve the appearance of your breasts (such as a lift), fees will apply.  I am not sure what the $5000 was for, I suspect it was for more than just removing the implants.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

I am sorry to hear about your accident and subsequent pain from your ruptured implant.  Your only option is to have them removed without insurance's help.

Joe Gryskiewicz, MD, FACS · Answer

Hi Janette, I am sorry to hear about your accident, although I am unclear what type of accident you had or how this affects both implants.  You certainly can have your implants removed.  I am assuming your had silicone. Realize you may have some unwanted changes, such as droopiness, which you will need to discuss ahead of time with your surgeon.  If you are having pain, you may want to have a workup for possible ruptured implants, or why you actually have pain. Breast implants, ruptured or not, usually are not painful to any great degree.  As to the $5,000 from your original surgeon, perhaps you can revisit that price with him/her, or even price shop.  All the best with your pain, "Dr. Joe"

Tom J. Pousti, MD · Answer

I am sorry to hear about the problems you are experiencing. Unfortunately, online consultants will not be able to answer your question regarding insurance company coverage, specifically enough to be helpful. You will need to check with your insurance company about the planned procedure and coverage. Best wishes.

Alan M. Engler, MD, FACS (retired) · Answer

Insurance coverage varies, from company to company and even within a given company there are often many different plans.  As such, in general, you'll need to contact your own insurance company to see what the provisions are.Symptomatic breast implants issues may qualify for coverage, depending on exactly what the problems are (and, as noted above, restrictions of the insurance company).  Removal of the implants and the capsules may be indicated, based on what you describe above, and may also be covered.I hope that this helps and good luck,Dr. EMember of RealSelf100

Are capsule implant removals covered by ohip?

Answers (5)

More Breast Implant Removal Questions

What is the technique used and the cost of deflating Saline Implants (350cc's over the muscle w/unilateral Grade 3 capsule)?

What does explant with no breast tissue look like?

My breasts became very ugly after Breast Implant Removal. Is there any method to fill my breast to be normal without surgery?

Is it possible to not have the vertical line when I get my saline implants removed? (photo)

Why does my nipple itch following explant?

WE SEND PRETTY
EMAILS