If you have a capsular contraction that is painful, can you use insurance to have implants removed for medical reasons?

Most insurance companies will not cover implant removal as it is a cosmetic procedure to start.  Some companies will cover removal only (not capsulectomy) if there is a documented silicone rupture on MRI.  Don't let an insurance company dictate what is right for you.  Good luck.

Implant removal is generally not a covered benefit by insurance unless the implants were originally placed for medical reasons, such as reconstruction after breast cancer.  Visit a board certified plastic surgeon near you for a consultation and price quotation.

No, insurance will usually not cover the removal of implants, even with painful hard capsules, unless the implants were done for reconstructive purposes after breast cancer. Elective cosmetic augmentation is not covered by insurance, and neither is the removal, capsulectomy, or exchange of implants covered.

Capsular contracture is typically not covered by insurance. In cases of silicone rupture, total capsulectomy may be recommended and covered by insurance. However, most insurance companies do not cover complications from cosmetic procedures. To be sure, contact your insurance company to ask what your specific policy covers.

If you have a severe, painful capsular contracture, your insurance may cover removal of your implants and the scar tissue capsule surrounding them.  Any reconstructive procedures to make your breasts look good following removal are not typically covered.  Your best bet is following up with a plastic surgeon experienced with implant removal to discuss the best course of action.  

If your insurance does not exclude complications of cosmetic surgery, most will pay for a painful capsular contracture which is felt to be due to subclinical infection.