Who Should Be Financially Responsible for Revision Blepharoplasty?

Question

Should the original plastic surgeon be financially responsible for re-constructive surgery needed for correcting droopy eyelid after Blepharoplasty?

Steven H. Williams, MD · Answer

Thanks for your question -
Most plastic surgeons will waive the professional fee if there is need for a revision in the first year.  This means you will likely still be responsible for the anesthesia and facility fees if any.
However, each situation is different and the discussion should start with your doctor.
 
Good luck!

Trevor M. Born, MD · Answer

Dear Anna, in general most surgeons do not charge for the professional part of the corrective surgery- but will have the patient pay for the overhead costs.  This is usually covered in your pre-op discussion with the surgeon or the patient consultant.
 
However, if there is a gross technical error the surgeon may cover all of the costs.  It can be frustrating to have a surgical correction- more cost, downtime and inconvenience of having to go through the process again.
Speak with your surgeon and convey your concerns.
Good Luck;
With Warm Regards,
Trevor M Born MD

Kenneth D. Steinsapir, MD · Answer

Dear Anna
I am not an attorney.  You are really asking a legal question.
However, it is generally in almost all consents that additional surgery may be needed in the future and that complications of surgery can occur and this is the risk the patient bares in undertaking not just cosmetic surgery but any surgery.
In particular eyelid surgery often requires revisional surgery.  A big part of the problem is that the eyelids must work while they heal.  Swelling of the eyelids following surgery can worsen an existing droopy eyelid or even cause a droopy eyelid.  Generally this is not the fault of the surgeon but rather a known potential risk of having the surgery.
We live in a litigious society so you might find an attorney who would take your case but unless there was something particularly outrageous about what your surgeon did or did not do, I think most surgeons would not equate patient dissatisfaction, or even a post-operative eyelid malposition with medical malpractice.  A doctor can do every thing right but you may still have an issue following surgery that necessitates further surgery.  Generally because of the unpredictability of how individuals heal from surgery and even how they will subjectively feel about the outcome of surgery, surgeons do not offer guarantees regarding the outcome of surgery.  We simply try to do the best for our patients.  It is likely that this information was in your surgical consent.
If your relationship with your doctor has not broken down, many surgeons will do their best to make a dissatisfied patient happy including offering discounted revisional surgery.  If your relationship has broken down with your original surgeon, you might explore with you new surgeon whether your particular problem might be covered by your health insurance.

Richard D. Gentile, MD · Answer

As many have responded to your question the circumstances regarding revisions differ, but there are some guidlines many surgeons consider on the request for a revision.  First of all many surgeons will not entertain a request for revision surgery until 6 months have passed and many will wait a year to see what the final result of the surgery will be. 
If the surgeon disagrees that revision surgery is unnecessary and that it will not improve the ultimate final result you may be on your own if you pursure revision surgery
If the surgeon concurrs there may or may not be a surgeons fee involved but will usually always be outside charges fees such as operating room and anesthesia. 
If the surgeon waves their revision fee it is usually best to have them handle the revision unless there are other circumstances that make you want to select a different surgeon.

Christopher L. Hess, MD · Answer

Revisional surgery and the costs that go with it is always a delicate situation.  Each surgeon's policy on it is different.  For example if I think a revision is needed than the patient is responsible for the OR and anesthesia costs but I will not charge them as long as it is in the first year.  Other surgeons charge a surgeons fee which I don't agree with but it's up to them.  I tell my patients during their preoperative meeting.
So unfortunately you will be responsible for most of the costs.

Scott E. Kasden, MD, FACS · Answer

Most likely, no.  You likely signed a mountain of paperwork prior to surgery including a form that elaborated the policy on financial responsibility for revisions and complications.  It is likely that you agreed to be financially responsible.  
Generally, I will do everything possible to please the patient, especially after an unfavorable outcome.  If I can do a revision in the office, I usually won't charge, or may charge for supplies.  If it needs to go to the hospital, the patient will be responsible for thoses charges, but I won't charge.  Sometimes insurance will cover the procedure.
Hope this helps.
sek

George J. Beraka, MD (retired) · Answer

I can tell you what we do.  There is no surgical feee for any revision that is done within a year of the original surgery, but the patient is responsible for the cost of the operating room and the anesthesia.  After a year, we charge a reduced fee.  And we tell every patient our policy from the very beginning.
Our goal is to make sure that every patient feels they were treated more than fairly
There are no universal rules or laws in this area.

Barry H. Dolich, MD (retired) · Answer

This is something that should have been worked out prior to surgery because it varies widely in different parts of the country and amongst surgeons. In my office in the Bronx, I do the revision gratis. If hospital fees are involved (anesthesia, etc.) that is the resposibility of the patient--assuming insurance does not apply.

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