Is there any insurance that covers Biopolymer injection removal?

Question

Hey I'm 24 , I got these injections 4 yrs ago and its really debilitating me now I'm extremely scared and need to take this out . Of course i don't have no where near 15-30k to shell out for surgery. I have Memorial Regional insurance ,what are my options , I weigh 140 I'm 5’2 . The area is my butt but i can feel it going down my leg I'm limping and everything please help I'm scared !

Jeremy S. Nikfarjam, MD · Answer

Hi and thank you for your question. 
I am really sorry to hear about the pain that you are experiencing. Unfortunately, your experience is not an uncommon one and the pain (that can be debilitating at times0 is often a direct result of these foreign body injections and the body's natural response to it. There is hope though!
Some insurance companies will cover silicone/biopolymer foreign body removal surgery based on the symptomatology that a patient is experiencing. Every insurance company is different however in the criteria required for medical necessity and the level of benefits offered so it is definitely worth reaching out to board certified plastic surgeons who specialize in these removal procedures for a consultation. 
In my private plastic surgery practice I perform many silicone/biopolymer foreign body removal surgeries each month and work exclusively through insurance as an out-of-network provider. I encourage you to schedule a few consultations with plastic surgeons who specialize in this highly complex surgery and please make sure that you only consult with those plastic surgeons who are board certified by the American Board of Plastic Surgery (ABPS). Be sure to ask them about their removal technique (I perform surgical excision of this material in a two-stage surgery) and their protocols as it relates to trying to obtain medical necessity coverage for this surgery. 
I hope that this helps and I wish you all the best.

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers are commonly used in the face and body. They may sometimes cause noticeable symptoms that we gauge using the Karamanoukian Soft Tissue Reaction Grading Scale from I to V. The severity of your complications dictates the interventions needed, ranging from itching and burning to severe necrosis of the soft tissue. Nerve pain and symptomatic swelling is also possible. Insurance may cover your surgery, but that is a discussion that requires you to contact and appeal to your insurance carrier. Options for removal are complex and depend on whether you have the material in your face or body. We reverse BBL with silicone commonly and remove silicone from the lips very commonly. Diffuse silicone in the face is not likely to respond to removal. Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. We can also test for the material to determine the likelihood of silicone granulomas and silicone reaction.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding biopolymer removal and insurance coverage. Some insurance plans do cover silicone removal, whereas others do not. It really depends on the quality of your insurance plan. Unfortunately, there is not one set of symptoms that is covered by all insurance companies. It varies. I would suggest you inquire with multiple insurance companies to see if biopolymer removal is covered. Presently, there is no insurance disqualification for pre-existing medical problems. Therefore, you can ask your insurance company if they cover biopolymer removal. Thank you for your question regarding biopolymer injections removal and if insurance can cover your procedure. Good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Praful Ramineni, MD · Answer

Generally insurance will not cover silicone/biopolymer removal due to it being "experimental", however the cost should be much less than 15-30k.

Darryl J. Blinski, MD · Answer

Most health insurances will NOT offer coverage to correct illegal injections to the buttock, in fact I know of none. Best to seek boarded PS wiling to take on your case by in person or virtual consults. I do these cases after detailed discussions. But fees are in the thousands of $$s.

Is there any insurance that covers Biopolymer injection removal?

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Answer: Is there any insurance that covers Biopolymer injection removal?

Answer: Is there any insurance that covers Biopolymer injection removal?

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Is there any insurance that covers Biopolymer injection removal?

Answers (5)

Answer: Insurance

Answer: Insurance

Answer: Is there any insurance that covers Biopolymer injection removal?

Answer: Is there any insurance that covers Biopolymer injection removal?

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Recommended reading

Everything you need to know about Silicone Injection Removal

Our mission is to create a world where every investment in modern beauty is Worth It.