Will insurance cover Capsular contraction at Grade 4 ?

Thank you for your question and I am sorry to hear of your capsular contracture.  I would recommend reaching out to your insurance company to see if its a covered procedure.  They will want to know if your breast implants were placed for cosmetic or reconstructive purposes as most cosmetic patients will not have contracture typically covered.  Hope this helps.

It all depends.If it was for reconstructive purposes, probably. If it was for cosmetic reasons originally, then maybe.Some plans I have seen say they will cover contractors in a cosmetic breast surgery:Grade III and IV only, or some say just IVBoth silicone and saline, or maybe just siliconeOnly if there is a ruptured silicone implantIf they do, it is usually only the removal of the implant and scar tissue, and rarely, if ever, have I seen a plan cover the replacement, or a new implant, which many surgeons would recommend.  

If your capsular contracture is causing distortion of breast shape and pain then treatment is considered medically necessary. If your original surgery was reconstructive and covered by insurance then almost certainly your insurance company should cover the treatment of this condition. However if the original surgery was cosmetic then you should go through the process of preauthorization as some insurance companies do not cover the treatment of conditions which are a sequelae to cosmetic surgery. You should also look into the possibility of any financial assistance from the implant manufacturer. I think the latter is highly unlikely as capsular contracture is a known complication of breast implant surgery, inherent to the presence of an implant and not any defect in the product.