Paying to Replace Leaking Implants

Question

live in oregon and i received saline implants 8 yrs ago.i have always had an itch on that side in the same place,right side saline has leaked completely out.my surgeon said it would be the same price as when i got the first ones,but its not my fault.the manuf.is covering $1200.00 for the implant its self. why doesn't my surgeon/dr.take some of the responsibility he is the one that put them in.how do we know its not dr's fault?no pics lft side 34 c/rt 34 a! please help lopsided at 46 yrs young.

William Bruno, MD · Answer

Breast implants have a warranty for the first ten years which covers the implant and a portion of the anesthesia and operating room costs.  1200 is the reimbursement  for  one implant, however the total cost to you should not typically be the same as when you originally had the surgery. This varies from surgeon to surgeon.  Usually the cost is less overall but this depends on the facility fee and anesthesia fee.  You can probably have one saline implant replaced for about 4000.

	The warranty covers the defective implant, it doesn't necessarily cover ALL the surgical costs however.

	You can discuss this with your surgeon or seek out another opinion.

	Best wishes,

	Dr.Bruno

Richard H. Tholen, MD, FACS · Answer

Certainly it is upsetting to have a saline breast implant deflate; that is just one of the reasons that most of my patients now (since November 2006) choose to have the latest-generation cohesive silicone gel implants used for their breast augmentation.

	But you had your implants placed 8 years ago, when the FDA did not allow use of silicone gel implants for first-time elective breast enlargement patients. The manufacturer does provide free lifetime replacement for their implants (both manufacturers), and will reduce the price of silicone gel implants by the cost of one saline implant if you decide to switch both now that you have to undergo surgery for your deflation. If you purchased an extended warranty at the time of your surgery, the manufacturer covers additional $$ for the procedure costs. But now you need to have surgery--consider that a bit more spent now to replace both implants with silicone may prevent another operation, cost, and time off work in the future.

	But really, your surgeon is not at fault for your 8 year later implant deflation; neither are you, unless you subjected your implant to unusual pressure or injury, and nobody would knowingly do that, would they? Every surgeon has their own re-do policy; this is something I explain to every patient who sees me for consultation, and each patient also receives a written copy of revisional surgery or re-do surgery cost responsibility. In my office, I would not charge a surgeon's fee for implant replacement (I donate my time for free for my own patients) even 8 years later, and my patient is responsible for operating room and anesthesia costs (and implant costs, if not covered by manufacturer or if the patient elects for a size change). Other surgeons may charge a surgeon's fee (perhaps reduced) after a prescribed period of time (usually a year) in addition to overhead costs (OR and anesthesia). The latter is fair; I choose to be better than fair.

	We "know" it's not the doctor's fault since you had 8 years of non-deflation. And don't you feel just a tiny bit ashamed implying it might be? Do you take tires that have been on your car for 8 years back for a "free" tire (and removal and replacement labor) if you have a flat?

	Really, I understand that some patients expect their surgeon to be "perfect," but asking for 8-year-in-the-future perfection is a bit unreasonable. Now, go make nice with your surgeon and get yourself taken care of! Good luck!!

Kris M. Reddy, MD, FACS · Answer

Breast implants are medical devices that will last generally no more than 10 years. However, many patients have implants that have lasted beautifully well over 15 years. If the surgeon made an error that leads to a rupture, you would have known soon after the initial surgery. After eight years, it is reasonable for the surgeon to charge you his/her customary fees for implant exchanges.

Todd B. Koch, MD · Answer

Eventually, all saline implants will deflate requiring replacement.  There is no one at fault here not you, not your surgeon and not the manufacturer.  You should have known from the get go that your implants would need to be replaced at some time down the road.  The implant company offers a very nice warranty.  Surgeons do not normally offer to replace deflated implants at no cost.  The patient understands from the start that there will be additional costs if the implants deflate.

Steven Wallach, MD · Answer

A doctor has no specific responsibility for an implant that ruptured as in your case.  I know that it is upsetting to have a ruptured implant, but it can be fixed.

Jeremy Waldman, MD · Answer

Surgical cost vary from doctor to doctor and ussully include a professional fee, anesthesia fee, facility fee, and implant charges. The implant warranty will cover a portion of the cost to repalce the leaking implant. If this event occured 8 years after your initial surgery it would be hard to assume that the implant leaked because of something that the doctor did. Both saline and siliocne implants can leak over time. At this point the leaking implant needs to be replaced and often, since it has been 8 years already, you may be given the option to replace the left one as well. I would expect the surgeon to charge you for the surgery but usually this is less than the initial operation (again this varies by provider).

John Whitt, MD (retired) · Answer

This is a question which should be addressed at the time of your initial consultation as there is a lack of uniformity. Your surgeon really bears no blame for the implants leaking unless it happens immediately due to needle tear, etc. I personally do not charge for replacing implants which I placed originally, but other surgeons in my practice do.

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