If Revisions Need to Be Done, does the Patient Typically Pay out of Pocket Again?

The cost of breast implant revisions varies from surgeon to surgeon. Some plastic surgeons may have the patient pay only for the OR fee and anesthesia without charging a surgeon's fee. You should ask about the surgeon's policy before signing up for surgery. There may also be a fee if a new breast implant is required during the revision surgery. Most plastic surgeons want their patients to be happy and will not charge for their time in the OR, but the anesthesia fees are more difficult to control.

Consult with your plastic surgeon for more details regarding his or her revision policy.

Best wishes,

Dr.Bruno

Dear 7499anon,Every surgeon has a revision policy. Many involve reduced or even no fees for the surgeon (depending on the situation) while the patient may still be responsible for facility (the use of the operating room, staff, and supplies) and anesthesia fees. Best to go back to your surgeon and have a talk about your concerns again. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Every doctor has a different policy regarding payment for surgical revisions. For example, although I will often do revisions for free, my surgical consent clearly states that the patient will be responsible for anesthesia ad operating costs. In general, I try to work with the patient and treat them as fairly as possible to avoid them having to spend additional money after their first surgery and try to avoid assessing blame to either the patient or the surgeon, but every doctor has their own policy.

Practices vary significantly. We do ask that the patient covers the cost of the operating room and anesthesia but we do not charge for a professional fee. The practice policies should be very carefully explained in the paper work you signed for the practice.

Elective cosmetic surgery is not covered by insurance, it is pre-pay, out of pocket.  So, if a second or revision surgery is necessary, WHO PAYS?  Great question, but not such a great answer.  IT VARIES! 

It varies from office to office, doctor to doctor, patient to patient and procedure to procedure.  Some doctors will waive their professional fee, but charge for anesthesia and facility costs.  Others may give an overall discount, 25-50% from the entire cost.  Some may charge full fee.

Return to your original Plastic Surgeon and express your concerns and ask about revision fees.  Then, go to at least one other board certified plastic surgeon, two would be better, and ask what procedure they recommend and their cost.  Now, you have some comparisons to make and a bargaining tool with the original surgeon.  Return again to the original surgeon and ask about the revision fee, please ask the doctor, not the finance manager.  The doctor will be more compassionate and more likely to give you a discount than a paid employee who's job it is to bring $$ in!

When talking with the surgeon about a revision, this would be a great time to add another procedure and/or adjust the original procedure (i.e. bigger implants, saline to silicone, adding lipo).  The surgeon will be happy to add a procedure to generate revenue, to offset the loss of money on the revision.  You would have to come up with the $$ to pay for the new procedure, but the surgeon may waive his fee for the revision if he knows he is getting paid anyway!  You would be getting 2 procedures for the price of 1.

Good Luck

It is a practice specific issue. Each individual practice has their own pricing/charging policies. Best to ask before an operation. In most cases there is a supply/anesthesia fee. 

Thank you for the question.

You will find that surgeons do not “guarantee their work”. Charges for revisionary surgery will vary from office to office and probably on a case-by-case basis as well.

Generally, successful plastic surgeons rely on positive word-of-mouth and will work hard to maintain satisfied patients. Costs of revisionary surgery may range from zero,  to anesthesia/surgery center fees, to discounted surgeon's fees.

I hope this helps.

First off, the overwhelming majority of plastic surgeons will not "guarantee" their work because healing/anatomy/etc varies from patient to patient and results can vary. The acceptability of a result is often subjective. As a surgeon, I have seen results that were so-so but the patients were delighted and vice versa. It is usually a good idea to inquire about the surgeon's policy regarding revisional surgery prior to having the initial surgery. That having been said, most surgeons place a high premium on making their patients happy and usually offer some form of discount. Depending upon the case, some surgeons will only make their patients pay for operating room and anesthesia costs whereas others feel their time, skill and expertise mandates a professional fee. Hope this helps! Good luck!!!

I read a lot in Real Self about bottoming out which I do not personally see in my patients. Perhaps this is because I aim for natural augments and do not recommend extremely large implants. Many posters self label normal healing as bottoming out in error. If a patient is dissatisfied with size, for example, they would bear the cost of revision surgery but I would reduce the price because I want them to be happy. Issues related to infection are included. Last year, a patient was in a car accident shortly after surgery and one implant extruded. I reduced the price of removal and replacement as an accommodation. Unless there is a real issue between the patient and surgeon, you should first return to the plastic surgeon who performed the operation. When revising other people's work, I do not reduce my fees. Also, the prep agreement should spell out the responsibilities of both parties and it is important to be upfront with patients on financial terms.

Every plastic surgeon should have a policy abot the costs of a revision surgery since it happens more frequently than you might of thought.  In large studies up to 20 to 30% of breast augmentation patients had some type of secondary procedure within a year or two after the first surgery.  Why?  Size change and scar revision are the most common reasons followed by asymmetry and capsule removal operations.

Most surgeons will show you a written policy abot who pays what for one of these procedures.  It is rare that it will be "free."  The surgeon may choose to write off his fee for secondary surgery but the anesthesiolgist probably won't.  And then there is the cost of the operatiing room and the supplies...

If you are contemplating a revision get the costs you will incur in writing before you sign the consent form.

If you are looking around for a surgeon to do your fisrt breast procedure ask to see the policy about revision costs in writing.  If the surgeon doesn't have that you should probably look a little harder for another surgeon.  One who will freely discuss this ahead of time.