Does insurance cover cost of implant removal if there is rupture? Can I sleep on my side or stomach w/ ruptured implants?

If your implants are ruptured insurance does not generally cover the removal cost, but some may.  You need to contact your carrier to find out about your specific policy.  A test such as an MRI may need to be done to determine if a rupture occurred.  If it did, it is recommended that the implants be removed when it is reasonably possible.

For the most part, insurance will NOT cover breast implant removal even if the implants are ruptured.  But unless you have had trauma following your surgery, the chance that both are ruptured is very small. If they are ruptured, they can simply be removed.  A capsulectomy does not need to be performed in this case.I hope that helps and wish you the very best!Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

Thank you for sharing your excellent question.  The first step would be to see an ASPS board certified plastic surgeon to confirm your implant rupture so that the best treatment option can be recommended.  If the implants were placed for cosmetic reasons it is unlikely that your insurance will cover the cost of removal but you may wish to reach out to your insurance plan to confirm this.  As for sleeping you can position yourself on your side or stomach without causing issues to your implants. Hope this helps.

Before it is confirmed that you have a rupture it will be important to determine if you have silicone or saline implants. if they are saline, a deflation will be easy to pick up because the breast will be dramatically smaller. Pain is not often associated with implant rupture but capsular contracture can be. If the implants were silicone, and MRI is the best test to confirm if there is an implant rupture or not. In terms of insurance coverage, if there is a confirmed rupture (by imaging), then many but not all insurance companies will cover removal. They usually do not cover removal is capsular contracture. None will cover replacing the implants after. However, the implant companies offer warranties and so they will typically cover replacement implants and cost towards additional surgery for ruptures. Capsular contractors are also now often covered for first time breast augmentation by the implant vendors. You should have the make/serial number of the implants available and confirm with the implant company whose device you have once you know if there is a rupture or a capsular contracture or something else.

I recommend contacting your insurance company as everyone has a different EOB. Your insurance company will let you know if this a covered medical benefit. I recommend finding a board certified plastic surgeon in your area for removal. If the implant is ruptured you will need a capsulectomy as well.