Ruptured silicone implant 22 years old. What are my options with NJ Health Medicaid?

Question

I had reconstructive breast surgery with silicone implants under muscles 22 years ago. Rt implant ruptured and moved above muscle. Left breast has a 9mm x 7mm x 5mm mass. Both are painful all the time, burning, painful to touch as well. Pain, burning, painful to touch. What are my options with NJ Health Medicaid ? I can’t walk around with only 1 implant.

Shaher W. Khan, MD · Answer

Hello thank you for your question. I’m sorry to hear you are having so much pain. Insurance will cover the removal of the implant but the whole purpose of the surgery is to remove the capsule, implant, and any inflamed tissues. Insurance does not cover the removal of capsules, typically. You do not want to undergo an incomplete surgery, especially with a rupture. The entire implant and capsule must be removed in ENBLOC fashion for your health.

Randal Haworth, MD, FACS · Answer

I would strongly advise you to seek medical attention from a qualified plastic surgeon or breast specialist as soon as possible. Pain, burning, and a mass in the breast could be signs of a serious condition, such as an infection or breast cancer.

Depending on the diagnosis and severity of your condition, the surgeon may recommend removal or replacement of the ruptured implant, treatment for the mass in the left breast, or a combination of procedures to restore the symmetry and health of your breasts.

It's important to discuss your options with your surgeon and insurance provider to determine the best course of action for your specific situation. They can provide you with more information on the potential risks and benefits of each option and help you make an informed decision about your treatment.

Best of luck !

Connie Hiers, MD, FACS · Answer

Ask your primary physician to refer you to a plastic surgeon who does reconstructive surgery. This surgeon can then remove and/or replace your implants.  There should be no issue with removal of both and reimplantation of the reconstructed breast. The other breast may need approval.

Camille Cash, MD · Answer

I encourage you to visit with a board certified plastic surgeon near you for an evaluation.  The symptoms that you describe indicate intervention is needed.  You can speak with your insurance carrier to determine if coverage is provided and what criteria need to be met.

Ruptured silicone implant 22 years old. What are my options with NJ Health Medicaid?

Answers (4)

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