If One Silicone Implant is Leaking, How Urgent is Explantation? Would Insurance Cover This Expense? I

If One Silicone Implant is Leaking, How Urgent is Explantation?  Would Insurance Cover This Expense?

Doctor Answers 6

Explanation of leaking silicone implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree that a leaking silicone implant should be replaced sooner rather than later.  Health insurance does not cover the consequences of cosmetic surgery so, unless the implant was inserted during a breast reconstruction, its removal and replacement would not be covered.  If you had surgery in the US with implants purchased from a US manufacturer, the applicable warranty should cover a replacement implant.  If you purchased an extended warranty, additional funds may be available from the manufacturer toward the replacement surgery. 

Leaking silicone breast implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The sooner you explant a leaking silicone implant the better. Once your breast tissue deflates, the skin envelop contracts, changing the shape of your breast even if a new implant is placed (bigger problem with saline implants). Older generation silicone implants are problematic because they are a sticky gel that starts to migrate in your tissue. Once that happens, it is impractical to go searching for those migrated particles to remove them. The newest generation implants are designed to maintain their shape even after rupture so silicone migration would not be as much of a concern.

Generally, insurance does not cover this complication of breast augmentation. Having said that, I have had a patient where the HMO has agreed to cover this procedure. If you were enrolled in cosmetic insurance at the time of your surgery, that may cover it as well.

Depending on when you had your breast augmentation surgery and which brand of implants were used, the implant company (Allergan or Mentor) may have some sort of insurance policy where they replace the implants for free and give you a stipend to help cover the cost of surgery.

The best thing would be to check with the plastic surgeon who performed your breast augmentation surgery, have him examine you, and discuss your options with you.

Perry Liu, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 4 reviews

Silicone Implant Leaking

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A leaking Silicone breast implant should be replaced soon, but it is not an emergency operation.  Leaving the implant in your body allows more time for the silicone to leak outside the shell of the implant.  If this happens, it is more difficult to remove the ruptured silicone from the surrounding areas.  If the implants were placed for cosmetic reasons, it is generally not covered by insurance to remove them.  Check with your insurance company first since sometimes they will cover removal, but not replacement.

Leaking silicone implant and removal.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

When a silicone implant is found to be leaking, the recommendation is for removal. This is not an emergency, however it should be taken care of sooner rather than later. One obvious reason is that removal of the silicone gel when it is still contained within the implant capsule is much easier than when it spreads outside the capsule and into the breast tissue. The insurance question depends upon your insurance company and the policy you have with them. Some insurance companies will cover the removal of the implant and the capsule, but rarely will they cover replacement of the implant. If the implant is less than 10 years old, the implant manufacturer may cover the cost of the new implants and the surgery.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Silicone implant leak

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is always better to take care of it once you recognize the problem. If it were from cosmetic surgery, then it is self-pay.

Leaking Silicone Implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Ideally, it's never a bad idea to replace the implant(s) sooner rather later. However, having said that there certainly isn't reason for concern or medical issues associated with having a ruptured implant. 

If you're asking if your health insurance will cover implant replacement, no it won't. This is still a cosmetic procedure. All implants have warranties assuming you had them done here in the states. Check with the manufacturer of your implants to see what the warranty entails.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.