Silicone Injection removal covered if medically necessary? (Photo)

Question

Hello so I was injected with silicone in my buttocks about 6 years ago. I keep getting sciatica with terrible leg and back pain. My butt is very hard, lumpy and saggy. I've spoken to my insurance and it is Medically necessary. Any one know of any surgeons who will take on my case with my Insurance? It was a foolish thing now I know I was young and dumb and insecure and pray and wish I could go back. Please help I'm pain daily and unsure what to do please please help me.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your inquiry regarding the removal of silicone injections from the buttock and whether your insurance plan will cover such a procedure. Not all plastic surgeons are familiar with this particular type of procedure, but luckily some experienced professionals specialize in silicone removal across the United States. Many of these specialists do accept insurance plans for this type of surgery. However, it depends on your insurance. Having personally performed over a thousand silicone removal surgeries, I am confident that you will be able to find an experienced professional who can provide you with superior care and outcomes.

When considering a big procedure to remove silicone from the buttock, it is essential to seek out a board-certified plastic surgeon with experience in this specific area. Be sure to do your research and make sure they have performed at least 100 buttock silicone removal surgeries, as well as looking through before and after pictures for their previous patients. Reviews on RealSelf can also provide valuable insight into their services. If you can't find an experienced specialist in your area, consider travelling out of state if necessary. We here at Dr. Katzen's office are committed to providing only the highest standard of care - I am a Verified Plastic Surgeon and have achieved certification from the American Board of Plastic Surgery, American College of Surgery, International Society of Aesthetic Plastic Surgery and International College of Surgery. I am also President of the American Society of Bariatric Plastic Surgeons, a member of the American Society of Plastic Surgery, the American Academy of Cosmetic Surgery and a RealSelf Hall of Famer.

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers are commonly used in the face and body. They may sometimes cause noticeable symptoms that we gauge using the Karamanoukian Soft Tissue Reaction Grading Scale from I to V. The severity of your complications dictates the interventions needed, ranging from itching and burning to severe necrosis of the soft tissue. Nerve pain and symptomatic swelling is also possible. Insurance may cover your surgery, but that is a discussion that requires you to contact and appeal to your insurance carrier. Options for removal are complex and depend on whether you have the material in your face or body. We reverse BBL with silicone commonly and remove silicone from the lips very commonly. Diffuse silicone in the face is not likely to respond to removal. Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. We can also test for the material to determine the likelihood of silicone granulomas and silicone reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeremy S. Nikfarjam, MD · Answer

Hi randall804, First of all, you are not alone in this. I have seen thousands of patients who have been victimized by illegal silicone injections. The symptoms I see range from mild to moderate to severe- requiring emergent hospital admissions. What you report is a familiar story that we here in the office- pain in the buttocks, back, and legs. Sometimes this pain is accompanied by intermittent tingling in the extremities. Second of all, treatment is possible! After training in hospitals in The Bronx in the early '00s, I saw countless patients present to the emergency room with symptoms related to silicone disease but were not given any substantial treatment. They were given antibiotics and pain medications and sent home. It was then that I decided to pioneer the silicone removal center in New York. You can read more through the link below. Ultimately, I perform a two-stage open removal procedure (through a small incision inside the buttocks crease) with a third stage reconstructive BBL. All three stages are pre-authorized through a patient's health insurance. I only perform these procedures in a hospital setting with a dedicated team that I have handpicked to assist in these unique procedures. I believe this is a medical problem that needs real, medical treatment (in the U.S., in a hospital, with a board-certified plastic surgeon). Of course, the aesthetic component is very important, and as a plastic surgeon, I do everything I can to make sure my patients look great afterwards as well. Please feel free to contact my team to inquire about your particular insurance policy. -Dr. Nik

Darryl J. Blinski, MD · Answer

Sorry for your very foolish decision. Bit most boarded PSs will offer multiple staged revision surgeries only if you pay first and whatever insurance reimburses the surgeon would sign over to you. In other words just because your insurance company says it "might " cover the surgeries needed there is never a written guarantee. Thus the surgeon requires pre payment fir these operations. If you find a surgeon willing to accept only insurance payment great. In other cases there is a cosmetic portion of these surgeries that is not insurance covered. So at least $4,000-$6,000 is required to pre pay for the cosmetic portion. Best to virtual consult with. BTW do you have a written approval from your insurance company?

Silicone Injection removal covered if medically necessary? (Photo)

Answers (4)

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