How Much Does Breast Reconstruction Cost?
The average cost of breast reconstruction surgery is $13,750, according to 1,170 reviews from RealSelf members, but complex cases can cost as much as $50,000 without health insurance coverage.
Read on to find out why you might pay more or less for breast reconstruction, when insurance covers it, and whether the cost is really worth it.
Related: Everything You Need to Know About Breast Reconstruction
Is breast reconstruction covered by health insurance?
The Women’s Health and Cancer Rights Act of 1998 (WHCRA) requires all health insurance companies that cover mastectomies to provide coverage for:
- All stages of breast reconstruction surgery for the side on which you've had the mastectomy (including nipple reconstruction, if necessary)
- Prostheses, prior to the completion of your reconstruction surgery
- Treatment for any complications, including lymphedema
If you've had one breast removed or altered, the law also requires insurance coverage for plastic surgery on the opposite breast (for instance, a breast reduction, lift, breast augmentation, or fat grafting), to create a symmetrical look.
In practice, that means the insurance company will cover a portion of the cost of your procedure(s)—but, depending on the details of your insurance plan, you may still have significant out-of-pocket expenses.
You might also decide you need revision surgery, to get the best results on your reconstructed breast. Your insurance should also cover at least a portion of revision surgery costs.
Organizations like BRAVE can help you navigate (and potentially even cover) breast reconstruction-related costs, whether you have health insurance or not.
The WHCRA does not apply to Medicare or Medicaid. However, Medicare covers breast reconstruction if you had a mastectomy due to breast cancer. Medicaid coverage varies by state, so you'll have to get this information from your state agency.
There are no federal laws that require insurance companies to cover prophylactic mastectomy or reconstruction, and the procedure is rarely covered by health insurers. Deductibles, coinsurance, and copays often apply. In some cases, prophylactic surgery may not be covered at all.
The bottom line: Talk to your insurance provider about your benefits before moving forward with your surgery—but know that they might not be forthcoming about everything the company should legally cover. Some plastic surgeons who specialize in breast reconstruction have legal support or other trained staff members who can advocate with your insurer on your behalf.
What affects the cost of breast reconstruction?
Several factors impact breast reconstruction costs, including:
1) Your provider’s credentials and level of experience
Most plastic surgeons are trained to perform breast reconstruction surgery, but it's worth the time to find a board-certified plastic surgeon who specializes in breast reconstruction to join your surgery team (ideally in partnership with the breast surgeon who performs your mastectomy).
Many plastic surgeons who specialize in breast augmentation procedures perform breast reconstruction surgery only rarely, and they may not offer the technique that's best suited to your needs.
The more advanced training and experience a provider has performing breast reconstruction surgery, the higher their surgeon's fee is likely to be. For instance, microsurgery fellowships provide invaluable training for surgeons who go on to perform breast reconstruction with tissue flap grafting, using donor tissue from other areas of the body.
Choose a surgeon whose level of experience you feel comfortable with, who produces exceptional results with the reconstruction technique you're considering on a regular basis.
See our guide to essential questions to ask at a breast reconstruction consultation.
2) The type of breast reconstruction procedure you have.
There are two primary breast reconstruction options:
- Implant-based reconstruction uses the same type of breast implants as cosmetic breast augmentation surgery.
- Autologous (or tissue flap) reconstruction uses your own tissue, taken from another part of the body (often the buttocks or lower abdomen) to rebuild the breast. For instance, a latissimus dorsi flap uses tissue from the upper back, while a DIEP flap uses tissue from the abdomen.
In cases where more volume is needed, patients may have a combination of the two (aka a hybrid or composite breast reconstruction).
About 80% of breast reconstruction surgeries are implant-based, in part because all plastic surgeons are trained to perform this relatively simple procedure.
Flap reconstructions require plastic surgeons to have expertise in microsurgery, since the procedures require reconnection of blood vessels in the chest. Flap procedures are far more complex, technically challenging, labor-intensive, and time-consuming, which will be reflected in the surgeon's fee.
However, flap surgery can be a better option for patients who don't have enough remaining tissue to cover an implant or simply don't want implants.
Consulting with at least one surgeon who offers a range of techniques will help you better understand your treatment options and compare costs.
3) How many procedures you need.
In some cases, breast reconstruction can be performed in the same operation as the mastectomy (aka immediate breast reconstruction).
If you’re having a prophylactic mastectomy to reduce your risk of breast cancer, reconstruction is almost always done during the same operation. Having immediate reconstruction means you'll pay hospital and anesthesia fees just once, reducing your overall cost.
Depending on your cancer treatment plan and personal preferences, you may also have reconstructive surgery weeks, months, or even years after your mastectomy (after your tissues have healed from radiation treatment, for example).
Delayed reconstruction will be more expensive, especially if your procedure involves a series of two or more procedures. The need for multiple surgeries is more common with flap-based reconstruction: an initial procedure harvests the donor tissue and reconstructs the breast(s), while a second procedure several months later (once the tissue is healthy) refines your results.
Another factor to consider: each procedure will come with recovery time that you'll have to take off work.
Talk with your surgical team about how they think you can get the best outcome with the fewest number of procedures.
4) How many breasts are being reconstructed
Some women who develop breast cancer in one breast choose to have a double (or bilateral) mastectomy or a bilateral mastectomy. The cost for reconstructing both breasts won't be double the amount of reconstructing one (having both procedures done simultaneously is more cost-effective), but it will be more than having a single breast reconstructed.
Other women keep the other breast but opt for a procedure like breast reduction, a breast lift, or implant-based augmentation, to improve symmetry. Your plastic surgeon and oncologic team can talk you through all the options and how they'll impact your final bill.
5) Where your breast reconstruction is performed
Surgical procedures usually cost more in major metro areas, which have a higher cost of living than suburban or rural areas. Depending on whether it's performed simultaneously with or without mastectomy, breast reconstruction is usually performed in a hospital or ambulatory surgical center, where costs are typically much lower.
In some cases, for instance, if you live in a more rural area where a specialized plastic surgeon isn't available locally, it may be necessary to travel to pursue the reconstruction option that's your best and preferred option. You'll need to factor in the cost of transportation and accommodations for the initial consultation and at least one surgery (though likely more) to the estimate that providers quote you.
Breast reconstruction costs may include the surgeon's fee, hospital or surgical facility costs, anesthesia fees, and the cost of breast implants and tissue expanders (if applicable). But be sure to ask providers you consult what's in the estimate they quote you and what out-of-pocket expenses you can expect to incur.
6) How long you recover in a medical facility
Breast reconstruction is major surgery. It's usually performed in a hospital under general anesthesia, and depending on how your recovery goes—you can expect a post-op stay in the hospital or recovery center of at least 1–2 days for implant-based reconstruction, or 3–6 days for flap procedures.
The longer your post-op stay, the higher your recovery fees will be.
7) Whether you're having nipple or areola reconstruction
Most breast surgeons now agree that as long as cancer has not impacted the nipple, there’s no risk in performing a nipple-sparing mastectomy. However, if you weren't able to keep yours, both the nipple and areola can be reconstructed through surgery, 3D tattooing, or both.
Often a separate (outpatient) procedure from breast reconstruction, it's usually the final step of the reconstruction process.
The cost for nipple reconstruction will depend on what you opt to have done. For instance, 3D tattooing costs about $350 for one nipple and $600–$800 for two nipples, depending on if it's performed by a permanent makeup artist or plastic surgeon. Some providers offer the service free to breast cancer survivors.
Is breast reconstruction worth the money?
Breast reconstruction has an impressive 95% Worth It Rating from RealSelf members.
Many of those who rated their experience "Worth It" say that the surgery made them feel whole again, including one member who says it "literally changed my life."
Of those who rated it "Not Worth It," many experienced complications like infections, some of which led to multiple surgeries that still left them feeling "disfigured."
It's important to decide for yourself if breast reconstruction is right for you. Immediate reconstruction generally produces better cosmetic results, but sometimes waiting until you're fully healed after cancer treatment can make the decision easier.
In the meantime, a breast prosthesis you can wear—or not wear—under clothing is another (very affordable) option.