Breast Reconstruction Costs and Financing

by Trudi Schrieber

If you have recently undergone a single or double mastectomy, you may be researching options for breast reconstruction. One of the biggest questions you may be considering is, how much does breast reconstruction cost?

Costs

Without insurance, breast reconstruction that uses implants usually costs between $5,000 to $15,000 per breast. If both breasts receive reconstruction, the cost will total $10,000-30,000. Additional surgical options, such as the “flap” technique, which uses tissue from a patient’s own body to create the new breasts, are more expensive. Prices may run around $50,000 per breast. Additional fees may also be added for anesthesia, and the facility in which the surgery takes place. With health insurance, out-of-pocket costs for breast reconstruction usually total $300 to $3,000.

Insurance

Federal and state laws mandate insurance coverage for breast reconstruction costs following a mastectomy; therefore, most insurance companies provide coverage for reconstruction surgery, although there may be some restrictions. The Women’s Health and Cancer Rights Act of 1998 mandates that most insurance companies covering the costs of a mastectomy must also cover the costs of breast reconstruction. Women whose insurance falls under this mandate are required to pay a co-pay, as well as an annual deductible, which varies by insurance company.

Insurance covering breast reconstruction costs should cover both surgery and implants. With implant surgery, the plastic surgeon inserts expanders under the skin and muscle of the chest. He or she gradually stretches the skin by slowly inflating the expander with saline solution over a four- to six-month period. When the skin is ready, the expanders are removed, and replaced with silicone or saline implants. The surgery takes place under general anesthesia, and generally takes a few weeks to a month for recovery.

Patients who undergo the flap method of surgery, which involves removing skin, blood vessels and muscles from another area of the patient’s body to re-create the breast, may pay higher out-of-pocket expenses, even with insurance. The flap method takes four to 12 hours to complete, and requires a week of recovery in the hospital, as well as two months additional recovery thereafter. One to two additional outpatient surgeries are usually required after the initial operation for revisions.

Insurance usually covers implant replacements, as well. Most breast reconstructions will require a replacement surgery in 10-15 years after the initial reconstruction. Insurance may or may not cover the cost of getting a nipple and areola tattooed by a plastic surgeon. This usually costs $200-600 per breast, but some providers offer the tattoos free to breast cancer survivors.

Financing

Women who do not have health insurance that will cover breast reconstruction costs can often apply for financing with their doctor, or through organizations like CareCredit. You will want to speak with your doctor about available options, and whether fees or pre-payment options are included. Companies such as CareCredit may offer payments plans for as long as 60 months.

Discounts

Organizations such as My Hope Chest and the United Breast Cancer Foundation offer financial help for women who need help paying for breast reconstruction costs.

Selecting a board-certified breast reconstruction surgeon is the most important step you can take to learn more about the costs or insurance coverage for this procedure. Your doctor will sit down with you and discuss your financing options and possible discounts, whether through his or her own practice, or outside organizations. It is also important that you contact your health insurance company and fully understand the benefits available to you, as well as potential limitations.

To find out more about breast reconstruction costs and financing, contact Plastic Surgery Portal. Our representatives will schedule your personal consultation with a top plastic surgeon in your area.