Navigating the financial aspect of breast implant removal combined with a mastopexy (explant with a lift) requires understanding that this is a specialized cosmetic and reconstructive service. The total price reflects a highly individualized treatment plan tailored to a patient’s specific anatomy and medical history. Since this surgery addresses both device removal and aesthetic reshaping, the financial commitment involves multiple providers and fees. Estimating the total expenditure requires examining national averages, regional market conditions, and specific surgical techniques.
Defining the Explant and Lift Procedure and Associated Cost Range
The explant and mastopexy combination addresses implant removal and the resulting tissue laxity. When the implant’s volumetric support is gone, the tissue may appear deflated or droopy. The lift corrects this by removing excess skin and repositioning the nipple-areola complex, making this a common joint approach for aesthetic results.
The national average cost for a combined explant and mastopexy typically ranges from $11,500 up to $16,000, with complex cases reaching $18,000 or more. This figure is a preliminary estimate and not a fixed price. The concurrent mastopexy extends operating time and requires greater surgical skill, contributing directly to the higher cost compared to explant surgery alone.
Primary Variables Driving Price Fluctuation
The final price is heavily influenced by factors beyond the core procedure, starting with the surgeon’s fee. A surgeon’s experience, board certification, and reputation for complex revisions significantly affect their professional fee. Highly specialized surgeons often charge a premium due to their expertise and demand.
Geographic location also dictates pricing, as major metropolitan areas and regions with a higher cost of living generally feature higher surgical fees. An explant performed in a large coastal city will likely cost substantially more than in a smaller regional market. This fluctuation reflects overhead costs and the local competitive market for cosmetic services.
The specific surgical complexity also drives the price upward, particularly regarding scar tissue removal. If the surgeon performs a total capsulectomy, or the technically demanding en bloc capsulectomy (removing the capsule and implant as a single unit), the procedure duration increases. This added complexity requires more time and specialized skill, which is reflected in the surgeon’s final fee.
Itemized Breakdown of Surgical Expenses
While the surgeon’s fee covers the professional service, a significant portion of the total cost is derived from separate line items billed by other providers and the facility. Anesthesia fees cover the services of the anesthesiologist during the operation. This cost is calculated based on the total operating time and the type of anesthesia administered, with longer, more complex cases incurring a higher fee.
Facility fees (OR fees) account for the use of the surgical center or hospital setting. This charge covers nursing staff, medical supplies, sterilizing equipment, and general overhead. The cost varies depending on whether the procedure takes place in an outpatient center or a hospital, with the latter sometimes being more expensive.
Additional necessary expenses include pathology and laboratory testing fees. The removed capsular tissue is often sent to a lab for pathological analysis. This testing is mandatory for diagnosing conditions like capsular contracture or screening for BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma). These fees are entirely separate from the surgeon’s or facility’s charges and ensure patient safety and accurate diagnosis.
Navigating Insurance Coverage and Financing Options
Insurance coverage for the combined procedure distinguishes between the explant and the lift components. The explant portion may qualify for coverage if deemed medically necessary, typically established through documented complications like implant rupture, severe capsular contracture (Grade III or IV), or symptoms related to Breast Implant Illness (BII).
Securing coverage requires thorough pre-authorization, where the surgeon provides documentation of the medical grounds for removal. If the explant is covered, the patient remains responsible for deductibles, copayments, and out-of-network costs. However, the subsequent mastopexy is almost universally classified as cosmetic and is not covered by health insurance, becoming the patient’s direct financial responsibility.
Patients typically cover the cosmetic portion and any uncovered medical costs through various financing strategies. Many offices offer in-house payment plans or partner with third-party medical financing companies. Utilizing a Health Savings Account (HSA) or Flexible Spending Account (FSA) is another viable option, as these accounts allow for the use of pre-tax dollars for qualified medical expenses, including the cosmetic surgery portion.