Implant Recall - insurance will not cover?

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notsure
notsure Member Posts: 41
edited October 2019 in Breast Reconstruction

I had I am now Regretting that step due to the recent recall. The left side is now worse than before, constant pain and in a supportive bra 24x7. No matter the evidence I can not breathe thinking this may cause harm to me and want them replaced immediately. My plastics has explained this removal and replacement surgery is 100 percent not covered since it is elective. anyone run into the same issue? Are there any options to have it covered by insurance? What are the symptoms of the cancer from the implants?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2019

    The recall is for implants “on the shelf”, not for those currently implanted in patients. The current recommendation from the FDA indicates that they feel that the risk from surgical explantatio carries more risk of harm than leaving the implants in place. Meaning that risk of complication, infection, etc., as with any surgery, is greater than the risk of implant caused disease, not that there is surgical risk specific to these implants. If you have pre-existing pain or problems from your current implants, independent of the recall, a revision surgery should be covered by your insurance if properly coded by your surgeon. The symptoms of this rare lymphoma are swelling and fluid accumulation around the implant. I believe that breast MRI and/or ultrasound would usually show the issue.

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  • Scrafgal
    Scrafgal Member Posts: 631
    edited July 2019

    notsure

    Sorry to hear of your discomfort. Bc.org posted an article that I think lists the symptoms. I've seen it in other media articles.

    Before this recall, I already had a revision surgery scheduled for symmetry purposes...common with unilateral mastectomies. I didn't schedule a surgery just to have the implant changed from textured to smooth. So, because this revision surgery for symmetry was already scheduled as part of my reconstruction, the implant exchange was just part of the covered surgery that included fat grafting, lift, etc. that was necessary for final contouring.

    If you are experiencing problems it seems that fixing it should be part of ongoing reconstruction coverage, but I am not sure. At least that's how I thought it worked for reconstruction. I mean, if an implant ruptures, isn't the surgery covered? I thought so...

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited July 2019

    I believe Special and Scrafgal are correct. FDA is NOT recommending removal of these implants. If you have problems or symptoms, you should make an appointment to discuss this in more detail with your PS - REGARDLESS of what implants you have. The doc may recommend an MRI. If necessary for any medical problem, revision surgery should be covered if you have ongoing pain or other symptoms, and should be unrelated to this issue. Try to calm down. The risk to your life is very small even if you are diagnosed with BIA-ALCL.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2019

    I am posting this on several threads that are discussion the recalled implants. And BTW, it is not implants in your body, only what was in stock on the shelves.

    I have the Allergan 410 Anatomical Textured implants. They were "installed" in 2011. I really like the implants so I determined to have some testing before jumping off the cliff. My MO ordered both a diagnostic ULS and an MRI. I went back to the radiologist who was 'spot on' for my original diagnosis.

    I had already seen both the PS and the MO and both of them said they don't see any problems, but...

    Today I had the ULS. This is a radiologist that I REALLY trust. He has seen a couple of ALCL instances out of a ton of people. I wanted an ULS to verify - and maybe an MRI follow up. In his opinion, he has seen either fluid or a mass if the patient has ALCL. He saw nothing abnormal on my films. My gut reaction is NO - I am not going to explant and I am not going to have any more surgery just now. As I suspected, my pain is likely from radiation after effects. When I pushed him for a 'survivorship plan', (my MO basically says do nothing) he suggested I come back every two years since I already had a recurrence 2 years after the original cancer & implants. He said many women come every year because they are worried and need reassurance or to have their hands held. Not a judgement, just a fact.

    He said I can surely have the MRI if I want, but I am confident enough of his skills that I will pass on the MRI & extra radiation for now. And I will agree with my PS that I don't need to worry so much.
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  • nash
    nash Member Posts: 2,600
    edited October 2019

    MinusTwo, just FYI, MRIs do not involve radiation.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2019

    Yup - right. Thanks Nash. I was thinking about the CT and/or Pet/CT that will follow if they find any suspicious areas. Second guessing myself anyway while I wait on the ULS reports. May go ahead with the MRI since it's on order.

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