For insurance purposes, the distinction between cosmetic and reconstructive should be based primarily on the reason the surgery was performed. Derived from the Greek “plasticos,” which means to mold or give form, the specialty of plastic surgery comprises two general categories: cosmetic surgery and reconstructive surgery. By reshaping normal structures of a patient’s body, cosmetic surgery aims to improve his or her self-esteem and aesthetic appearance. Reconstructive surgery, on the other hand, endeavors to improve function or normalize the appearance of abnormal structures of the body caused by birth defects, developmental abnormalities, tumors, disease, or trauma.
Reconstructive vs Cosmetic Procedures
Reconstructive surgery is often covered to some extent by health insurance policies, but varies depending on the specific procedure. Cosmetic surgery, however, is considered elective and not a medical necessity, so insurance coverage is rare. Certain procedures, such as breast reduction, eyelid operations (blepharoplasty), and nose surgery (rhinoplasty), may be partially covered by insurance plans, but only if they are performed for functional or symptomatic improvement.
Dr. Sayah is contracted with only a few insurance companies. In case he is not contracted with your insurance company, you are responsible for payment in full for fees and deductible before any procedures are performed. You can file reimbursement claims directly with your respective insurance carrier. Please familiarize yourself fully with your insurance policy and its restrictions while researching the procedure you are considering.
Call (310) 385-0000 if you have additional questions.