Removal of Breast Implant CPT Code A Comprehensive Guide

Introduction:

Removal of breast implants, also known as implant explantation, is a surgical procedure that involves the complete or partial removal of breast implants. This article aims to provide a detailed overview of the CPT code for breast implant removal, considering perspectives from both professional plastic surgeons and patients.

Understanding the CPT Code for Breast Implant Removal

1. CPT Code Definition:

The CPT code for removal of breast implants is 19328 (Exploration and/or removal of mammary prosthesis(s) (including capsulectomy), with or without biopsy of the breast).

2. Surgical Indications:

Breast implant removal is indicated in various scenarios, including implant rupture, capsular contracture, implant-related complications, infection, pain, dissatisfaction with results, or as part of a breast reconstruction process.

3. Preoperative Evaluation:

Prior to the surgery, patients undergo a thorough preoperative evaluation, including a physical examination, imaging studies (such as mammography or ultrasound), and discussion of expectations and potential risks. This evaluation helps determine the appropriate surgical technique and extent of implant removal.

4. Surgical Techniques:

The surgical techniques for breast implant removal depend on the patient's specific needs and the condition of the implants. Common techniques include en bloc capsulectomy, total capsulectomy, or simple removal without the surrounding capsule. The choice of technique is dictated by factors like implant integrity, capsular contracture severity, and presence of implant-associated complications.

5. Anesthesia:

Breast implant removal can be performed under general anesthesia or local anesthesia with sedation. The choice of anesthesia is made after considering patient preferences, surgical complexity, and the surgeon's recommendation.

6. Procedure Steps:

The surgeon makes an incision to access the implant and surrounds it. The capsule is usually removed entirely or partially, depending on the patient's condition and surgical plan. In case of implant rupture, all free silicone or saline material is meticulously removed. The incision is then closed, and drainage tubes may be placed if necessary.

7. Recovery and Postoperative Care:

After the surgery, patients are advised to wear a supportive bra, limit physical activities, and follow the specific postoperative instructions given by their surgeon. The recovery period varies depending on the extent of the procedure, but most individuals can resume regular daily activities within a week. Strenuous exercise or heavy lifting should be avoided for several weeks.

8. Potential Complications:

Like any surgical procedure, breast implant removal carries certain risks and complications. These may include infection, bleeding, hematoma, seroma formation, scarring, changes in breast sensation, contour irregularities, and poor wound healing. It is important for patients to be aware of these potential complications and discuss them with their surgeon prior to making a decision.

9. Cost and Insurance Coverage:

The cost of breast implant removal varies depending on several factors, including the surgeon's experience, geographical location, the complexity of the procedure, and additional services required (such as diagnostic tests or postoperative care). In the United States, the average cost ranges from $5,000 to $10,000. Insurance coverage for breast implant removal is generally limited to cases where it is medically necessary due to complications or reconstruction purposes. However, coverage varies across insurance plans and may require prior authorization.

10. Patient Satisfaction and Expectations:

While some patients may have concerns about the appearance or changes to the breast after implant removal, studies have shown that overall patient satisfaction is high. Understanding patient expectations, proper preoperative counseling, and comprehensive postoperative care contribute to achieving desired outcomes and patient satisfaction.

11. Impact on Breast Reconstruction:

In cases where breast implant removal is performed as part of breast reconstruction, the procedure can create a foundation for subsequent reconstructive surgeries. The surgeon can assess the breast tissue, nipple-areolar complex, and available surgical options to provide a personalized treatment plan for each patient.

12. Revision Surgery and Implant Replacement:

For patients who desire breast augmentation after implant removal, revision surgery can be considered once the breast has healed completely. This usually involves addressing any remaining concerns regarding breast shape, volume, or symmetry. The decision for implant replacement should be made after careful discussion with the surgeon, considering the patient's goals and potential risks.

13. Psychological Impact and Counseling:

Physical appearance and body image concerns are important factors in breast implant removal decision-making. Plastic surgeons should have open and honest conversations with their patients, addressing both the physical and emotional aspects of the procedure. Referrals for psychological counseling or support groups can be beneficial for patients who require additional emotional support.

14. Surgeon Experience and Credentialing:

Choosing a board-certified plastic surgeon who specializes in breast implant removal is essential. Patients are encouraged to research the surgeon's qualifications, experience, and patient testimonials before making a final decision. Second opinions are also reasonable and recommended.

15. Follow-Up and Long-Term Monitoring:

Regular follow-up appointments with the surgeon are crucial after breast implant removal. This allows for appropriate monitoring, assessment of healing, detection of potential complications, and addressing any concerns the patient may have. Long-term monitoring may involve breast imaging studies to assess breast health.

Conclusion

Breast implant removal, as indicated by CPT code 19328, is a complex surgical procedure with various considerations for both patients and plastic surgeons. It is crucial for patients to have a comprehensive understanding of the procedure, associated risks, and potential outcomes. By collaborating with a skilled and experienced plastic surgeon, patients can make informed decisions and achieve satisfactory results that align with their expectations and overall well-being.