Plastic surgery: what is reimbursed?

Published on : 04 November 20203 min reading time

Restorative surgery was born out of the maxillofacial and physical reconstruction, following the ravages of the First World War, and aimed at restoring integrity to a damaged face or body. Considered as therapeutic, it is treated, unlike cosmetic surgery, an “accessory surgery” which is not fundamentally based on medical motivations. But the borderline is sometimes thin, the two disciplines being moreover united within the same surgical specialty.

Aesthetic surgery and reconstructive surgery: what’s the difference?

Before tackling the question of reimbursement for cosmetic surgery and reimbursement for reconstructive surgery, it is important to recall what they mean, as confusion is not uncommon.

Restorative surgery

This is a type of surgery that aims to reconstruct the deterioration of physical appearance. Restorative surgery can be performed, for example, following a serious accident, in the case of a congenital malformation (e.g. when one is born with a cleft palate), in the case of an illness (e.g. breast cancer leading to its removal). In short, it is about repairing damage or trauma that has been caused to the body. The primary goal is not to beautify the body.

Cosmetic surgery

Cosmetic surgery is more a matter of personal comfort. It allows everyone to modify their appearance for aesthetic reasons. It is a purely personal choice, not motivated by medical reasons. It concerns operations such as breast augmentation, facelifts, liposuctions, etc.

Most medical procedures and treatments are reimbursed directly by the Health Insurance. Some of them require what is known as a prior agreement between the patient, the health professional and the Health Insurance. This is the case for plastic surgery procedures.

Plastic surgery operations on the face

The nose

The operation is reimbursed if it reshapes the nasal septum. A deviated nasal septum is always the consequence of a trauma, accident or a congenital malformation leading to respiratory discomfort. On the other hand, a rhinoplasty to correct a nose that is too long, too wide or too big is not. Consequently, an operation to correct a bump on the nose, if it is of non-traumatic origin, is not reimbursed, even if it causes a complex. However, in the case of breathing difficulties, it is possible to submit a request for prior agreement to the Social Security.

Ears sticking out

It is a congenital malformation. The operation which consists in putting them back together (otoplasty) is taken care of in children as well as in adults, as soon as it causes a major complex in the young subject or a social discomfort in the adult. These criteria are subject to the assessment of the plastic surgeon.

Chin and lips

The chin in galloping or very receding chin: the people concerned can be very complex, but the operation is only taken care of, with prior agreement, if the disharmony causes a maxillo-facial problem. A child born with a cleft lip (hare’s beak) can be operated on from the age of 3 months in order to avoid speech problems and feeding difficulties, in which case the operation is reimbursed.

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