Reconstructive surgery is performed to restore the body's integrity. It is performed following accidents, birth defects or cancer.
The reimbursement of reconstructive surgery covers 100 % of expenses in public facilities. In private facilities, excess fees are partly covered by mutual insurance companies.
However, there is a clearly defined list of procedures that are covered, and reimbursement is subject to certain conditions.
Cosmetic surgery, The main aim of this treatment is to beautify the body. It is not covered.
The plastic surgeon in Paris as everywhere else in France, must fill out the application form, known as the «Demande de prise en charge".« prior agreement ».
It should be addressed to medical consultant of the French health insurance system, before scheduling the’intervention. If the doctor has not replied within 3 weeks of receiving the request, the claim is considered accepted.
Please note, however, that excess fees are not reimbursed by the French health insurance system, but are partially covered by mutual insurance companies. You can send your surgery quotation to your mutual insurance company to estimate how much your insurance company will reimburse.
An intervention plastic may be necessary for a variety of reasons. The question of care for cosmetic surgery is therefore important.
The reimbursement for cosmetic surgery by the French Social Security system. Compensation is specific to each surgical procedures is based on medical criteria.
Only a limited number of cosmetic surgery operations are reimbursed.
In the case of «comfort» cosmetic surgery, the costs are borne by the patient.
Here is an overview of the surgical procedures covered by the Social Security :
Isolated liposuction (or liposuction) is never covered by Social Security. This is purely cosmetic surgery. No reimbursement from the Social Security system or the mutual cannot take place.
The only exception is coverage is when liposuction is combined with abdominoplasty, brachioplasty (arm lift) or cruroplasty (thigh lift), These are covered by the French Social Security system. Only in these cases can liposuction be reimbursed.
Under certain conditions, Social Security sometimes covers the cost of tummies damaged by pregnancy or weight loss.
The first and most important is the presence of a "abdominal apron completely covering the pubis.
The second is :
The presence of stretch marks or abdominal diastasis is not a criterion for treatment, nor is the number of pregnancies.
In order for’abdominoplasty is effective, a request for prior agreement is required.
A document will be given to you at your first consultation. You must send it to your local health insurance office. You will then be called in by a social security medical officer. He or she will check whether you meet the criteria for reimbursement by Social Security and your mutual insurance company.
The only situation in which a rhinoplasty is covered by the French health insurance system is when the nasal trauma is severe and long-standing, and visible to the naked eye.
Here are some of the cases in which a refund is possible:
The cost of rhinoplasty restorative requires a prior agreement.
Some patients simply have a deviation of the nasal septum. In this case, only the deviation of the nasal septum is covered by Social Security. Cosmetic rhinoplasty is billed separately, but is not covered.
For otoplasty to be covered, the deformities must cause significant social discomfort.
No prior agreement is required.
An operation from the age of 8 is possible.
The aim of reconstructive surgery is to repair the body following an accident. accident, a disease or a malformation.
It is reimbursed at 100 % by the French health insurance system, provided it is carried out by a specialist. plastic surgeon in a public or contracted hospital.
Excess fees in private facilities are not covered. Some mutual insurance companies may be able to top up surgery reimbursement the’Insurance Illness.
Some procedures require prior agreement, others do not.
The following cases are covered:
Breast cancer surgery is covered.
Removal of skin lesions, carcinoma, sebaceous cysts, nevi, lipomas are taken care of.
A treatment mammary ptosise is an operation that consists of lift a breast. Here too, there is no Social Security cover, except in the case of breast reduction.
In the case of breast reduction more than 300 grams per breast, Social Security reimburses the cost. In this case, reimbursement is made automatically, with no need to request reimbursement from Social Security.
Many of them type: « Cosmetic breast surgery reimbursement »on the Internet.
Social security covers reconstructive and reconstructive surgery. breast reduction important. To achieve this, a minimum of 300 grams must be removed from each breast, resulting in the loss of at least two cups.
There is an additional fee, the amount of which varies according to the size of the operation. This extra charge may be covered by your health insurance.
Interventions for breast ptosis (mastopexy), on the other hand, are never covered by the Social Security.
The cases covered are :
In all cases, prior agreement must be obtained before treatment can begin.
Breast augmentation surgery in Paris responds to a frequent request from women wishing to restore or harmonize the volume of their breasts. Although it is generally a matter for cosmetic surgery, it can, in certain cases, particularly in the case of clustering (absence of mammary gland, cup size below A), qualify for partial coverage. To find out more about To find out more about the cost of breast augmentation, please consult our dedicated article..
Yes, some cosmetic surgeries become restorative after massive weight loss, These include abdominoplasty with abdominal apron and brachioplasty with functional excess skin. A request for prior agreement is essential, and only a plastic surgeon can assess it accurately during a consultation. Mere cosmetic discomfort is not enough to obtain Social Security coverage.
No, psychological suffering alone does not justify reimbursement for cosmetic surgery, This is the case if the patient has a recognized malformation or anatomical anomaly (e.g.: protruding ears with otoplasty). Assurance Maladie relies exclusively on objective medical and functional criteria, and not on emotional or subjective arguments.
Yes, mutual insurance companies may cover all or part of the extra fees for reconstructive surgery, The procedure must already be accepted by Social Security (e.g. breast reduction >300 g, abdominal apron, breast reconstruction). It is advisable to send the surgeon's estimate to your mutual insurance company to find out the exact reimbursement amount.
No, certain reconstructive surgeries are automatically covered without prior agreement, such as otoplasty in children or removal of skin tumors. On the other hand, procedures such as abdominoplasty, the functional rhinoplasty, or the post-bariatric repair require formal application to Social Security, which may require an examination by the medical advisor.
Social Security reimburses certain breast surgeries if certain criteria are met reduction >300 g per breast, major asymmetry, malformation (tuberous breasts, asymmetric thorax), or absence of mammary gland. On the other hand, isolated breast ptosis or augmentation for aesthetic purposes are never reimbursed. Only a plastic surgeon can confirm your eligibility for reimbursement.
Dr Jérémy Djian is a plastic surgeon based at 5 square Thiers, near the Victor Hugo roundabout, in the 16th arrondissement of Paris.
He trained in Paris and remains attached to the hospital in the prestigious department of Pr Laurent Lantieri.
Hello,
Following a sleeve, I lost 40 kg, at the breast level 105F to 95B is that I have to a breast reconstruction since the care falls and sags and I have a breast larger than the other e
Do I have to be taken in charge, I am at 100% disability and I have a good mutual insurance?
I remain at your disposal
Sincerely
Hello, ma'am,
Unfortunately, the breasts are not taken care of after weight loss by sleeve,
Some fees may be partially covered by your health insurance,
Kind regards,
Dr Djian
Hello Doctor
After 4 pregnancies my belly is deformed
I would like to send you some photos so that you can give me your opinion on a health insurance claim.
Thank you for your reply.
Hello, ma'am,
If you can't come in person, we can do a teleconsultation on doctolib,
Yours sincerely,
Dr Djian
Hello,
Following a weight loss, I have an apron that makes it difficult for me to tie my shoes, prevents me from going about my daily life and makes it difficult for me to dress properly. I'd like to know if this could be covered by the Sécu and my mutual insurance company.
Sincerely
Hello, ma'am,
If you have lost a lot of weight and your BMI is < 30, treatment is possible,
Dr Djian
Hello Dr Djian
Following two pregnancies close together, I've put on 20 kg and I'm overweight. I'd like to have a breast reduction because it hurts my back and I've had scoliosis since I was a teenager. .
What steps do I need to take to benefit from social security coverage? And what fees do I have to pay?
I look forward to hearing from you. Please accept, Dr Djian, my most respectful regards.
Dear Madam,
you should be examined,
Surgery fees (see rates page) are partly covered by the mutual insurance company.
Dr Djian
I often have back pain, I think it may come from my large breasts, is surgery covered?
Dear Madam,
If the reduction of your breasts results in a loss of more than 300 grams on each breast, treatment is possible.
However, you will still have to pay for the surgery (partly covered by your health insurance).
Kind regards
My daughter (22 years old) has excessively large breasts: a 95H cup. She has suffered from back pain for many years. She would like to undergo breast reduction surgery to lose 2 or 3 cup sizes.
What is the procedure to follow? And how much will the procedure or the extra fees cost?
Thank you for your reply
Sincerely
Ms EGUIA
Dear Madam,
The first step is to carry out a diagnostic consultation.
If it's a breast reduction, which seems to be the case (95H), an estimate will be issued: you can find indicative prices on the Prices page of the site.
Breast reduction is covered. However, there are still surgical fees which are partly covered by the mutual insurance company. Reimbursement amounts vary from one mutual insurance company to another,
Kind regards
Good evening I've lost 12 kilos I'd like to reduce my breasts I'd like to know if it's covered I've already consulted a doctor and he told me normally it's covered I need to find a doctor I looked on the internet I found you I hope to have an answer from you
Dear Madam,
To be considered, 300 grams per breast must be removed. To assess whether this is possible without altering the shape of your breast, you should be examined,
Kind regards
Hello, following my 3 pregnancies I have lost a lot of breast already that I did not have much and this is a huge complex for me today ..... it prevents me from living I do not accept my body at all ..... I would like a breast augmentation and I would like to know if I could be covered by social security having very low incomes .....
Hello,
Breast augmentation is only covered if there is breast agenesis = total absence of the mammary gland.
In your case, this will not be covered. All surgery prices are listed in the relevant section.
Sincerely
I had a sleeve operation 18 months ago and now I'd like to have some fat removed from my stomach and arm. How much is it reimbursed by social security and mutual insurance if I want to have the operation and how much are the fees? Thank you
Hello,
In the case of Sleeve surgery, the tummy can only be treated after weight loss if the abdominal apron covers the ewe.
Some surcharges are covered in part by the mutual insurance company (not in full).
Sincerely
Hello, I'm currently having a 70A appraised. I'm 25 years old and I'm suffering a lot psychologically. I have almost no breasts, I wonder if the social security can cover an operation in a case like mine. thank you in advance for your answer.
Dear Madam,
if you have 0 mammary gland, this is called breast agenesis: there is a treatment available.
Nevertheless, there will be surgical fees covered in part by the mutual insurance company,
Kind regards
Hello Dr, I am currently a G cup and would like to make a reduction to a c cup.
Does ss cover this?
Thank you for your reply. Sincerely
Mrs caffiaux
Hello, ma'am,
Yes, but if you opt for a plastic surgeon in a private clinic, there is a surgery fee.
These are partly covered by mutual insurance companies.
Kind regards
Hello,
I'd like to have a nymphoplasty/labiaplasty for non-aesthetic purposes. Do you have any idea what reimbursement/expenses are generally covered? What steps do I need to take?
Thank you in advance for your answers,
Sincerely
C.Pouchou
Hello, ma'am,
If there is psychological damage, treatment may be available.
Surgery fees are available.
Consultation is required in all cases.
Yours sincerely