{"id":817,"date":"2020-11-17T12:38:22","date_gmt":"2020-11-17T12:38:22","guid":{"rendered":"https:\/\/docteurdjian.com\/?p=817"},"modified":"2026-04-15T07:53:54","modified_gmt":"2026-04-15T07:53:54","slug":"chirurgie-esthetique-et-prise-en-charge-securite-sociale-mutuelles","status":"publish","type":"post","link":"https:\/\/docteurdjian.com\/en\/chirurgie-esthetique-et-prise-en-charge-securite-sociale-mutuelles\/","title":{"rendered":"Cosmetic surgery and care"},"content":{"rendered":"<p>Are you considering surgery in Paris? Would you like to know whether you will be reimbursed by Social Security? First of all, you need to know whether your operation falls within the scope of reconstructive or cosmetic surgery.<\/p>\n<h2>RECONSTRUCTIVE AND COSMETIC SURGERY: WHAT'S THE DIFFERENCE?<\/h2>\n<p>&nbsp;<\/p>\n<p>Reconstructive surgery is performed to restore the body's integrity. It is performed following accidents, birth defects or cancer.<\/p>\n<p>The <strong>reimbursement of reconstructive surgery<\/strong> covers 100 % of expenses in public facilities. In private facilities, excess fees are partly covered by mutual insurance companies.<\/p>\n<p>However, there is a clearly defined list of procedures that are covered, and reimbursement is subject to certain conditions.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Cosmetic surgery<\/strong>, The main aim of this treatment is to beautify the body. It is not covered.<\/p>\n<p>&nbsp;<\/p>\n<h2>RECONSTRUCTIVE SURGERY: HOW MUCH IS REIMBURSED BY SOCIAL SECURITY?<\/h2>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/docteurdjian.com\/en\/\"><strong><span style=\"text-decoration: underline;\">The<\/span> plastic surgeon in Paris<\/strong><\/a> as everywhere else in France, must fill out the application form, known as the \u00abDemande de prise en charge\".\u00ab <strong>prior agreement<\/strong>\u00a0\".<\/p>\n<p>It should be addressed to <strong>medical consultant<\/strong> of the Assurance maladie, before scheduling the\u2019<strong>intervention<\/strong>. If the doctor has not replied within 3 weeks of receiving the request, the claim is considered accepted.<\/p>\n<p>Please note, however, that <strong>excess fees<\/strong> 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.<\/p>\n<p>&nbsp;<\/p>\n<h2>WHICH COSMETIC SURGERY PROCEDURES ARE ELIGIBLE FOR REIMBURSEMENT?<\/h2>\n<p>&nbsp;<\/p>\n<p>An intervention <strong>plastic<\/strong> may be necessary for a variety of reasons. The question of <strong>care for cosmetic surgery<\/strong> is therefore crucial.<\/p>\n<p>The <strong>reimbursement for cosmetic surgery<\/strong> by the French Social Security system. Compensation is specific to each <strong>surgical procedures<\/strong> and is based on medical criteria.<\/p>\n<p>Only a limited number of cosmetic surgery operations are reimbursed.<\/p>\n<p>In the case of \u00abcomfort\u00bb cosmetic surgery, the costs are borne by the patient.<\/p>\n<p>&nbsp;<\/p>\n<p>Here is an overview of the surgical procedures covered by the <strong>Social Security<\/strong>\u00a0:<\/p>\n<p>&nbsp;<\/p>\n<h3>Liposuction or liposuction<\/h3>\n<p>&nbsp;<\/p>\n<p>Isolated liposuction (or liposuction) is never covered by Social Security. This is purely cosmetic surgery. No <strong>reimbursement<\/strong> from the Social Security system or the <strong>mutual<\/strong> cannot take place.<\/p>\n<p>The only exception is <strong>coverage<\/strong> is when liposuction is combined with abdominoplasty, <a href=\"https:\/\/docteurdjian.com\/en\/intervention\/lifting-des-bras-brachioplastie-paris\/\"><strong>brachioplasty (arm lift)<\/strong><\/a> or <strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/lifting-des-cuisses-cruroplastie-paris\/\">cruroplasty (thigh lift)<\/a><\/strong>, These are covered by the French Social Security system. Only in these cases can liposuction be reimbursed.<\/p>\n<p>&nbsp;<\/p>\n<h3>Abdominoplasty (tummy tuck)<\/h3>\n<p>&nbsp;<\/p>\n<p>Under certain conditions, Social Security sometimes covers the cost of tummies damaged by pregnancy or weight loss.<\/p>\n<p>The first and most important is the presence of a <strong>\"abdominal apron<\/strong> completely covering the pubis.<\/p>\n<p>The second is :<\/p>\n<ul>\n<li>major weight loss through weight-loss surgery (sleeve, bypass)<\/li>\n<li>weight loss through a major diet<\/li>\n<li>pregnancy sequelae<\/li>\n<\/ul>\n<p>The presence of stretch marks or abdominal diastasis is not a criterion for treatment, nor is the number of pregnancies.<\/p>\n<p>In order for\u2019<strong>abdominoplasty<\/strong> is effective, a request for prior agreement is required.<\/p>\n<p>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.<\/p>\n<p>&nbsp;<\/p>\n<h3>Rhinoplasty<\/h3>\n<p>&nbsp;<\/p>\n<p>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.<\/p>\n<p>Here are a few cases where a refund is possible:<\/p>\n<ul>\n<li>A <strong>deviated nasal septum<\/strong> important ;<\/li>\n<li>Nose drooping;<\/li>\n<li>Respiratory function disorders related to nasal birth defects (such as harelip);<\/li>\n<li>Nasal valve problems.<\/li>\n<\/ul>\n<p>The cost of rhinoplasty <strong>restorative<\/strong> requires a prior agreement.<\/p>\n<p>Some patients simply have a deviation of the <strong>nasal septum.<\/strong> In this case, only the deviation of the nasal septum is covered by Social Security. Cosmetic rhinoplasty is billed separately, but is not covered.<\/p>\n<p>&nbsp;<\/p>\n<h3>Otoplasty<\/h3>\n<p>&nbsp;<\/p>\n<p>For otoplasty to be covered, the deformities must cause significant social discomfort.<\/p>\n<p>No prior agreement is required.<\/p>\n<p>An operation from the age of 8 is possible.<\/p>\n<p>&nbsp;<\/p>\n<h2>RECONSTRUCTIVE SURGERY: HOW IS IT MANAGED?<\/h2>\n<p>&nbsp;<\/p>\n<p>The aim of reconstructive surgery is to repair the body following an accident. <strong>accident<\/strong>, a <strong>disease<\/strong> or a <strong>malformation<\/strong>.<\/p>\n<p>It is reimbursed at 100 % by the French health insurance system, provided it is carried out by a specialist. <strong>plastic surgeon<\/strong> in a public or contracted hospital.<\/p>\n<p>Excess fees in private facilities are not covered. Some mutual insurance companies may be able to top up <strong>surgery reimbursement<\/strong> the\u2019<strong>Insurance<\/strong> Illness.<\/p>\n<p>Some procedures require prior agreement, others do not.<\/p>\n<p>&nbsp;<\/p>\n<h3>Breast surgery<\/h3>\n<p>&nbsp;<\/p>\n<p>The following cases are covered:<\/p>\n<ul>\n<li>a birth bonnet &lt;A<\/li>\n<li>major breast asymmetry<\/li>\n<li>thoracic malformations<\/li>\n<li>from <strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/seins-tubereux-protheses-lipofilling-paris\/\">tuberous breasts<\/a><\/strong><\/li>\n<li>breast reductions &gt;300 grams per side<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Breast reconstruction<\/h3>\n<p>&nbsp;<\/p>\n<p>Breast cancer surgery is covered.<\/p>\n<p>&nbsp;<\/p>\n<h3>Skin tumors<\/h3>\n<p>&nbsp;<\/p>\n<p>Removal of skin lesions, <strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/cancer-peau-carcinome-basocellulaire-epidermoide-melanome\/\">carcinoma<\/a><\/strong>, <strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/tumeurs-benignes-lipome-kyste-sebace-naevus\/\">sebaceous cysts, nevi, lipomas<\/a><\/strong> are supported.<\/p>\n<p>&nbsp;<\/p>\n<h3>Breast ptosis and management<\/h3>\n<p>&nbsp;<\/p>\n<p>A <strong>treatment <a href=\"https:\/\/docteurdjian.com\/en\/ptose-mammaire\/\"><span style=\"text-decoration: underline;\">mammary ptosis<\/span><span style=\"text-decoration: underline;\">e<\/span><\/a><\/strong> is an operation that consists of<strong> lift a breast<\/strong>. Here too, there is no Social Security cover, except in the case of breast reduction.<\/p>\n<p>&nbsp;<\/p>\n<h3>Breast reduction and management<\/h3>\n<p>&nbsp;<\/p>\n<p>In the case of breast reduction <strong>more than 300 grams per breast<\/strong>, Social Security reimburses the cost. In this case, reimbursement is made automatically, with no need to request reimbursement from Social Security.<\/p>\n<p>&nbsp;<\/p>\n<h2>WHICH MUTUAL INSURER REIMBURSES COSMETIC SURGERY?<\/h2>\n<p>&nbsp;<\/p>\n<h3>Breast surgery and social security coverage<\/h3>\n<p>&nbsp;<\/p>\n<p>Many of them type: \u00ab\u00a0<strong>Cosmetic breast surgery reimbursement<\/strong>\u00a0\u00bbon the Internet.<\/p>\n<p>Social security covers reconstructive and reconstructive surgery. <strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/reduction-mammaire-seins-paris\/\">breast reduction<\/a><\/strong> important. To achieve this, a minimum of 300 grams must be removed from each breast, resulting in the loss of at least two cups.<\/p>\n<p>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.<\/p>\n<p>Interventions for <strong>breast ptosis<\/strong> (mastopexy), on the other hand, are never covered by the <strong><a href=\"https:\/\/forum-assures.ameli.fr\/questions\/2157203-prise-charge-cpam-chirurgie-reparatrice\">Social Security<\/a>.<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h3>What are the conditions for social security coverage?<\/h3>\n<p>&nbsp;<\/p>\n<p>The cases covered are :<\/p>\n<ul>\n<li>The total absence of mammary glands (a chest like a man's, for example); ;<\/li>\n<li>Significant breast asymmetries (at least two cup sizes apart); ;<\/li>\n<li>Certain rare cases of breast malformation, such as tuberous breasts; ;<\/li>\n<li>Reconstructive surgery.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>In all cases, prior agreement must be obtained before treatment can begin.<\/p>\n<p><strong data-start=\"132\" data-end=\"167\">The<\/strong><a href=\"https:\/\/docteurdjian.com\/en\/intervention\/augmentation-mammaire-protheses-paris\/\"><strong data-start=\"132\" data-end=\"167\">breast augmentation in Paris<\/strong><\/a> 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 some cases, particularly in the case of <strong>clustering<\/strong> (absence of mammary gland, cup size below A), qualify for partial coverage. To find out more about <strong><a href=\"https:\/\/docteurdjian.com\/en\/prise-en-charge-augmentation-mammaire\/\">treatment for breast augmentation<\/a>, Please refer to our dedicated article<\/strong>.<\/p>","protected":false},"excerpt":{"rendered":"<p>Vous envisagez une op\u00e9ration chirurgicale \u00e0 Paris ? Vous aimeriez savoir si vous pourrez b\u00e9n\u00e9ficier d\u2019un remboursement de la S\u00e9curit\u00e9 Sociale ? Il convient dans un premier temps de savoir si votre intervention rel\u00e8ve de la chirurgie r\u00e9paratrice ou de la chirurgie esth\u00e9tique. CHIRURGIE REPARATRICE ET CHIRURGIE ESTHETIQUE : QUELLE DIFFERENCE ? &nbsp; La chirurgie [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[643],"tags":[],"class_list":["post-817","post","type-post","status-publish","format-standard","hentry","category-prix"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.5 (Yoast SEO v27.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Chirurgie esth\u00e9tique ou r\u00e9paratrice : Quelle prise en charge ?<\/title>\n<meta name=\"description\" content=\"Liposuccion, rhinoplastie, chirurgie mammaire\u2026 Le Dr Djian vous d\u00e9taille la prise en charge et les crit\u00e8res m\u00e9dicaux pour etre rembours\u00e9.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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