Who takes care of the revision cost after the breast augmentation?

6:11 PM

Q) If the revision surgery is necessary, who takes care of the cost? Is it the clinic or the patient?

A) This is a frequently asked question. I would like to discuss about this today.

There are many things to consider when answering this question so I would like to divide the content into several parts.

1. Does the 'Surgery cost’ include the costs that are related to the problems after the surgery? Or is it just for that one time surgery?

2. Which party covers the medical costs when there is a medical accident and when there isn’t?

3. If the hospital is responsible for the problems caused after the surgery in terms of number of days responsible, how long is this duration?

4. If there is a conflict between the patient and the hospital regarding the amount of costs that each are responsible for, how can this be solved?

I would like to summarize these contents as below..

1. Does the 'Surgery cost’ include the costs that are related to the problems after the surgery? Or is it just for that one time surgery?

Let’s say that you are purchasing a car or any other industrial product. There is a warranty period for the product that you are purchasing.
Hyundai cars have warranty period of 3 years or 60,000 km.
Of course, this warranty or the free after service is not available, if the driver is at fault. If you get into an accident by yourself, you will not be able to get the free after service although the car has been purchased for less than 3 years.

You can regard this as the the automobile maker has already included this 3 year warranty costs into the price that the customer is paying..

Other industrial products such as TV, home appliance, notebooks, digital cameras, etc all have this free after service and this means that all these products have the after service costs covered in the final price.

But, there is no such term as “warranty service” in the medical industry.

Let’s say that a patient diagnosed with 2nd degree colorectal cancer was treated and released from the hospital. She paid all her medical costs. However, the cancer developed again after 5 years and so she went to the same hospital as in the past to get her treatment. This would not be a warranty service, but she would have to pay the hospital fee again.

Why is the term “warranty-service” not applicable in the medical field?

Medical industry is not a sales industry but is a service industry. Service is not a laptop or TV that the consumer takes but is something that you need to pay for the labor of another person. Therefore, there cannot be an idea as” service for a product” in the medical field.

So it is impossible to include the warranty service fee in the initial hospital cost of the patients from the beginning.

Almost all the medical costs, whether they are related to a surgery or not, are provided through “a person’s labor” and this service is claimed in the cost therefore, the hospital claim this cost on the patient at every visit.
In principle, the surgery cost only covers the surgery itself.

2.  Which party covers the medical costs when there is a medical accident and when there isn’t?

Although it is a principle, that once you pay for the service (labor) you cannot get the money back, there are problems when the hospital (service provider) and the patient (customer) do not agree on certain factors before the service is provided.

For example, if you get a double eyelid cosmetic surgery but you do think that your new eyes do not look as pretty, you might demand for the revision or certain amount of the money that you pain back.
You might not like to sports massage that you got and you might ask for a refund or you might hire a housemaid but you do not like the cleanliness in your house and not pay for that work.

In such cases, it is common that the service provider and the customer negotiate and come to an agreement. The massage shop might offer an extended service or a discount in the next visit.

But, it becomes difficult to come to such agreement if there is a side effect after a surgery. If a patient gets a breast augmentation but finds that the breasts are opened up and the implant is exposed on the next day, this responsibility will be fully on the hospital.
In such case, the hospital would need to cover all the expenses related in order to ‘solve this problem’.

If the patient required 300cc implant and got the breast augmentation, but comes back the next day and request for a change to 350cc, the patient would be 100% liable for the expenses. The reason for this revision is 100% patient’s change in thought.

What if the patient needs a revision surgery due to the capsular contracture 5 years after the first surgery?
There is no medically proven cause of capsular contracture. We still do not know if it is caused due to the type of body that the patient has or the doctor’s surgery method. Therefore it is difficult to decide on who should be responsible for this cost.

Personally, I think that both the hospital and the patient are responsible for capsular contracture and both needs to pay the costs related. If the revision requires just the enlarging of the tissue then the patient should pay for the anesthesia and the revision should be free of charge. If the capsular contracture is severe and the revision takes a long time, the costs could be divided up between the hospital and the patient.

However, the costs related with the revision and such complications should be agreed upon before the original surgery. Therefore, it is important that the hospital explains all the complications that could arise after the breast augmentation.

3. If the hospital is responsible for the problems caused after the surgery in terms of number of days responsible, how long is this duration?

This is similar to the question above, but a lot of the patients ask it.
One can set the terms for the car, saying that the auto parts get old and the car can get into an accident here are there so we will take care of it for 3 years. But, this is difficult to do so for a human body.
"The effect of the surgery takes toll after a few years, and the body will go back into its original state after a few years as well.” This is a difficult condition to state.

Anyway, a lot of the hospitals do put such management duration after the surgery. (I do not know if this is well managed)

In Japan, a lot of the patients go to “my doctor” and so the doctor is able to keep track and take care of the same patient for over 20 years, however, this is not the same in Korea. The hospitals are also into capitalism. The patients do not have ‘one doctor’ who they can rely on and the hospitals do not think that it will take care of that particular patient for a long period of time.
The duration time of the patients visiting a particular hospital in Kangnam area is about 3  years. If they need to go to a clinic after that, they would look for a ‘better’ or a ‘hotter’ clinic (in demand) on the internet and visit a new one.

I think that it would be good to keep track of the breast augmentation patient and follow up on the patient from one particular hospital. However, I have never seen this happen. It would be good if Korea has that “my doctor” such as those in UK or Japan. This is why it is difficult to find any papers regarding the 20 year observation after a surgery.

It is difficult to observe a patient even for 5 years. All the medical systems and the medical culture are strictly into capitalism.
I hope that at least the patient can have the concept of “my doctor” or “family doctor” and the same for the doctor so that both parties can keep a strong relationship.

4. If there is a conflict between the patient and the hospital regarding the amount of costs that each are responsible for, how can this be solved?

If a 7 year old cohesive gel implant has a small rupture and this leads to a little amount of leakage, this would require a revision surgery.

If this revision is done in another hospital that is different from the original surgery, the medical costs could be higher than before. But if you go to the original hospital, you might not have to pay as much and solve your problem.

For example, if the 1st surgery costed you about 5 million won 7 years ago, the revision would cost no less than 7.7 million won as the revision would be more difficult and more time consuming than the first one. Also, there was no value added tax 5 years ago. Now there is 10% value added tax to all cosmetic surgeries in Korea. (Value added tax is imposed on the customer)

The patient needs to go through another long period of recovery, concern for the revision, pain, etc therefore it is a burden for the patient to pay for the revision surgery.
What is the cause of the leakage / collapse of that 7 year old cohesive gel implant?
Nobody knows the answer.

The implant might have been a defect, the doctor might have damaged the implant when putting it in, or the patient might have required too large sized implant. It is difficult to put all the fault to one side of the party.

All the implants within our country are manufactured by multinational corporations and provide life-time warranties. You do not need to be concerned about the cost of the implants for the revision surgery.

However, the problem is the costs of anesthesia and the revision itself. If there was no follow-up for 7 years, then it is difficult to say that the patient is at fault therefore, it would be ideal to calculate the related costs as low as possible for the patient.

Today, we looked at who pays the price for the revision surgery in breast augmentation. One needs medical and legal knowledge in order to take care of such problems reasonably. The more important fact is that the hospital and the patient needs to discuss about such problems before the first surgery.

This is all for today. Thank you very much.

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2 개의 댓글

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