Plastic surgery encompasses both cosmetic surgery and reconstructive surgery and seeks to maximize both appearance and function, regardless of the initial presentation. Often a significant amount of overlap exists between the two and in 1999 the name of the specialty was changed from Plastic and Reconstructive Surgery simply to Plastic Surgery to reflect this.
Reconstructive surgery is performed on abnormal structures of the body, caused by congential defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate or improve a normal appearance. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly depending on the quality of the insurance.
Cosmetic surgery is performed to reshape normal structures of the body, usually to improve form and appearance. Cosmetic surgery typically is not covered by health insurance.
There are a number of “gray areas” in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or cosmetic, depending on each patient’s situation. For example, eyelid surgery (blepharoplasty) – a procedure normally performed to achieve cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient’s vision.
