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In which cases can Social Security cover cosmetic surgeries?

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Curative medicine is part of the field of traditional medicine (also called therapeutic or care), which aims to preserve or recover health, in any of its manifestations. Their common note is acting in situations of patient need.

Instead, the satisfying medicine (voluntary or perfective), unlike the previous category, addresses situations in which the patient’s health is not at stake, but instead involves meeting certain health demands in the field of personal improvement or well-being.

Generally the plastic surgery It falls within the so-called satisfactory medicine and specifically that of plastic medicine, understanding this science as that which aims to achieve anatomical and functional normality in the body structure. Transform the human body to correct deformities or improve deficiencies.

However, cosmetic surgery admits a double classification: reparative or reconstructive surgery (repair the effects of an accident or deformity, for example) and aesthetic or cosmetic surgery (reshape those parts of the body that are not satisfactory for the patient) with limits between the two sometimes difficult to set.

This distinction has not only clinical relevance, since Health Services assume the interventions of the first group (by considering them traditional or curative medicine), but not the latter (by considering them as satisfactory medicine). However, the decision is always evaluative: A reduction mammoplasty is not normally acceptable as a service provided by the Public Health System, but if the patient’s current condition causes lumbar orthopedic problems, the solution may be the opposite.

There is consensus that the differentiating note between both categories is found in the therapeutic need, understood as the clinical requirement to carry out certain actions to maintain the life or good health of the patient.

Along these lines, in point 5 of Annex III of Royal Decree 1030/2006, of September 15, which establishes the portfolio of common services of the National Health System and the procedure for updating it, and in relation to the Indication or prescription, and the performance, where appropriate, of specific diagnostic and therapeutic procedures; All diagnostic and therapeutic procedures with aesthetic purposes are excluded, which are not related to an accident, illness or congenital malformation.spa treatments and rest cures.

Generally, among the cosmetic surgeries that are covered by Social Security is breast surgery for reconstruction due to cancerthe correction of breast asymmetry, otoplasty in case of deformity, rhinoplasty for respiratory problems or malformation, blepharoplasty in case of vision problems, bariatric surgery in cases of serious overweight that affects health and facial surgery in cases of malformation in face and neck.

However, each request is individually studied, with the requirements for acceptance being that they are cases of reconstructive surgery due to deformities from birth or secondary to an accident. Likewise, those cases in which the individual may be psychologically affected by a complex, or because it could cause a physical problem in the future.

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