This article is from the Plastic and Reconstructive Surgery FAQ, by email@example.com (Robert Green) with numerous contributions by others.
Generally speaking, if a surgery is done primarily to improve
the health of a person, or the function of an organ, it is
considered medically necessary. Surgeries such as corrective
rhinoplasty to improve air flow through the nose, or eyelid
surgery to improve the field of vision by lifting sagging,
droopy eyelids might fall into this category. These surgeries
may or may not also improve the patient's appearance, but this is
a secondary purpose.
If a surgery is done with the primary goal of improving the
appearance of the patient, this is considered a cosmetic
procedure. Usually these procedures must be paid for out of
pocket, except in some cases of correcting accidental or
It is worth noting that these lines are often blurry, especially
in terms of coverage by medical insurance. As an example, a scar
revision for an automobile accident injury may be covered by
an auto insurance policy, yet another surgery, identical from a
medical standpoint, that resulted from an accident fall injury
might not be covered by insurance.
Another example is breast reconstruction following breast
cancer surgery -- some insurance companies will cover this,
while others consider this primarily cosmetic in nature. It goes
without saying that this is a hotly contested issue between those
insurance companies and the affected patients.