Cosmetic Question: I have a question about panniculectomy. I had a gastric by-pass and lost 150 pounds. Now I have tummy skin half-way to my knees. One plastic surgeon said I needed a cosmetic tummy tuck and insurance would not pay. Another plastic surgeon said it was a panniculectomy and insurance would pay. Help!
Cosmetic Answer:
Let me sort out your confusion.
A panniculectomy is an operation that removes excess, over-hanging tummy skin.
A tummy tuck is an operation that removes all excess tummy skin – from the ribs on down – plus removes excess fat and tightens stretched muscle.
If you just want the over-hanging skin gone: you need a panniculectomy.
If you want to look good, with the tummy improved over all – you need a tummy tuck.
A tummy tuck is always a cosmetic operation.
But some insurance will pay for some panniculectomies – the large ones.
The excess, hanging skin (pannus) has to be so large that it causes you medical problems.
For instance, your pannus
Probably makes it hard to urinate.
Probably causes infections in the skin fold and bladder infections and
May make it hard to walk.
These panniculectomies are covered by insurance…but wait, there’s more:
Check your policy. Does your policy specifically exclude panniculectomy or operations to correct effects of weight loss? If so, your insurance will not pay.
But, if it does cover weight loss operations, your surgeon still needs to get approval in advance via a pre-determination report.
So you were confused because both surgeons were partly correct. Your insurance may pay for a panniculectomy. But it will never pay for restoring the rest of your tummy’s appearance.
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