More and more patients are losing large amounts of their body weight, with and without surgery or weight loss medications. However you accomplished it, it is an achievement!
At Aesthetica Surgery & Spa, we see patients who have reached their goal weight and now find that they have excess skin on the chest, abdomen, arms, legs, and face. A few of these patients have lamented that they did not realize that the skin does not shink all the way back to its original size, and they are left feeling frustrated. This blog will cover the journey of body contouring for massive weight loss patients and highlight an abdominal skin removal procedure known as a panniculectomy and its insurance process.
For the other parts of the body, you can check out my related blog, Body Contouring After Major Weight Loss: The Patient’s Journey for more information.
Panniculectomy Is Covered by Insurance
The operation to remove the skin flap that hangs down over the mons (lady and man parts) is called a panniculectomy. We call it a panni for short, and if you call your insurance company or look on their website, it will say it is a covered benefit. But it doesn’t say that you have to qualify and have pre-approval or that it only covers the skin that hangs down. It does not include releasing the skin all the way to the ribs and pulling it down, thus removing everything from the belly button down to the mons.
The reason insurance covers the panni is that it is a hygiene operation. Removing the flap of skin will help eliminate the rashes and skin breakdown under the flap. This is not a cosmetic operation but often is confused with the tummy tuck, which is a cosmetic procedure.
Panniculectomy Insurance Requirements & Process
The very first thing to do is call us! We deal with this every day and will answer your questions and get you started. A quick preliminary step is that you will send a selfie pic to me, and I can take a look to see if it looks like it is enough skin to try for insurance approval.
If it looks like it is, we will help guide you on the process of gaining insurance pre-approval for the panniculectomy. Next, you will be sent a checklist of items you need to gather, including the following documentation:
- Your highest weight
- Problems with skin breakdown and rashes
- Medicines you have used to treat skin breakdown and rashes
- Any other medical records that support the medical necessity of the surgery (such as chiropractic visits related to back pain or other medical visits where you complained about these problems, and it was documented)
Once you gather this paperwork, you will bring it to the office to meet with the insurance specialist, who will confirm it is complete and take photos to submit along with the paperwork.
The Insurance Waiting Game
Sometimes, the approval comes in a timely manner, and sometimes, it can take a few weeks. Other times, they will send a denial, stating you have not met their criteria. We will work with you to determine the next step. If they are not going to cover it, we can switch gears and discuss how this is handled as a self-pay procedure. During this time period, we will schedule a virtual consultation so I can cover the big things you need to know as we are planning surgery, such as time off, restrictions on exercise, the most common complications, and the drains!
You are approved!
Both you and my office will receive notification of your approval, and once we get this, we can book your surgery. I do these operations on Wednesday at two outpatient centers in Columbus, or if your panni is super-sized, we will need to schedule in the hospital and include an overnight observation stay. So when you get your approval, look at your possible dates for surgery and call us.
The Pre-op Visit
The pre-op visit is about an hour long and is a comprehensive office visit. During this visit, you will review the paperwork and handbook and get your recovery items: socks and sequential compression devices, the soap you need, and supplements to promote improved healing. We do all prescriptions electronically, so we will need your preferred pharmacy to take care of this. If you want to add the cosmetic component to your panni, this is also when you would pay the fee for this.
Combining Your Panniculectomy With Other Procedures
Many patients would like to add other body contouring procedures to their panni, and, in general, I think this is a good idea—but only up to a certain point.
First, it depends on the size of the panni. For smaller amounts of skin removal, of around 5 to 10 pounds, it is possible to do this as an outpatient and add other things, like a breast lift or arm lift. However, as the amount of skin we need to remove gets larger, the safety of doing other procedures at the same time is an issue; we will discuss this on a case-by-case basis. You have to remember that the skin that is coming off has blood volume in it, and we do not want to take off so much that you are anemic afterward.
Way To GO!
We are thrilled for you and your weight loss! It is a huge accomplishment, and we want to work with you on your body contouring journey. If you have insurance, we will try to get the abdomen portion covered. After all, you have paid your monthly premiums AND lost weight, making for a much healthier future.
To begin the journey, call us at Aesthetica and let us take you the rest of the way. You can reach us by phone at (614) 569-2649 or by using our online form to request a consultation. We can’t wait to help you put the finishing touches on your weight loss transformation!
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