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  1. #1
    Gastric Sleeve Member BamaBrit's Avatar
    I have had a gastric sleeve.
    Name
    Carla
    Surgery date
    01/10/2017
    Surgeon
    Dr. Jay Suggs
    Join Date
    Nov 2017
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    09-17-2018 08:39 AM
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    Default Abdominoplasty Consult

    Hey everyone! I posted several weeks about about a panniculectomy to see if anyone had ever had one or knew anything about it. I went for a consultation for a panniculectomy on Friday at a plastic surgeon. He said that I wouldn't be happy with a panniculectomy because it wouldn't be cosmetically flattering to me. I wasn't expecting that. Has anyone ever been to a panniculectomy consult and have been told that? Has anyone ever had one and wasn't pleased with it? Anyway, he said that I would be much more pleased with an abdominoplasty (aka tummy tuck) instead. I told him that my insurance would only pay for a panniculectomy not a tummy tuck because they considered it cosmetic. He told me to sit up and suck in my stomach and then expand it a few times while he was pressing on the middle of my abdomin. He said that my abdominal muscles have separated due to being over weight for so long. He said that it was fairly common for people who have been obese for a long period of time or if someone had gone through several pregnancies. He also took some pictures due to some skin issues I've been having in my abdominal area. I went and read my policy under keynotes (maybe keywords?) and, if I read it right, it said that it may pay for it if the abdominal muscles have become separated and this would be considered reconstructive surgery. Again, thats IF I read that correctly. I was wondering if anyone could shed some light on this for me? Has anyone had an abdominoplasty covered by insurance? Has anyone had a panniculectomy and did/didn't like it? I'm not sure what to think at this moment. Should I go for a second opinion on the panniculectomy? I'm anxious to see what insurance says about the predetermination for the abdominoplasty.

    Thanks for everyone's help!



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  3. #2
    Gastric Sleeve Member Marsh17's Avatar
    I have not had a gastric sleeve.
    Surgery date
    03/27/2018
    Join Date
    Feb 2018
    Last Activity
    08-27-2018 04:08 AM
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    Default Re: Abdominoplasty Consult

    Hi Carla,
    I would call your insurance company and see what your plan covers. Depending on your insurance you may also be able to look on line to see if it is covered. The document that outlines your detailed insurance plan is sometimes called the Summary Plan Description or SPD. Sometimes they can email it to you in a PDF file then you can keep it on your "desktop" and search the document by doing a control "F" and then type in the word you are searching for i.e abdominoplasty. The Summary Plan Descriptions are usually very large documents so the control "F" is helpful. Best of luck to you!

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  5. #3
    Gastric Sleeve Member Stacey03's Avatar
    I have had a gastric sleeve.
    Name
    Edie
    Surgery date
    11/07/2017
    Surgeon
    Dr Phil lockie
    Join Date
    Oct 2017
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    04-27-2019 09:56 AM
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    Australia
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    Default Re: Abdominoplasty Consult

    Hmmm yes I think check with insurance too. I mean I do agree that the tummy tuck would give the best result but also its a good up sell. You pay a lot more for that. Let us know how you get on.


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  7. #4
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
    Join Date
    Nov 2016
    Last Activity
    09-12-2019 04:13 PM
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    Default Re: Abdominoplasty Consult

    Sometimes with the right documentation from the surgeon you can get things covered. See if that is the case with your insurance. The worst thing they can tell you is no.



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  9. #5
    Gastric Sleeve Member BamaBrit's Avatar
    I have had a gastric sleeve.
    Name
    Carla
    Surgery date
    01/10/2017
    Surgeon
    Dr. Jay Suggs
    Join Date
    Nov 2017
    Last Activity
    09-17-2018 08:39 AM
    Posts
    123
    Said "Thanks" 100 Times
    Was Thanked 90 Times in 51 Posts
    Said "Welcome to Gastric Sleeve" 243 Times

    Default Re: Abdominoplasty Consult

    Yeah thats what my plastic surgeon said too. He said even if I was denied that we could try another way. If its meant to be it'll happen.



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