Does My Health Insurance Cover Panniculectomy?

by | Last updated on January 24, 2024

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  1. You are physically healthy and at a stable weight.
  2. You have realistic expectations.
  3. You are a nonsmoker.
  4. You are bothered by the appearance of your abdomen.
  5. You have recurring or persistent rashes or infections underneath the hanging fold of skin.
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Is a Panniculectomy considered cosmetic surgery?

Panniculectomy performed for cosmetic purposes (e.g., to improve, change, or enhance appearance in the absence of signs or symptoms of functional abnormalities, improve self-esteem, psychological symptomatology, psychological complaints) is considered cosmetic and not covered .

What is the BMI for a Panniculectomy?

Reaches a body mass index (BMI) less than or equal to 30 kg/m 2 ; or. Has documented at least a 100 pound weight loss; or. Has achieved a weight loss which is 40% or greater of the excess body weight that was present prior to the individual’s weight loss program or surgical intervention.

How much weight do you lose after a Panniculectomy?

Results: Average abdominal skin resection was 16.1 pounds, ranging from 10.3 to 49 pounds . Hernia repair was necessary in 13 patients. Additional surgery performed at the time of panniculectomy included skin reduction surgery of the back (40 percent), chest (32 percent), inner thigh (28 percent), and arm (28 percent).

Do I need a tummy tuck or Panniculectomy?

The main difference between Panniculectomy vs Tummy Tuck is that a panniculectomy is often considered a medical necessity while a tummy tuck is typically for cosmetic purposes . More severe sagging that causes health issues like rashes and ulcers is addressed through a panniculectomy.

Does insurance cover apron surgery?

Typically, breast reduction and panniculectomy (removal of “skin apron” on lower abdomen) are the most likely to be covered by insurance . However, these procedures may still be deemed unnecessary or may not provide all of the lifting required to achieve optimal results.

Does insurance cover skin removal?

Insurance companies typically cover weight loss surgery, but don’t always cover cosmetic surgery to remove excess skin after significant weight loss .

Does Blue Cross Blue Shield of Alabama cover a Panniculectomy?

Abdominoplasty, Panniculectomy, and Lipectomy of the abdomen meet Blue Cross and Blue Shield of Alabama’s medical criteria for coverage when all of the following conditions are met: • The panniculus folds hang below the pubis; AND • Clinical records document the presence of symptomatology such as chronic irritation, ...

Why is a Panniculectomy medically necessary?

Panniculectomy surgery may be indicated to reduce the panniculus . The surgery removes the excess skin and fat that hangs over the abdominal area. It may be indicated if the panniculus interferes with a person’s daily activities (ADLs) and/or results in severe skin conditions that do not resolve after medical treatment.

What is the difference between a Panniculectomy and an abdominoplasty?

The biggest difference is the goal of the surgical procedure. A tummy tuck tightens the abdominal muscles and removes excess fat, skin, and tissue, while a panniculectomy is performed to remove a pannus .

What is a medically necessary reason for having a tummy tuck?

In flattening the abdomen and removing excess stomach fat, a tummy tuck surgically tightens the weakened muscles, resulting in much-needed abdominal support that can alleviate your back pain. To improve posture : A byproduct of stronger abdominal muscles and decreased back pain is improved posture.

What is included in a Panniculectomy?

Definition. Panniculectomy is a surgery done to remove stretched out, excess fat and overhanging skin from your abdomen . This can occur after a person undergoes massive weight loss. The skin may hang down and cover your thighs and genitals.

What is the maximum BMI for tummy tuck?

HOWEVER, it is generally accepted by reputable plastic surgeons that if one’s body mass index (BMI) is 40 or above , a level that stratifies one as morbidly obese, you should not undergo a tummy tuck. (BMI is the relationship of one’s height to one’s weight.

What is the recovery time for Brachioplasty?

Arm lift recovery time is usually 1 to 2 weeks . For a quicker recovery, it’s important to follow your post operative instructions. Get plenty of rest and avoid any strenuous activity that may include bearing weight or lifting over your head. It’s normal for your arm and hand strength to feel weak at first.

How many sizes do you lose with a Panniculectomy?

Most women lose between 2 and 3 pants sizes after a tuck, but there are patients who lose even more. If you had a lot of loose skin before the procedure, for example, you could go down 4 more pants sizes.

Will my stomach be flat after a Panniculectomy?

After the procedure, you can expect your low abdomen to look flatter and smoother . Most people also notice a new boost in their self-esteem after their panniculectomy because they feel more positive about their appearance.

How long does it take to do a Panniculectomy?

About the Procedure

Most often, the surgeon will make two incisions. The first is a long incision from hipbone to hipbone, just above the pubic area. A complete panniculectomy can take from 2 to 5 hours , depending on the extent of work required.

How much does a Panniculectomy cost?

A panniculectomy is more expensive than a tummy tuck, but it’s often covered by medical insurance. The cost can range from $8,000 to $15,000 , plus anesthesia and other extras. A tummy tuck is less expensive but is not covered by insurance. This elective procedure costs on average around $6,200.

Do Panniculectomy scars go away?

Previous abdominal surgery may limit the potential results of a panniculectomy. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. The panniculectomy scar may take several months to a year to fade as much as it will .

How do you get rid of apron belly?

It’s impossible to spot treat an apron belly. The only ways to reduce one are through overall weight reduction and surgical/non-surgical options .

How long does a Panniculectomy take to heal?

THE APPEARANCE OF YOUR INCISION

It takes 2-4 months for the incision to heal (inside and outside). The puckering of the incisions will smooth out over several months, but the scar will remain wide and red anywhere from six months to one year after surgery. Once the scar has matured, the redness will go away.

Can you get a Panniculectomy without weight loss?

Often, panniculectomy becomes necessary after a person has experienced significant weight loss , such as the kind that comes after bariatric surgery. Post-pregnancy can also create the need for this procedure, although this is not the most common reason for it.

Can you have a baby after a Panniculectomy?

It is of the utmost importance to give your body enough time to heal and recover from the side effects of the surgery before getting pregnant. Pregnancy is very demanding on a woman’s body; so, doctors advise women to refrain from getting pregnant for at least one year after the tummy tuck .

How much does it cost to have loose skin removed?

Excess skin removal surgery costs

These are the average costs for the most common plastic surgeries for loose skin after weight loss, according to the 2020 Plastic Surgery Statistics Report: Panniculectomy: $8,000-$15,000 . Lower body lift: $7,924. Upper arm lift: $4,861.

When should you get skin removal surgery?
  1. You have reached your goal weight and your weight has remained stable for at least 6 months. ...
  2. You are in good general health. ...
  3. You have realistic expectations about surgery. ...
  4. You understand that you may have visible scars when wearing certain garments, such as swimsuits.

What is a mini tummy tuck?

A mini-abdominoplasty involves a smaller incision, limited tissue elevation and removal of less tissue, compared to a full abdominoplasty . One of the benefits of this type of cosmetic surgery is that it’s less invasive and doesn’t involve a large incision near the patient’s belly button. Procedure.

Rebecca Patel
Author
Rebecca Patel
Rebecca is a beauty and style expert with over 10 years of experience in the industry. She is a licensed esthetician and has worked with top brands in the beauty industry. Rebecca is passionate about helping people feel confident and beautiful in their own skin, and she uses her expertise to create informative and helpful content that educates readers on the latest trends and techniques in the beauty world.