Post Surgery TUMMY TUCK!?!? (Tricare Approval?!)

I need help figuring out how to FIND and basically just go about trying to get TRICARE to approve me for a tummy tuck! I have lost a total of 115 pounds since my surgery, which was in August 2008, and my tummy skin is really saggy and so is the skin on my inner thighs.

I have read online in a few places that Tricare is actually pretty good about approving plastic surgery after gastric bypass as long as you can prove that it is "needed" rather than just cosmetic. Like if the saggy or loose skin causes rashes or causes you to cut yourself while shaving, or even causes emotional "turmoil" (extreme self consciousness! LOL). SO... I was just wondering if ANYBODY knows how to start off the process or has Tricare and knows what to do and how to do it??? Also if anyone has any surgeon suggestions!?!?

Thanks!!!

Hiya Jaclyn!

I've been working in plastics for a few years and getting ANY insurance to cover "reconstructive" surgery is almost impossible.   "If" they cover anything at all, it is almost always limited to just the panniculectamy (amputation of excess abdominal skin without any muscle work).  The basic guidelines are:  If while in a sitting position, your pannus (excess abdominal skini) reaches down to about your knees or if you can lift it straight out about 6 inches while standing up....and if you have documentation from a dermatologist, pcp, etc. that you have skin breakdown of some type, deeming it medically necessary....then....you may be considered.  But most are denied!

The other piece is finding a surgeon who is contracted with your insurance company.  Tricare is rare.

I hate to be a Debbie Downer but there are a lot of rumors in the biz.....like if you have a hernia then you get free plastic surgery or  that you can donate your skin to a burn unit for free plastic surgery or that just because we have lost over 100 lbs, we are entitled to coverage for plastic surgery.  Nope.

You may want to check with your military doc and see if he/she will refer you to a military plastic surgeon.  I did hear that they may have some coverage and that one may be at Nellis in L.V. and at Randolph in TX?

Congrats on your weight loss!!!!  Good luck with the next step!  I have seen lives change and people break down in tears of joy over the results of their Post Bariatric body contouring!

As for recommendations....I no longer work for Dr. Mazaheri but "hands down", I consider him the best plastic surgeon in AZ!!!  .....  I totally recommend getting at least 3 consults and make sure you're comparing apples to apples with prices.  The other criteria for selection is to check the medical boards, check for lawsuits and ask around on the boards for other people's opinions on their results.  Make sure the surgeon has oodles of Post Bariatric p.s. pictures to show you and that they have a specialty in working with our types of bodies (extreme excess skin).  Someone can be an excellent plastic surgeon and then totally screw up with our body types.

You're in the FUN phase of the journey!!!!  Enjoy!


BTW....Dr. Mazaheri's # is 480.951.4343  He may give you a discounted consultation if you tell him Joyce sent ya?  LOL!  Who knows....maybe he'll charge you more!

Tricare covered my tummy tuck.  I had to be 6 months at a stable weight and I had documentation of rashes.  That was all it took.  If you want you can pm me. You might also want to post this on the "Plastic Surgery Forum".

Hello, I had a baby 6 months ago I gained over 90lbs.. I have been dieting and sseing the diet dr and nothing is working. The diet pills they prescribe make me crash and I get extremly tired.. I am looking into getting the lap band or gastric by pass im not sure which yet. I currently have an extreme amount of excess skin hanging over my c-section scar it often has an oder and is always irriated. How do I do about getting approved?

Any information would be helpful... Thank you