plastic surgery

I'm a long way away from plastic surgery right now, but I was wondering....what do you need to prove in order for your insurance to pay for it?  I would assume rashes and the like, but what if you dont get rashes?  I'm very careful about all that...should I not be?  Just asking.....

In order for skin reduction surgery to be considered necessary and covered under most insurance guidelines, the patient has to have at least THREE  DOCUMENTED staphylo****us OR strepto****us- infected skin rashes in the folds of skin to be operated on in ONE year.

That means that you have to identify that you have a rash or an outbreak, have the doctor examine it, culture and treat it, and it has to recur at least twice within the same year. Oftentimes doctors won't culture the blebs or weeping areas until the first recurrence--staph and strep infections of the skin have a fairly typical appearance and are easily treated with an antibiotic ointment such as Mupirocin.

Typically the doc will treat with that first, and if you show up again in a few months with a similar rash, will culture the area to see if the STRAIN of bacteria you have is resistant to or susceptible to certain antibiotics. 

You do not want to invite trouble, in my medical opinion. Staph and strep can go horribly wrong if untreated or allowed to flourish. Loose skin may take some getting used to, but it is a vast improvement over the alternative. For those who want plastic surgery, there are reputable medical tourism sites, financing, payment plans, etc.

Someday I'd like a tummy tuck and a lower body lift, but I look damn good in my size 6 jeans even with the extra skin!

It's funny.

Preop, I used to pretty regularly get heinous *****ly heat under my panni. (The panni developed when I dropped 140 pounds a couple of years ago. It didn't go away when I regained, it just got bigger and further away from my body.)

Now, nothin'. The panni's getting thinner and longer. NO *****LY HEAT. All summer long I was waiting for something to happen so I could get my doc to document it.   Absolutely nothing!!

I think I have some yeast issues. I'll ask my medical group doc about getting something to handle that. Maybe that will work!

I'm not going to start rubbing raw chicken or whatever under there just to invite the bugs. My luck I'd get the flesh eating bacteria and they'd make me more lopsided than I am now.

I think I need to start saving my pennies!

Good luck!

Uh oh I have not had any weird staph type things.  I did have a staph infected abcess post op though (A month later)  I wonder if that counts?   Same area.   I have documented yest infections in the panni area though, my surgeon said they can qualify you for plastics too sometimes.  I hope so. 

Hi,

I think rashes are one of the best ways to get approval, I've also heard of back pain from carrying the weight as an alternative.  It all depends on your insurance coverage, I would check that out first. 
I've been getting tons of good info from the Plastic Surgery Board on OH.  I'm planning on PS next year, hopefully by summertime.  I'll be going down to Monterray, Mexico with Dr. Sauceda doing my surgeries!

Diane