Panniculectomy requirements

Hi Karenbean. Best of luck are you on facebook?

16. Excision of excess fatty tissue and/or skin a. Panniculectomy is only insured in the following cir****tances and when prior authorization of payment is obtained from the MOHLTC: i. where there is significant associated symptomatology related to the pannus; ii. where the pannus extends to a level below the pubis symphysis; and iii. where the patient's weight has been stable for a minimum of 6 months when panniculectomy is requested in relation to weight loss. b. Excision of excess fatty tissue and/or skin other than for panniculectomy is not an insured service. [Commentary: Examples of significant clinical symptomatology include significant pain, chronic skin breakdown, and recurrent cellulitis and/or ulcers.] Hello, above is the Ohip criteria for panniculectomy in Ontario. I used a plastic surgeon in the GTA and he is very good at getting you as much coverage as possible, most people do the upgrade and his prices are very reasonable. www.elahiplasticsurgery.com there is also a Ontario, Canada plastic surgery fb group with alot of info. Good Luck

My pannus did not extend that low. I still was covered.

Hi. I also am having my surgery with this doctor. Could I pm you to ask you a few questions?

Hi. I also am having my surgery with this doctor. Could I pm you to ask you a few questions?

Yes please do.... anytime.

Sorry just saw this now.

Nancy

Hi again

I am just curious about your experience with Dr Elahi. What did you have done and did you pay extra?

Thanks so much

Paula

Good morning Paula, I've have had alot of things done.... he really changed my life. Extended TT, with mons lift, muscle repair, hernia repair, relocation of the belly button, breast reduction/lift & lipo ( that was all my first surgery 6 years ago, I paid a $3500 upgrade fee with the Ohip coverage) now he is charging $ 5500. I later went on to get a thigh lift,upper blepharoplasty, rhinoplasty. ( all these were self pay) He is very kind and willing to work with Ohip which is a big help to fund what is covered. He needs to apply to Ohip and the approvals usually come in 4-6 weeks after. He has a very high approval rating ....If you get a Family Dr. refferal then the $150 consult fee is waved, or if you pay, it would then be deducted from any proceders you do with him. So you really only have your time and gas to loose. Good Luck

Hello everyone!

It has been sometime since I posted on this website. I had gastric bypass ruin Y in January 2017. I have lost 130 pounds and have maintained the weight loss for the last 3 1/2 years. I look and feel great! The gastric bypass bypass was life-changing for me.

This question is for Canadians covered by OHIP.

I have had a consult with a plastic surgeon. He put in all the paperwork for the panniculectomy. Ultimately, I'm going to have a complete abdominal plasty. Pay the difference. The problem is OHIP has denied the authorization to cover cost. My panni hangs half over my mons pubis (mons Venus). I hate how it sits in my lap while on the toilet. I have had rash/excoriation & odour. I have purchased just about every over the counter sprays and powders to keep the area clean. Without too much success. I wear compression panties to hold it in but that is ultimately causing irritable bowel from the intestinal compression.

I ultimately was determined to appeal this decision.

I wrote a very well written appeal letter complete with a letter from my family doctor and her recommendation for the panniculectomy. I also asked for a letter from the weight management clinic who initially referred me for the panniculectomy!

ultimately I had to fight for this panniculectomy I met the criteria and submitted my request. It was finally approved and I upgraded to a complete tummy tuck. I am having surgery three weeks from today. Dr. Ronnie Borsuk is the plastic surgeon doing the surgery. He is ranked # plastic surgeon in Ottawa on Rate MD. His reviews are excellent. I am quite happy with my experience with him so far. He operates out of Winchester Hospital. I believe he also operates out of a plastic surgery clinic privately. He only does the OHIP approved surgery out of the Winchester Hospital.

I am more than happy to share my experience with you. Please message me and I will forward my cell phone number. I am more than happy to help anyone who is trying to appeal a decision.

Sincerely

Mahalo