Plastic surgery? How much weight loss before going to consultations?

Hi, I am almost 2 years post op and have lost about 200 lbs, I have about 60 more pounds before I'm at my goal weight of 200 lbs, I'm already experiencing a lot of sagging skin and already experiencing a lot of skin irritation from the sagging skin and where it rubs, I'm just wondering when I should start thinking about going to get consultations, I have spoke with my insurance and they will cover anything that is medically necessary. I know a lot of PS don't accept insurance since its such a hassle and I've been having a hard time finding PS in my area that states they accept insurance on their websites. Any info or advice would be greatly appreciated. Thanks! 

Hi Ashley, I contacted my insurance company and got a list of all the plastic surgeons who are in their plan - from that list I narrowed it down to those surgeons who deal with patients with massive weight loss. Two of the surgeons I met were happy to deal with the insurance company, one that was on the list was dismissive about billing insurance and, well there were many reasons not to use him but this one.

I had many people tell me to wait until I was about 20 pounds from goal - between getting those initial visits until the actual surgery I shed the rest of my weight. The closer you are to a normal BMI the better your results and the surgery is safer and recovery easier. My plastic surgeon said he doesn't like to operate on anyone whose BMI is above 30 unless they are in exceptional good health due to research showing increased problems with healing. I know what it's like to shed a lot of weight and to be impatient and want to be at goal and have the surgery quickly - but if you are patient and can continue to shed weight - then wait till you are closer to goal.

Check with your insurance company to find out what requirements you might have to meet to get authorization for surgery - I had to go to my PCP for three months in a row to document rashes and I had to buy prescription medication to show I was working hard to eliminate rashes. Your insurance may have different requirements, but my requirements are fairly typical.

Good luck

I agree with everything Skylar said.

 Ashley,

 

Congratulations on your amazing progress.  Using insurance to pay for plastic surgery after weight loss can take some time to get approved.  For this reason, you can’t look into it too soon.  Documentation from your doctor is similar to getting weight loss surgery approved.  There needs to be physician notes that you have a persistent medical issue caused by your excess skin.  In our office, we’ve found that picture documentation is important.  A plastic surgeon the does insurance cases will now how to do this.  It sounds like you’ve have no issues.

Before you do anything you should make sure your insurance has benefits.  You’re already ahead of the game with your insurance coverage and early planning. 

Good luck to you.

 

http://www.nvpsaz.com/body/post-bariatric

Keep up the great work! There is never a wrong time to go in for a plastic surgery consultation, but you should wait to have plastic surgery until you are at or close to your goal weight and you have been weight stable for a minimum of 3-4 months. The two major reasons for this are: (1) if you have plastic surgery and continue to lose weight your skin will relax and you may compromise your aesthetic result and (2) when you are losing weight your body is not ready to repair the incisions required to give you the contour you desire.

Regarding insurance company coverage, you took the first step to see if your carrier covers procedures after weight. Many carriers, however, will only cover a panniculectomy which is a medically necessary procedure. This would include skin irritation (which you have), ulceration, yeast infections, and panniculitis to name a few. This requires documentation from either your primary care doctor other physician of the issues and failure of conservative medical therapy often including prescription topical medications. This has to be documented over a few months. Your insurance will often want to see pictures as well which can be documented by your plastic surgeon. This is very different from an abdominoplasty or "tummy tuck" which is a cosmetic procedure. Your plastic surgeon may have a fee above what the inusrance companies will reimburse for this part of the procedure.

The next issue as you mentioned is finding a plastic surgeon that accepts insurance. The easiest way to do this is to call you carrier and find which surgeons are in your plan.  Although finances are always an issue, choose a plastic surgeon that has experience dealing with post-weight loss patients.

I wish you continued success with your weight loss.