Feel Cheated and edema questions!!! Help!!

I had an abdominal lipectomy on February 26th! It was my understanding that this is just another term for tummy tuck! So I thought when I came out of surgery, my excess skin would be gone, muscles tightened, and new belly button! However, all that was done was excess tummy skin was gone! No belly button and no muscles tightened! When I asked my surgeon what happened, he replied that insurance doesn't cover muscles being tightened and he thought I didn't want a belly button! Is that true that anthem approved only excess skin part and nothing else? He said he would do belly button later cause he thought I didn't want one! But muscles were never included! After a week, I went in for check up and weighed an extra 30 lbs and my entire body was swollen, including my face! After series of tests, he said must b water weight n gave me water pills! He is so nonchalant n I'm freak in out bc behind my drains are large knots also! Reason y I was approved n one week after submission to ins. was bc I had bad case of cysts under tummy and on " my girl"! So I think that I hv gotten two cysts behind drains! Is thîs normal? What to do for edema? And last question, is it true that anthem bcbs preferred doesn't cover tightening muscles??

All these terms get thrown around interchangeably.  What it sounds like you got is a panniculectomy, which is removal of the excess skin in the pannus area (below the belly button) versus an abdominoplasty or tummy tuck with muscle tightening.  Most insurance will only cover the panniculectomy, although a lot of surgeons will do the panni, then finish the whole tummy tuck/muscle tightenng and only charge the patient for the difference.  Your surgeon really should have gone over all of this - particularly the belly button! - with you before surgery.

Retaining fluid is pretty common, but it sounds like you have an extreme case.  You need to get some face time with your surgeon and make him address your issues.  I know it's easier said than done, but it's what you need to do!

Wow. This sounds like a case of seriously bad communication.  Like, epically bad.  I'm so sorry that you were surprised when you woke up from surgery, what an awful feeling.   Did you sign a waiver?  I know with my PS, I have to sign some pretty extensive paperwork that describes the operation and possible complications.    Before they put me under, they even made me tell everyone in the operating room what procedures I was getting.  Do you have copies of the paperwork you signed for your operation?

It is very common for insurance companies to only pay for exactly the type of operation you described.  The belly button and muscle tightening are not considered medically necessary by most.  They only covering the extra skin removal (like you had) if it is causing documented medical problems - rashes, for example.  There are always exceptions, but it is extremely rare for an insurance company to pay for a full tummy tuck type of procedure. 

But that isn't the big issue in your story, that isn't the part that is so scary and alarming.  It's the total lack of communication between you and the surgeon that is so scary.   What do you think happened?  Do you think he made a mistake? Or do you think you two were talking about different things and not realizing it? 

Your swelling does sound excessive.  How miserable!!    His nonchalance might just be his way of trying to keep you calm, by the way.  I had a severe and life threatening bleed after giving birth to my son and my OB/GYN seemed so cool and collected.  I required many transfusions and was in the hospital for over a week.   She later confided that she was terrified that I was going to die and I was lucky to have survived.  Yikes.  So what could have been described as "nonchalance" was really just a professional trying to stay cool and calm to keep a patient cool and calm.  So I say all of this to say that his "nonchalance" doesn't mean he isn't taking you seriously.  It sounds like he ran a lot of test and has looked you over - he probably just wants you to not stress out and is hoping the swelling will resolve with time.

Do you think you want to seek out a second opinion on your healing?  I'm sure there is a lot of "trust issues" now with this surgeon, so I just wonder if you feel that you trust him with your after care.   This is sort of a question for everyone because I really don't know -- what are her options?  Can a PS patient seek out aftercare with another PS, or are PS very hesitant to take on the "work" of others? 

Kaykayhick - please keep us posted.  I hope things get better soon!!  (((HUGS)))  Sending you lots of good vibes and prayers for healing and strength.  Take good care of yourself. 

I signed a paper that said abdominal lipectomy and repositioning of (medical term) belly button! He was also supposed to lift mons pubis which was not on paper so I questioned him about that and asked him did he remember he was supposed to do that too! He said yes! So I think he was so focused on not forgetting to do that part that he forgot to do my belly button! I had cysts that he had to remove from mons pubis n surgery took longer than he expected 4.5 hrs instead of the 2 he proposed plus he had upper respiratory inf and was already running late for my surgery! I think also I should hv went back to his office before surgery but the insurance replied in less than a week which was surprising to me so they kind of rushed me into scheduling due to the insurance moving so fast! So yes I would say Huge Miscommunication but even nurse talked about my new pretty belly button so I kno he was supposed to do that part but he won't admit it! He claim he is goin to fix that part but not until we get edema under control! But I have a problem with him trying to act like we never discussed it at all as if I'm stupid or sum! I wish he would just admit he forgot n fix it with no extra fees! But if I hv to, I will get a copy of what I signed in the hospital to prove that he was supposed to give me a new one!

Yes, definitely gather up all the paperwork you can find now.

ARG!  I can't believe this happened to you.  It really sucks and I'm so sorry.  I mean, mistakes happen but... it still sucks.  Also, he was doing surgery with an upper respiratory infection??  Like, an active infection????  Is that even safe?  What the heck!

And, the thing is... yes, he can (and should) "fix it" free of charge... but that still another operation for you, another recovery period for you, and all the risks involved with another round of surgery.   

I hope this resolves soon and you end up with the belly button of your dreams. :)  I'm so sorry you have all this extra stress to deal with on top of trying to recover from surgery.  Take good care of yourself first and foremost.  Let yourself heal well before you make any big decisions about how you want to handle this.   (((HUGS)))

sounds like you didn't get a TT, but a panni removal only.  That is what most insurance covers.  Most do not cover muscle tightening or belly button relocations.  He also don't cover lifting the mons pubis.  did he lift yours?  I think you got what you were supposed to get according to the insurance coverage, however, if he agreed to give you more than you need to discuss that with him.  I had a friend who had the same problem.  They didn't lift her mons publis.  The surgeon told her that would be an extra $2K and she hadn't asked for it. 

As far as edema is concerned, I had that problem.  I would easily gain 20 to 30 lbs.  My face was swollen too, but I had a facelift so I assumed it was from that surgery.  My edema has lessened slowly over the last year.  It can take up to a year for your body to find it's collateral circulation post plastics.  Edema is very normal and that is probably why your doctor was nonchalant about it.  Some have massive edema and others have none.  For us, it's a horrible side effect, since many of us live by the scale- but for the surgeon it's an every day occurance.

I would call your insurance and ask them exactly what they paid for -- they will be able to tell you.

That's a good point that edema is common after PS and is much more traumatic for us (WLS patients who tend to obsess on about the scale) than it is for the surgeon.  

Did you research this surgeon before your surgery?? There was definitely bad communication. From being on this board, I know that most insurance companies only cover skin removal.

I had hernia repair done with him! He actually specializes in bariatric surgery! I was impressed with how he cares about how he cuts you n he actually told me after that surgery that he would help me get rid of excess skin n help me get insurance to pay! I actually thought I would have at least one more consult with him prior to surgery but I ended getting a sphincteronomy four days before! I tried to research on here any more plastic surgeons in my area n I couldn't find any! Most travel n I couldn't afford traveling plus my deductible! But now I wish I had went to the only one plastic surgeon here at least for a consult!! So that's my fault but like I said, I was approved three days after submittal and had to hv the other surgery as well! I thank you guys for your replies n I will be checking into what I signed and what insurance actually paid for!!

You are right that it would have been better to meet with a board certified plastic surgeon for a consult first, but I can understand the cir****tances that led you to where you are now.   I know there are many bariatric surgeons that like to offer plastic surgery services to their patients, but they are frequently not board certified plastic surgeons.   The difference between what is required for someone to say they are a board certified plastic surgeon versus someone who is a "cosmetic surgeon" or someone who "offers plastic surgery" can be quite vast.  For instance, a GP can take a brief seminar to learn how to do liposuction -- but that sure doesn't mean I'd want them to get anywhere near me with a cannula! ;)

Please, please don't beat yourself up over it now.  It won't do you any good. Right now you should only focus on your healing and moving forward.  Think about if you want to continue to use this surgeon, or if you want to get a consult elsewhere to "finish the job" and start saving $$ for whatever you may need to pay out of pocket.

I'm sure this will all get sorted out.  Good luck on the road ahead and I hope you keep us posted.  But, really..  right now, just try to rest and recover.  Your healing is most important right now, the rest of this can wait and be sorted later.