Question:
Revision to TT?

I am not 100% satisfied with the results of my TT which I had a month ago. I realize that some of this may be swelling, but I am sad to see that although the area under my belly button is flat, I still have a roll and fat above that area. (he did an extended, anchor cut) SO - I'm asking about revisions. If I request, or if the PS sees the need for a revision, does Insurance cover that?? Does it get re-submitted and is there some sort of typical policy that insurance companies go by, for situations of TT's that need further work or revision? Just curious. I haven't seen this issue addressed here and wanted to have some info before/in case I need it! Thanks everyone!    — Mary W. (posted on May 26, 2004)

May 26, 2004
a month out..your not all healed yet.i hope you wearing a girdel hopefully down to at least your theighs. this well help with the swelling.you want to make sure its not fluid filling up in that area.the girdel as annoying as it is will help that.god luck to you.Tracey
   — traceybubbles

May 26, 2004
I doubt that insurance will cover a revision to a tummy tuck. A friend's plastic surgeon, charged her only for anethesia to revise her tt. She had dog ears which were obviously the fault of the doctor. I'm not sure that the fat above your stomach is the doctor's fault though unless you had liposuction. A tummy tuck will tighten muscles and take away extra skin, but it will not do anything for the fat.
   — Lisa N M.

May 26, 2004
You are still swollen and this could go down. Wait a few months and see what happens. Did he do lipo in that area? Maybe if you tell him you want more fat taken out, he will do that at little or no charge. He should guarantee his work unless your expectations aren't realistic.
   — Kris T.

May 26, 2004
Mary, you asked my question! I am five weeks out today. My surgeon said we would discuss "touch up" work at 6 months. Some of what you are seeing may be swelling, and it may go down. I will keep my fingers crossed for both of us. But I do know EXACTLY how you feel. A lot of preparation, apprehension, excitement before this surgery, and then a big letdown because it doesn't look exactly how you had hoped. Why me why me?? The way I've been dealing with it, so far, with a little help from my mom, is to be grateful for all that I do have today. I am almost 120 pounds lighter than 21 months ago. I no longer take medication for diabetes. My blood pressure is normal. I came through this second surgery magnificantly. For me, it was much more uncomfortable than the RNY, but I learned how much stronger and healthier I am. It was so much easier for me to pull myself out of the bed this time. I didn't have a bar over the bed, and I pulled myself up by pushing with my arms. I never could have done that at 275 pounds. I am healing well, completely, and no infection. I am getting back into exercise and feeling good about myself. I am fitting very nicely into size 12 tight fitting pants, which I now wear with my shirt tucked in, even with a little "roll" on the top. Even though I weigh 160, there were so many things I could not wear because of the panni. Everyone says I look great. And I feel great. I finally invested in some new bras with underwire that have worked wonders (I really need a boob lift but don't have the $$$$$$) You know, as much as I want to be perfect, I am trying to accept the fact that I won't be. I weighed almost 300 pounds for many years. My skin is damaged beyond repair. If it wasn't this tummy tuck that didn't turn out perfect (or so it appears at this point), I would be agonizing about my upper arms or inner thighs. I have got to get over those things and get on with my life. I will never be able to spend the money to get everything fixed. Yes, I am upset because I paid out of pocket for the above the belly button part. We both have every right to be upset, frustrated, worried, crushed. But I am going to trying to keep my cool and see what the next few months bring, it might be a little early to jump to conclusions. In the long run, if it doesn't get better and I can't live with it, I expect that I will have some expense in terms of anesthesia, etc. And yes it makes me very very mad. However, I don't expect to have to pay the doctor anymore than what I have paid. But I guess I will have to wait and see. Right now I am trying to maintain a good relationship with him, and not scream, yell or blame. I don't know about you, but I really had a lot of skin. I looked at the pictures again and had forgotten what it looked like 5 short weeks ago. I think he did the best he could. It sure is nice to be rid of that panni!! Hugs to you. Valerie
   — Valerie B.

May 26, 2004
Hi Mary: I had my TT mid Jan. of this year. I have a big fatty area on the left side that should be revised. The first post op visit I got the same "It's too early it's probably swelling" thing you did. After a few more visits I said, "Look, swelling or not, this is a lot of extra skin over here, do you really think it's all swelling?" She said no it probably will need to be revised, but it won't be a problem to get the insurance to pay for a scar revision. Because of problems with the hospital during the original TT, I called a different surgeon's office to see if they could do the scar revision. They wouldn't even give me a consultation without me paying for it up front. They said it is considered cosmetic, and the insurance wouldn't pay for it. I said ok fine, but if it does get covered, will you refund the money I paid for the consult or how does that work? She said no they will never apply for insurance coverage for a consult for a scar revision regardless of whether it would be covered later or not. So basically that told me that she felt I had no chance of getting coverage, but she wasn't going to argue with me about it. They also were not going to take any chance of not getting covered for the consult fee. Sigh. I haven't been back to the original surgeon again since the last conversation about the revision, but I have an appointment in June, so I'll see what is said then. I probably won't get a revision unless it's covered, because even if she waives her fees and I just owe for the anesthesia and hospital fee, it's still more than I want to pay out of pocket. I am disappointed the initial surgery didn't turn out right to start with. But I guess it's unfair to expect the surgeon to pay out of pocket for the fees she can't control. But it's equally unfair that I should have to pay for it too. I'm not the one who didn't do a good job to start with. If I were going to have further surgery I'd just get it done then, but I'm done now, so that's out. Hope yours is just swelling and will go down enough for you to live with. S
   — sherry hedgecock

May 26, 2004
Hi. I would wait until AT LEAST 3, maybe 6 months to decide on doing ANY revisions. Swelling, skin settling, ect., take that long to give you your final result. I try and be realistic (i.e. show pics) of what I think an individual's result may be, and really discuss limitations to avoid disappointment. In general, INS will never cover a "touch up" but will only cover complications like infection, fluid collections (seromas), etc. I tell patients up front that I will correct (free) anything I can do in the office safely within the first year. Hospital touch-ups require them to pay for the anesthesia only. It's a tough situation for both sides, because I feel patients pay for results. Knowing the limitations up front is something all patients must know before PS. Best of luck...be patient...and look at your "before" pics to see how far you've come !
   — DrL

May 26, 2004
You definitely need to give it at least another 2-6 months before making any decisions. I am almost 3-1/2 months out from a LBL and I can tell you the way I look now and the way I looked at 1 month is night and day. My body still is doing shrinking and adjusting. I've gone from a 16 right after surgery to a 12 most of the time now. <p>As far as a revision and cost it comes down to your particular surgeon. If it can be done in the office or their own surgery center then I would assume it should be done for free. If a facility owned by someone else must be used then you would likely have to pay the facility charges and the surgeon would do it for free. It really depends on whether it is a problem caused by the surgeon not doing something right or whether it was inevitable because there was so much work to be done and one could only expect X result. I fall into the 2nd category. Now it appears more should have been lifted up at the outer thighs but I know he had it quite tight when he did the surgery/ However, because there still is quite a bit of weight on the legs it has relaxed some. He removed 19 lbs of skin, so it's not like he didn't do his job. It's just that I had so much material to remove that it truly is impossible to have perfect results the first time. However, the results are wonderful, so it's not like I am unhappy. I just need to be realistic about some of this. I gave him crappy stretched out skin to work with and tons of volume of skin to remove. He spent over 10 hours of surgery working on me, so I know he did his best. <p>I do have a small area right above the pubic bone that is pouched out. He is going to lipo it and resect some of the skin when he does my next surgery on June 7th. Since it won't take tons of time I know I won't get charged any facility charges and his cost would be nothing. The same with my belly button. It ended up bigger than either of us like, so he is going to work on it to make it smaller at no cost. The bottom line is the facility time will probably get billed to the insurance as part of the other work he will be doing. My doc is a perfectionist so he is always going to want to revise things to improve them. It will come down to what I feel is an issue. I may need a partial redo of the lateral thigh lift after my legs are done due to the volume of skin and fat I have right now. Once some of that weight is gone it is possible to have the best possible result I will need an additional lift. I would not consider this a revision or expect him to do any of it for free. It's just reality due to the volume of skin I need or needed removed. <p>Please just relax and give your body time to shrink and settle out. You will be surprised how it changes over the next few months.
   — zoedogcbr