Question:
What are the criteria for a plastic surgery?

I finally saw a plastic surgeon. What an horrible experience!!! First I think she took one look at my insurance and decided she didn't want me as a patient so she let me have it. Besides telling me how she wouldn't do it because of my insurance, she laid into me about how terribly heavy I was, how I had too many chronic health conditions, how absolutely life threatening a panniculectomy was, and she kept going on and on about the insurance criteria? I listened to her for about thirty seconds and decided she wasn't the surgeon for me. But like an idiot I sat there for another ten minutes or so while she ranted and raved. My question is, what exactly are the criteria for a panni? I have serious circulation problems when I sit down because I have such a large tummy. It is so obvious the problem comes from my weight and now the apron. But according to her this is not a criteria for a panni. Now I also have rashes and yeast infections and all of that, but my primary complaint is the circulation problems. My circulation is better since the RNY, but is a long way from being solved. I need this surgery. The whole experience left a bad taste in my mouth. I keep telling myself that I don't want a surgeon with no hospital privledges, and I wouldn't have gone with this doctor if she'd gotten on her hands and knees and begged, but even so my confidence is badly shaken. I've worked so hard and have come too far to let one doctor get to me, but I'll admit she did. Can anyone help? Leigh    — Leigh P. (posted on December 17, 2002)

December 17, 2002
Leigh, it certainly sounds to me like you meet the criteria for insurance to approve a tummy tuck. I've often heard that documented rashes/infections are criteria that the insurance companies look for. Has your PCP also documented the circulation problems? that would be an added criteria. It sounds to me like this surgeon does not have experience in massive weight loss and perhaps just prefers to do the face lifts and simple surgeries. You may have presented too much of a challenge for her or perhaps she just didn't want to deal with your insurance co. Don't let it rattle you-there are tons of plastic surgeons out there-you should look for one who has experience with WLS patients.
   — Cindy R.

December 17, 2002
hi not sure what state you are in i live in ohio have an excellent plastic surgeon if you want contact me and i will let you know who he is thanks
   — ROSEMARY A.

December 17, 2002
It sounds like you got a miserable doctor who has prejudices against overweight people. RUN do not walk away from this woman!! Any doctor who would have spoken to me in that manner would have gotten an earful back!!! You don't need to accept that kind of behavior from a supposed professional. There are plenty of other plastic surgeons who are good and caring. I was lucky to find one. But the first one I went to was prejudiced against previously overweight people and wanted to slice and dice me all over the place. Good plastic surgeons want to make you look your best as it's a reflection of there work and people will WANT to go to them due to there reputation. Keep looking - you will find someone who you like.
   — Patty H.

December 19, 2002
Leigh, definitely find a different surgeon. You need one who is experienced in handling your situation of removing a large pannus. Not everyone is qualified. I can't help with your insurance issues (Had mine done in Mexico d/t no insurance) My surgeon didn't blink an eye and he could show me pictures of others with similiar stats & surgery. I had a HUGE tummy removed and weighed over 300 lbs at the time. One thing you should consider before assuming you only want a panni is the possibility that you may need a full abdominoplasty with work being done to the underlying muscles. I was told up front that there was a possibility that from carrying my tummy for so long that I had damage to those muscles, and at the least, had really stretched those muscles out of shape. And that really was the case. I had a LOT of damage the the underlying muscles on my left side. It was a really big surgery. It was long, involved and took quite a while to heal. Also because of the massive nature I had to realize that there would be a touch up involved. It took a second surgery to remove the remaining fat tissue from my upper abdomen (only lipo, not bad) and a scar revision type surgery where they removed the fat from my mons pubis area and lifted it. I know personally, that I would not be happy with my surgery if my doctor hadn't addressed those issues and planned for the touchup to fix that. Since you're in a situation of having insurance I'd definitely fight for it to be covered. I totally sympathise with the physical side affects from your tummy that you're dealing with and think that any insurance company who doesn't strictly have an exclusion to not cover this would have to cover it. If they won't though you might consider self paying this. Its soooo worth it.
   — Shelly S.

December 20, 2002
Thank you all. I know that this surgeon was in way over her head, and didn't know how to deal with me. But knowing that still didn't help my shaky confidence. Thanks for the support. I really needed to hear it. Leigh
   — Leigh P.