Question:
Unhappy with my P/S ? Help Please!

Hello! I had my Abdominoplasty/ Panniculectomy one week ago yesterday with a 30# pannus removal. I had the inverted anchor incision. My problem is my right side is perfect, the left side is noticably more fatty, and it overhangs, putting my staples & incision in a crease making it very difficult to keep clean and dry. I understand it takes a few weeks to months to see the final results, but this is a very noticable difference in the sides. The surgeon told my wife right after surgery that I may need a revision in about 6 months, but why was it done this way to begin with? I have Medicare/ Medicaid and don't know if they will even pay for a revision. I am very happy with not having the pannus anymore, but I've worked so hard for this, it's just heartbreaking to see. Anyone else had anything like this happen? Thank You, Brandy -300# in a year    — BigB (posted on November 3, 2004)

November 3, 2004
It does take time, and if it doesn't improve enough, talk to the doctor, many will revise for free, but you have to pay anesthesia, an operating room charges.
   — **willow**

November 3, 2004
I dunno why, but the spot I saw as problematic the day I got home from surgery was indeed the very same spot that is a problem three months post-op from my LBL. Revision city. My PS's explanation was that the loose area I have above the belly button is the last place he closes (dunno why that's an explanation, but that's what he said. Was I swollen by the end of the operation? Was he afraid of closing it too tight? Did he get tired? Did someone miscalculate how tight my skin was when they started sewing that area? I dunno.)<P>My revision will be included in the price because I was a self-pay and it can be done in-office. I am overall very pleased with my results so I'm not complaining here (but like you, I wonder how these things happen when they're clearly visible immediately to us as patients).<P>If you see what's coming here, I'd start saving for the OR and anesthesia costs, and press your PS for an answer as to whether the revision would be free as far as his part of the cost is concerned. Wouldn't bet on it, though, because PS don't make much from Medicare/Medicaid or insurance patients, and so I don't know how often they'll revise "for free" for such patients. Guess it's a money thing. :-( And I think you're right to be worried about whether Medicare/Medicaid (or insurance for that matter) would pay for a cosmetic revision of the result you describe. Who knows. I'd start saving for a revision. This isn't unheard of, I've seen others in your dilemma.
   — Suzy C.

November 3, 2004
I too, had to have a revision on my BL. it was included in the original price and it was done in office so NO expenses.
   — Connie M.

November 3, 2004
Things will change drastically over the next 3 months so hang in there. It could be as simple as your body holding more fluid on that side. My two sides, from my lower body lift, healed at different rates. I accumulated 650 cc's of fluid on the left hip and had it drained plus a new drain installed, yet I never had any fluid build-up on the right hip. I did have a small revision just above the pubic area with my 2nd PS but it was totally free to me because the doc didn't charge anything and the time for anesthesia and the hospital charges were able to be lumped in with the other work insurance was covering. In reality it probably could have been done in his office which means it would have cost me nothing as there would have not been any charges from other entities or docs. It's amazing what they can do in their office. He cut out dead skin at the top of my butt crack and sewed it all back up. That's about an equivalent amount of work he revised during the 2nd surgery. <p>Sometimes when a person has a very large pannus to remove, which you certainly qualify for, they can not get it perfect the first time because there is so much work to do. The reason I needed the small revision is because he did my right hip first and he got it very tight. So when he went to do the left hip he backed off a little so as not to pull the T connection too tight. If there is too much stress on the incision then skin can die. The T connection is a problem area a lot of times. Because he backed off a little, eventually it was apparant that he had left it a little too loose. Like I said though, it was not a big deal to fix up. So don't panic and give your body time to settle down. I was shocked how the skin sucked down over time. It was 2 months before the scale reflected the who 19 lbs I had removed, so it takes time.
   — zoedogcbr

November 4, 2004
Hi. Its still very early and as swelling subsides, you will likely look better. Every weight loss patient gains and loses differently and ALL patients have "lopsided" tummies. I use liposuction to even this out, and so refuse to do panniculectomy-only surgery. Sadly, insurance sees the goals of surgery being met if the excesss skin is simply cut off..the extra work to balance the result is not considered.
   — DrL

November 4, 2004
Hi. Its still very early and as swelling subsides, you will likely look better. Every weight loss patient gains and loses differently and ALL patients have "lopsided" tummies. I use liposuction to even this out, and so refuse to do panniculectomy-only surgery. Sadly, insurance sees the goals of surgery being met if the excesss skin is simply cut off..the extra work to balance the result is not considered.
   — DrL

November 5, 2004
You are way off when it comes to timeline. It will be months before the swelling goes down and being able to see the results. It takes well close to 6 months and it depends on how you heal. When we have so much skin they have a hardtime determining how much to take off and how to shape it. One of the things my PS Doctor stated was try to exercise and frim up as much as possible. This helps them determine your muscles tone and outline and as a additional plus they may not have to cut as much. I'm going in for a butt and thigh lift. I will also have to have more surgery after because they can only cut off so much at one time. I'm actully going to need to surgeon to do my work. I've lost 193 lbs. Good Luck in your healing.
   — Linda R.