Question:
Is it better to wait for an abdominoplasty or go ahead with panni?

I'm scheduled for plastic surgery on Dec. 4. I was certain the doctor and I discussed an abdominoplasty. In fact, he talked about using my existing incision (from my open RNY). Today I met with him to ask a few lingering questions. Turns out he only submitted for a panni with possible hernia repair. He said that no insurance co. will cover an abdominoplasty and that his previous comments represented his recommendation, not what he expected ins. to cover. He then read my preapproval letter from my ins. company and just went off on the hassles of dealing with ins. companies. In fact, he said that he's so uncomfortable with their approval that it will have to be worked out before I go into surgery. He seems to be in the same boat as other docs who are reconsidering the complexity of dealing with ins. for plastic surgery related support following WLS. I'm concerned because I see on this site that others have been approved for the abdominoplasty, but since I do have approval, at least for the panni, I'm wondering if I should just go for it and handle any add'l work that needs to be done on my own. I'm terrified of taking on the liability of expenses that go beyond what my ins. will cover. What if I have complications? Don't know what to do. Advice?    — Lorri S. (posted on November 6, 2002)

November 6, 2002
What surgery you decide on is up to YOU. Don't let the doc bully you. In fact, I would probably be looking for another doc at this point since I would be unsure of whether or not I trusted this one. Whomever you choose, make it clear what you are looking for and demand that they submit THAT surgery to the insurance company. There are many posts on here about docs being reluctant to submit certain things. There is no harm in submitting a request. There is no harm in appealing a denial. If they will only approve the panni, then go ahead if you want to -- but find out from your own experience -- don't let the doc refuse to even submit for approval. This doc sounds VERY unprofessional and unsure of how the system works.
   — Jenni K.

November 6, 2002
I am scheduled for abdomnioplasty in two weeks. I had two consultations, and knowing pretty well that my insurance would not cover what I want done, I chose to have surgery by the second doctor(through a health maintainence org), who was 3000.00 less than the first doctor(private practise). I am biased in answering this because I knew from the start that If I just wanted to have the extra skin removed(panni) i would still have to pay for it. So instead, I opted to have the tummy tuck so my muscles can be tightened in addition to having the extra skin removed. It is worth it to me to pay for this surgery so I can feel normal around others.
   — twenc

November 6, 2002
I would not do just the panni if it was me. You can always do it if you need to, BUT if you do just that and need the other, the look left behind is a very deformed one. Flat tummy, with a gob above. Any surgery is risky, of course, so doing a major abdominal surgery twice is doubling your risk. You might want to check other PS for other opinions. I know a freind of mine was told her ins would never pay, so self-pd her plastics without question. She has GOOD insurance and it WOULD have paid for her tummy work, if nothing else, but the doc didn't want to accept that insurance dollar value, so he simply told her it wouldn't pay. It really was not fair.
   — vitalady

November 6, 2002
I have two hernias to be repaired and my surgeon is doing a panni at the same time. He says he will be tightening up the muscles because of the hernias. He says this is called a panni but is more like an abdominoplasty. I am paying out the wazoo for it so I hope it turns out good. He is the same doc who did my gastric bypass. I know the scar won't be the best because he is not a plastic surgeon but I am not planning on wearing any bikinis. I just don't trust anyone else getting near my bypass. I go in tomorrow at 6:15am.
   — MARSHA D.

November 7, 2002
There was NEVER any question with my PS that he would do the abdominoplasty. He wanted to make sure that I looked my best and that his work would look good to others. If you don't have any fat above your belly button, the panni is fine. But how many of us don't have fat above the belly button? It's got to be a VERY low percentage. I had a hip to hip incision with all the muscles tightened and it looks awesome. My PS is VERY pleased with his work and has taken before and after shots to show other potential clients on his good work. I would probably check with another PS too. This one seems to be all about the money.
   — Patty H.