BODY CONTOURING AFTER MAJOR WEIGHT LOSS
Introduction

List of Procedures | What Will My Insurance Cover?

In recent years, Gastric Bypass surgery has grown significantly in popularity as a treatment for obesity. This procedure is designed to result in a significant weight loss (often over 100 lbs) over a relatively short period of time (usually 12-18 months). With such dramatic weight loss, the skin often does not retain the elastic qualities necessary to shrink down to your new underlying shape. This often leaves patients with excessive amounts of hanging skin -- resulting in disappointment with their appearance, not being able to find clothing that fit properly, as well as creating problems with exercise and daily hygiene.

Because of the increase of patients who are in need of body contouring after significant weight loss, this has become an important focus of our practice. It is important to know that going to a plastic surgeon who specializes in gastric bypass patients is critical because there are many special factors involved with significant weight loss patients. Because of the amount of skin to be removed and the loss of elasticity of this skin, these patients must be treated very differently from non-gastric bypass body contouring patients. What may work well on other patients simply does not provide adequate shaping and contouring for the gastric bypass patient.

Dr. Nguyen understands the special needs of gastric bypass patients and has developed a comprehensive approach to help them achieve their optimal shape following weight loss. Dr. Nguyen designs a surgical plan specifically for each individual based upon the patient’s specific needs and priorities. Dr. Nguyen provides excellent results by applying the latest techniques in body sculpting, giving his patients the ability to feel more comfortable in and out of clothing You will be ready to consult with Dr. Nguyen once your weight has stabilized with no more than 5 lbs. lost per month over the last 3-6 months.

Often, patients will have several areas they wish to address. During your consultation, you will be asked to prioritize your areas of concern. Dr. Nguyen will assess your anatomy and your priorities to help you develop a comprehensive plan for your body contouring. During your initial consultation, your coordinator will work with Dr. Nguyen to determine which procedures, if any, will be likely be covered by insurance and authorization will be requested accordingly. You will often be given a quote on several different procedures that can be done together. For instance it is fairly common to combine a breast lift (with or without implants) with an arm lift, or a breast lift with a tummy tuck or thigh lift, etc. Dr. Nguyen will work with you to determine the best plan for you to achieve your overall body contouring goals. Patients who have undergone gastric bypass surgery have similar areas of concern. The corrective procedures necessary to regain normal body contour are similar for most patients.

Patient Testimonial "The service and the staff at Dr. Nguyen’s office are wonderful and I could not be happier with my results. I tell everyone about Dr. Nguyen and I have sent several people to him already." -- Shelley

Face Lift / Neck Lift
Some patients find that loss of facial fat during weight loss leaves them with loose hanging skin on their face and neck, causing a prematurely aged appearance. A facelift or necklift may be indicated to regain a firm, youthful appearance.

Mastopexy (Breast Lift)
Many women find that as they lose weight, they lose volume in their breasts, often more than they desire. The reduced volume is especially apparent at the top of the breast, decreasing cleavage and causing bras and clothing to fit incorrectly. Many gastric bypass patients require a breast lift (mastopexy) to lift the breast and reposition the areola to a higher, more youthful position. An implant is often used in conjuction with a breast lift to add volume, especially to the top of the breast if a breast lift alone will not accomplish the patient’s desired volume and shape.

Breast Lift/Reduction for Men
Men may also develop excessive tissue on the chest with weight gain & weight loss. Breast lift procedures are performed for men as well, alone or with reduction, to reduce size of the breast and create a more masculine contour.

Brachioplasty (Arm Lift)
Many major weight loss patients feel uncomfortable in short sleeves or sleeveless tops due to the looseness of the skin on their upper arms. This loose skin can also make clothing fit improperly and may limit the types of clothing you can wear. Brachioplasty, or arm lift, is a surgical procedure to remove excess skin and fat from the upper arm, reducing skin redundancy and improving the firmness of the skin in the upper arm area.

Panniculectomy / Tummy Tuck
The most common complaint of gastric bypass patients once they reach their goal weight is the loose hanging skin of the abdomen. The hanging skin of the abdomen, called the pannus or “apron” can cause a variety of problems for the patient. These include the inability to fit comfortably into clothing, difficulty in daily hygiene, yeast infections or cysts in the folds of skin, and lower back pain. The removal of this excess skin is acheived by panniculectomy, tummy tuck, or body lift procedures.

The term panniculectomy is used to describe the removal of the hanging, excess skin of the abdomen. This procedure does not include muscle tightening or liposuction. A panniculectomy may be covered by insurance if your plan allows for it and if you meet a series of standards set forth by the insurance regulators. A tummy tuck, on the other hand consists of three components: muscle tightening, liposculpture, and removal of excess skin. A tummy tuck is by definition a cosmetic procedure and is not covered by insurance.

Thigh Lift
Loose thighs may reduce the clothing styles you are able to wear and may cause problems such as rubbing and rashes on the inner thighs. A thigh lift is a surgical procedure to remove excess skin and fat from the thighs resulting in improved contour of the legs.

Lower Body Lift
A lower body lift is a common surgical procedure to remove excess skin and fat from the lower-middle body. This procedure tightens the abdomen and hips as well as lifting the buttocks and outer thighs. A lower body lift can markedly improve the contour of your abdomen, buttocks and outer thighs and will allow you to fit better in clothing and even wear clothing you have not been able to wear such as shorts or form fitting clothing.

What Will My Insurance Cover?

MAY BE COVERED

Breast Reduction
Reduction of the breast may be covered if the weight of the breast is causing pain and/or other health issues. Documentation from your primary physician of the neck and/or upper back pain, rashes, yeast infection of the skin under the breast, or other physical symptoms may be required. A minimum amount of breast tissue (approximately 500g) must be removed to show medical necessity. Also, documentation may be necessary to show that conservative measures have been attempted and have failed to alleviate symptoms. These measures may include chiropractor visits, pain medications, topical ointments for skin infections and rashes, etc. Photos will be taken at the time of consult to show the severity of the drooping, skin rashes/lesions, or shoulder grooving.

Panniculectomy
Removal of excessive skin over the abdomen may be covered if the pannus (hanging skin) occludes the pubic area and is causing health problems. Documentation from your primary physician of back pain, rashes, yeast infection of the skin under the pannus, or other physical symptoms may be required. Also, documentation may be necessary to show that conservative measures have been attempted and have failed to alleviate symptoms. These measures may include chiropractor visits, pain medications, topical ointments for skin infections and rashes, etc. Photos will be taken at the time of consult to show the severity of the pannus and skin rashes/lesions if present. Panniculectomy is not a Tummy Tuck and does not include tightening of the muscle or liposuction.

WILL NOT BE COVERED

The following procedures are not considered medically necessary by insurance standards and authorization may not be requested:

Breast Lift
Buttock Lift
Brachioplasty
Breast Augmentation
Thigh Lift