I Want an Abdominoplasty. What Can Insurance do For the Hernia Repair I Need? (photo)

There's a a huge gap in my stomach muscles & hernia from pregnancy, I look pregnant. My chiropractor attributes it to core weakness. My stomach gets upset when I run- nothing feels tucked in. My hernia is painful with exercise.Had a consultation w/a PS, and he said most PS’s won't deal with insurance companies, but he’d fix my hernia along with the TT without charging extra.Are there surgeons out there who work with insurance companies? Thoughts on going through a residency program to save $?

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5 Doctor Answers | Asked by RJ83 in Lynnwood, WA

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Bulge after pregnancy: diastasis or hernia?

How can you tell the difference between a rectus diastasis - or weak gap between the vertical stomach muscles - or a true hernia? First of all, put your fingers in your belly button, while you are lying down. Do you feel an "edge" or "hole" that your fingers can drop through? Note: if yes your fingers are right next to your bowels right now! Next, lie down. When you try to sit up (like four or five inches), can you feel a gap between your muscle edges (esp check below the... more

Lisa B. Cassileth, MD

3 reviews

Beverly Hills Plastic Surgeon

Abdominoplasty with mesh reinforcement ventral herniorrhaphy

Insurance will pay for hernia repair which can be performed at the time of abdominoplasty. The insurance company WILL NOT pay for the abdominoplasty portion of your operation. Most plastic surgeons are trained in general surgery and can do both procedures to minimize your out of pocket costs. Abdominoplasty with mesh reinforcement has been shown to be effective in producing weight loss and maintaining the reduced weight. Best of Luck, Gary Horndeski, M.D. more

Yes, hernia surgery and tummy tuck can be performed at the same time

Thank you for your question and photo. This photo does not look natural. Please see two or more board-certified plastic surgeons in person for a consultation and examination. If you do have a hernia, hernias are usually a covered benefit under insurance. Tummy tuck is a cosmetic surgery.

Repair of Hernia During Tummy Tuck

Based on your picture you certainly do look pregnant. I suspect that you have a very incompetent abdominal wall with Diastasis Recti ( separation of your large abdominal muscles) and likely a ventral hernia. This will require more than just a standard tummy tuck and may involve the need for synthetic mesh of biological grafts ( alloplastic material ). I strongly urge you to consult with a Board Certified Plastic Surgeon who performs reconstructive surgery. Many plastic surgeons who do... more

Rectus Diastasis

The separation you are describing is probably a condition called Rectus Diastasis. This happens when the 6-pack muscles separate with pregnancy and fail to return to normal. It’s not really a hernia. My experience has been that no insurance companies will cover this. I occasionally submit for persons with dramatic photos like you but again denial is the norm. Sometimes depending on your insurance plan it’s actually less expensive to just have a... more