Ask a doctor

My Diastais is Caused Form Transplant Surgery. Would Insurance Cover This Repair?

I had transplant surgery that cut me from sternum to belly button. I do have 3 children, but did not have this until transplant. Have already had therapy on back and chest from poor posture and lack of support. Would insurance cover this? I don't want my huge scar removed or anything like that. Just want this separation gone.

Doctor Answers (4)

Diastisis v. hernia

+1
  • Diastasis often occurs after gradual stretching of the abdominal cavity (pregnancy, weight gain).
  • After an incision as you have had, the weakness in the abdominal wall is likely to be a hernia.

 

Consider an evaluation with your transplant surgeon, who may be able to distinguish these two by exam, and if not by CT scan. He or she would be capable of repairing this, and more importantly helping you evaluate the benefits and risks of any surgery being contemplated.

 

Best wishes


Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Diastasis repair covered by insurance?

+1

If you have an actual hernia, then insurance will likely cover repair by your general surgeon. Diastasis (separation caused by stretching of the abdominal wall fascia) may be a harder "sell" to your insurance provider, but a tummy tuck by a plastic surgeon will almost certainly be denied. Insurance only covers repair of a functional problem, and would not cover any cosmetic component of this surgery. The cost to you (for the cosmetic "part" done in the hospital during the "functional part") may actually be more than if you simply have an ABPS-certified plastic surgeon perform the surgery you really want and need--a tummy tuck with included muscle repair.

Dr. Beraka poses a very reasonable additional concern. If you are on immunosuppresive drugs, there are additional risks that may overweigh cost and coverage questions! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 110 reviews

My Diastais is Caused Form Transplant Surgery. Would Insurance Cover This Repair?

+1

The only way to be sure is to see a surgeon who does that type of surgery and have him try and preauthorize the procedure with your company. Be careful of terminology as diastasis and hernia are quite different. Sounds like you have an incisional hernia. A scan should be able to deliniate the difference.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

You might also like...

Diastasis recti repair may be covered by insurance in your case.

+1

Hi.

The more important question is should you be contemplating elective surgery after a transplant.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.