I am 25 years old with 3 kids (all 3 c sections), and I have lost about 75 lbs. I am at my goal weight of 121 and I am 5'5. I have a small amount of excess skin on my lower stomach. I have Tricare Prime insurance and they are paying for ventral hernia repair. I was wondering around how much I would have to pay for a panniculectomy in conjunction with a hernia repair.
Whats the Average Price of Panniculectomy During Hernia Repair?
Doctor Answers (5)
Your hernia repair can be done through a transverse incision which is the same incision required for resecting the pannus. Resecting the hanging skin would add approximately 1 hour to your operating time. Operating time is about $1,000 an hour and the surgeon's fee is about $1,000 to $2,000 an hour. Your are looking at approximately $3,000 to do the panniculectomy.
Gary Horndeski, M.D.
Do Not undergo panniculectomy just because you think insurance might pay!
Congratulations on your weight loss! After pregnancy stretches your abdominal muscles you have a diastasis, and occasionally an umbilical hernia. True ventral hernias are more uncommon, but can occur. This would mean you actually have intra-abdominal contents (intestines, colon, or omentum) protruding outside your abdomen into the subcutaneous tissues, much like a weak spot in an inner tube. This warrants surgical repair to avoid stangulation of the bowel and peritonitis.
A small "outie" belly button is NOT a ventral hernia, and if your surgeon is telling you s/he can obtain coverage for hernia repair so that you can have (part of) the operating room fees and anesthsia costs "covered" by insurance, this is "stretching the truth" at best, and insurance fraud at worst. You could get stuck with the entire hospital bill, which will be thousands more than paying for what you really need and want, which is a tummy tuck with muscle repair.
The surgeon asks for separate payment "on the side" for the "cosmetic" part of the surgery. But your basic charges at the hospital (OR, anesthesia, etc.) are all billed at the (much higher) hospital rate, so even the "self-pay" portion of the operation can end up costing more than if you paid for the entire tummy tuck procedure (and skipped the attempt at coverage) by a reputable ABPS-certified plastic surgeon who will repair the hernia and diastasis as part of the cosmetic tummy tuck operation you actually want/need.
You do not have a pannus (by your description of a "small amount" of loose skin of the lower stomach), and panniculectomy is the wrong operation anyway, even if it IS "covered" by insurance.
Read Dr, Aldea's answer as well as the other answers here. Also, check on the credentials of the surgeon who is recommending this plan--I am concerned that s/he is not an ABPS-certified plastic surgeon, or has questionable ethics that might mislead you into either the wrong or an incomplete-result operation, inadequate tissue removal and need for another (self-pay) re-do operation, and/or a much more expensive than anticipated operation when all the bills get added up.
See a few more ABPS-certified plastic surgeons and get an idea who is telling the truth here. You deserve a fabulous result after all your hard work, even if it does cost a bit more up front. Factor-in the costs (not only money but time off work and repeat risks) of secondary surgery to get things right, and you see why we're concerned about your question and the "plan" as outlined. Best wishes! Dr. Tholen
Tummy Tuck or Panniculectomy Candidate?
Congratulations on your significant weight loss; you should be proud of this accomplishment. Based on your description, it sounds like you may be an excellent candidate for tummy tuck surgery. This operation differs from panniculectomy surgery. Tummy tuck operation will serve to reapproximate the abdominal wall muscles that have spread with pregnancy, will provide exposure for repair of the ventral hernia, and will remove the “excess skin” on the lower abdomen. Often, the presence of a C-section scar does cause the excess skin to overlap more so than it would otherwise.
You will find that the costs of abdominoplasty surgery will vary from region to region and from one office to another. It will be up to you to do your due diligence in the process of plastic surgeon selection. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.
I would also suggest that you do not base your selection of plastic surgeon primarily on costs of surgery; keep in mind that revisionary surgery may be more costly in many ways.
I hope this helps.
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Ventral Hernia VS. Muscle Separation, Insurance VS. Self-Pay Tummy Tucks
Your question is commonly asked and touches on several topics:
- Are pregnancies often associated with VENTRAL HERNIA (which depending on your insurance MAY be covered) VS. MUSCLE SEPARATION (whose repair is never covered by insurance companies)?
- Is pregnancy commonly associated with creation of a skin/fat overhanging apron ("Pannus")?
- What is the BEST way to find a Plastic surgeon who is most likely to help me achieve my cosmetic goals?
A Ventral Hernia is NOT the same as a Muscle Separation (diastasis). In order for a uterus to achieve the size it reaches at 9 months / full term it ALWAYS irreversibly stretches out the abdominal muscles and skin to a variable extent AND it irreversibly separates the six pack muscles (diastasis) to SOME extent. But it uncommonly causes and intra-abdominal organ/structure to squeeze out through a canal/sac into a location it does not normally occupy (the definition of a hernia).
Age and pregnancy(ies) create skin laxity but NEVER create a pannus. Since the skin stretches AFTER the underlying muscles have been stretched, merely removing the lower skin WITHOUT "taking in" and tightening the stretched out and separated tummy muscles (ie a "Panniculectomy") will NEVER result in a flat, attractive tummy and is the wrong operation in women who had one or more children.
No private medical insurance company and especially no Federal health coverage plan (Medicare, Medicaid, Champus, Tricare etc) EVER pays for cosmetic surgery, including tightening of the the tummy after pregnancies by repairing muscle separation. Furthermore, attempting to fool them will NOT be received kindly and may well result, as it should, in a FULL fraud investigation which may end in stiff fines and prison time.
Surgeons who climb over each other to offer you the lowest prices are NEVER the best surgeons and have to do so. Furthermore, anyone who is willing to commit insurance fraud, risking destruction of his career and jail time, by misrepresenting a muscle separation (diastasis) as a hernia and perform a Tummy Tuck (Abdominoplasty) by having the public pay for it is obviously not guided by basic considerations of self-preservation much less, ethics. Do you REALLY think such an individual would care about the quality of his work or your well-being? Think again.
Consult The American Society of Plastic Surgeons - wwwplasticsurgeryorg for its membership. See several Plastic surgeons and go with the one you like the most. A young, slim healthy woman such as your self should get a FANTASTIC result in the right hands. Please, do not compromise your health or results.
Peter A Aldea, MD
Panniculectomy versus Tummy Tuck
A panniculectomy is a procedure that is usually reserved for patients with a great deal of excess skin and soft tissues in the abdomen after significant weight loss. From your description, you have a "small amount" of excess skin in the lower abdomen which is best managed by a tummy tuck procedure. Exactly which form of a tummy tuck would be the best option for you depends upon where the excess tissues are on the abdomen and the quantity of those tissues. This requires a consultation and an examination, hopefully with a board certified plastic surgeon.
Hernia repairs and tummy tucks are frequently performed at the same time depending upon the patient's health and the ability to coordinate the general surgeon's and plastic surgeon's schedules. While hernia repairs are covered by almost all insurance carriers, tummy tucks are cosmetic and not a covered procedure. Hope this helps and best of luck.