Hernia Repair and Tummy Tuck at the Same Time on a Male?

I'm a healthy 32-year-old male. Over 2 years I lost 122 pounds through diet and exercise. Over the last year, I've gained 10-15 pounds of muscle and am currently around 195lbs, 5'9". My body fat was checked through water-dunking and was at 10.7%. I have loose skin around my lower abs/love handles. No loose skin anywhere else on my body. I also have 2 large hernia's in my lower ab/pubic region. This is from 3 years of cardio and kickboxing approximately 2 hours a day, everyday.

I have Healthnet HMO. Is it possible to get my hernia repair and Tummy Tuck surgeries at the same time? Would my HMO cover any of the costs involved with these surgeries?

Doctor Answers (10)

Tummy tuck and hernia repair in a man

+2

You may be one of the rare patients who can have a panniculectomy alone with a hernia repair, rather than a conventional tummy tuck, given your appearance. It doesn't appear that you have a lot of upper abdominal skin excess. Congrats on the abs of steel! The difficult decision (and I can't see fully from your pictures) will be what to do with the flanks, incision vs. live with the excess. You should talk to your PS about the options.

We are routinely denied when we perform a hernia repair with an abdominoplasty, even if mesh is required, separate umbilical hernia repair during a hybrid tummy tuck (R), etc. We have given up.

If you are diligent and persistent and your surgeon is patient, you may get your insurance company to cover the combined procedures after multiple appeals. However the chances are good your claim will be denied.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Combined Hernia Repair and Tummy Tuck in a Healthy Male.

+1

Your disciplined weight loss is admirable.

  • Approach your insurance company directly to see if they will cover part of or all of your abdominoplasty procedure along with your hernia repairs (hernia care is almost always covered by health insurance).
  • Have your insurance company provide you with a list of participating general surgeons who could repair your hernia.   If they will cover part or all of the tummy tuck, get a list of their plastic surgery providers, as well.
  • Schedule an appointment with a general surgeon to discuss your hernia repairs. If you are comfortable with this doctor, ask him (her) for the name of the plastic surgeon in your community (who participates with your insurance plan) that would do the best job for you with your abdominoplasty.

Best Regards,

Douglas J. Raskin, MD, DMD
Colorado Springs Plastic Surgeon
5.0 out of 5 stars 22 reviews

Hernia Repair and Tummy Tuck

+1

Hernia Repair (which insurance will generally pay if medically necessary) can be combined with a panniculectomy or tummy tuck.  A plastic surgeon can perform both or you can have a general surgeon perform the hernia and then a plastic surgeon to take care of panniculectomy or tummy tuck.  Consut with 3 surgeons in your area to get a clear understanding of your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 15 reviews

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Should.

+1

Your best bet would be for you to have the general surgeon fix the hernia, and the plastic surgeon to do the tummy tuck.  The ps will usually expose the hernia, and then return to complete the tt.

Insurance should pay for the hernia if medically needed, but not the tummy tuck as this is cosmetic.

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 45 reviews

Congratulations on the weight loss

+1

You probably have the best body I have seen after a 122 pound weight loss.  As Dr. Moelleken said, you could just have the lower abdominal skinn excess removed without a full tummy tuck and get the hernias fixed simultaneously.  Couldn't say though anything about costs and or coverage. 

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Hernia Repair with Tummy Tuck

+1

Congratulations on your weight loss! You can have a tummy tuck performed at the time of your herniorraphy if your general surgeon agrees. The main benefits are only one period of down time and some cost reduction, although it is unlikely that your insurance will cover the tummy tuck unless there are special conditions.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Congratulations!

+1

Good job on the weight loss and getting into shape. The two procedures can and probably should be done at the same time as the overall costs and recovery time will be less. I really doubt that any insurance will cover the tummy tuck AND beware, some insurers refuse to pay anything if these two procedures are done together.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 17 reviews

Hernia Repair and Tummy Tuck

+1

Given your insurance company, which I have dealt with before, your plastic surgeon would have to submit for a preauthorization for the hernia portion. If that is approved then you are good for the surgery, anesthesia and OR portion of the hernia repair. The tummy tuck will not be covered and you would be responsible for the costs accrued for this part of the surgery. That would included the OR, Anesthesia and Surgeons fees for the tummy tuck portion.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 31 reviews

Hernia repair with Abdominoplasty

+1

By getting "precertification" for the hernia repair you know that the anesthesia as well as the surgeon's cost for this part are covered. But you also need to know if they will cover an overnight stay as most hernia repairs are done as an outpatient but your surgeon may want at least one night stay for the abdominoplasty. Discuss these things with your surgeon beforehand so you know as close as possible what your out of pocket expenses will be. Remember, also, that you probably have deductibles for the surgery and the hospital.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Yes herniorrhaphy and abdominoplasty can be performed simultaneously

+1

Yes it is possible to have both surgeries at the same time. However, your insurance will likely cover only the hernia portions of the procedure. Of course, you will need to have this approved by your primary care giver. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 43 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.