Sean Yuan, MD, FACS

Facial liposuction may not significantly change an overall round facial appearance. Consider starting with masseter neuromodulator injections and possibly chin and filler injections for a more balanced result before considering definitive facial surgery.

It is very difficult to predict accurately the condition of your lower abdomen after an additional 30 lbs of weight loss. A better approach would be to reach your goal weight and maintain it for several months before considering the best treatment plan. Considering that you are young, have not had any pregnancies, and will have a BMI of 21 once you reach your goal weight, there is a good chance that you may not need surgical treatment. You may consider skin tightening if concerns arise

You've already explained why you don’t wish to have a tummy tuck, and your condition doesn’t necessarily require one. If you'd like to further tighten the skin, you might consider liposuction combined with skin tightening using Renuvion or BodyTite.

The nose won’t change significantly after weight loss. However, you should wait until you can tolerate a solid diet and feel fully recovered before considering any elective procedure, including rhinoplasty. I recommend waiting at least 2-3 months.

Here are several steps you need to take to increase the chance of having your panniculectomy covered by your medical insurance if you live in Pennsylvania. It is important to note that a panniculectomy is not the same as a tummy tuck.

If you have undergone significant weight loss, such as after bariatric surgery, you must wait for two years and ensure that your weight has been stable for the past six months.

Contact your medical insurance provider to confirm that there are no exclusions for this procedure. It may be helpful to obtain a copy of your coverage and review it thoroughly, line by line.

Next, you need to establish that the surgery is medically necessary by following these steps:

Have a physician, such as a family doctor (not the surgeon who will perform the surgery), document your skin condition, specifically intertrigo, for a minimum of three months with ongoing medical care and without remission or with recurrence.

Both physicians need to document that your abdominal condition negatively impacts your normal lifestyle and/or job performance.

The physician(s) should document that the excess soft tissue meets specific criteria, such as hanging beyond the pubic area, and provide the necessary photos as required by the insurance company.

You will need to find a physician who is willing to take on your case and check for any special requirements from your medical insurance. This physician should also be willing to communicate with the insurance company to obtain pre-approval. Please note that if you have Medicare, it may be even more challenging to find a physician. Medicare may not provide pre-approval and may consider the procedure as cosmetic, regardless of your condition. The surgeon may only find out after the surgery is performed.

If you successfully fulfill all the aforementioned goals, you will have a chance of having your panniculectomy covered by your medical insurance.

Sean Yuan, MD