Skin removal on thighs after 310 pound weight loss. Can it be considered medically necessary? (Photo)

can thigh surgery be considered medically necessary? i have lost 310 pounds and the skin on my thighs gets caught in toilet seats. which then causes skin to get torn bleed and a host of rashes and so on. the folds come down over bend of knee and caused likely permanent issues after knee replacement with vomplications from scar tissue

Doctor Answers 3

Skin removal on thighs after 310 pound weight loss. Can it be considered medically necessary?

Usually not, but insurance carriers are different.

I would try to find a board certified plastic surgeon who has performed hundreds of these procedures and who has pictures and reviews you like.

Kenneth Hughes, MD

Los Angeles, CA


Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Medically necessary thigh lift

Thank you for asking about your thigh lift.

  • First of all, congratulations on your weight loss.
  • I am sorry to hear of the problems you have with the resulting excess thigh skin.
  • Since every insurance policy is different, you need to do three things.
  • First call your insurer, explain the problem and ask if it could be covered or if it is specifically excluded from your insurance. If it is excluded, thigh surgery will not be covered.
  • If it might be covered, next find the list of plastic surgeons on your insurance panel and see one of them.
  • At consultation, if your surgeon feels that correction is medically necessary, your surgeon will need to write a pre-determination report explaining why surgery meets insurance coverage criteria.
  • That said, I have not seen any insurer in my area cover tummy tucks or any other body lift for several years.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Options

The covered benefits under your insurance policy are unique to your policy and also the market climate where you live.  In my experience, this has been a cosmetic procedure over the past 20 years.  I would advise that you contact your insurance carrier and pose the same question to them.

Hope this helps.


Dr. Ali Mosharrafa

Ali Mosharrafa, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 14 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.