My apron stomach - what options do I have to get this treated?

Question

Hi my name is Juanita and I suffer from pcos and have gained and loss a big deal of weight. Now tht I’ve had all my kids I have a big hangin stomach which is causing so many health and skin problems, especially my vaginal area with hygienic problems. I have Medicaid. I’m trying to find options to help me get this procedure

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question, Juanita. Based on your description of the apron stomach and the associated health and skin issues, you have a couple of options for treatment, especially given the medical concerns you’ve mentioned, such as hygiene issues and discomfort in your vaginal area.

Panniculectomy: This procedure removes the excess hanging skin and fat (the apron) from the lower abdomen. It’s primarily a functional surgery, designed to address problems like hygiene, rashes, and discomfort caused by the excess skin. Given your medical issues, Medicaid may cover this procedure if you can demonstrate that it’s medically necessary. Documentation from your doctor showing issues like rashes, infections, or other health problems caused by the excess skin will be essential in obtaining insurance approval.

Tummy Tuck (Abdominoplasty): While similar to a panniculectomy, a tummy tuck not only removes excess skin and fat but also tightens the abdominal muscles and improves the overall appearance of your midsection. However, this is generally considered a cosmetic procedure, so it may not be covered by Medicaid. If you are looking for both functional and cosmetic improvement, some plastic surgeons may offer the option to combine a panniculectomy (covered by Medicaid) with a tummy tuck, where you can pay the difference for the additional muscle repair and aesthetic benefits.

To get started, I recommend reaching out to your primary care physician or a plastic surgeon to discuss your options. You will need to document the medical reasons for the panniculectomy and follow the appropriate steps to submit a claim to Medicaid for coverage.

I hope this helps, and I wish you the best in addressing these concerns.

Sincerely,
Dr. Katzen

Adam Kinal, MD · Answer

Dear Graceful955656, Thank you for your question. However, giving a proper assessment with an in-person examination is easier. Don't hesitate to contact several Board Certified Surgeons who specialize in these procedures to get their evaluation. Several options may be available, including a Panniculectomy, a procedure that can get rid of 'the apron' of tissue, but you may need more. Several types of tummy tuck procedures may suit you better. A Tummy Tuck will address the skin of the upper and lower abdomen, get rid of those old scars from pregnancies, and more. Still, it is advised to seek an in-person evaluation with an experienced surgeon specializing in these procedures. Good luck.

Daniel Barrett, MD · Answer

Dear Graceful955656,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

If you have achieved your weight loss goal and are able to maintain it you will get the most complete results from a tummy tuck.  This will remove excess fat and skin as well as repair abdominal wall laxity.  The result will be a flatter, tighter abdomen.  This procedure will need to be paid out of pocket as it is not covered by insurance.  If you are wanting to use insurance you can explore a panniculectomy.  This procedure simple removes the hanging apron of skin from your abdomen.  You will need to find out the criteria needed for coverage with your insurance carrier.

H. Joseph Naim, MD, FACS · Answer

After you lose the excess weight with Bariatric Surgery, then you are a candidate for Panniculectomy.You can also consider a more complete treatment like Panniculectomy with muscle tightening and repositioning of the Belly Button, aka Tummy Tuck.Both of them can be done now, but will look better after weight loss.Best of luck.

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