What to Do with Excess Skin After Hernia Repair?

Question

I had a major hernia surgery in 10/08. I had 3 major hernias and multiple minor hernias in scar tissue.  My surgeon said, "You had the cadilac of all hernia surgeries." That was fine, but now I have this huge mass of sagging stomach skin.  I don't feel it's "cosmetic surgery" to get this removed.  I cannot wear my clothes because of this extra skin. When my hernias were fixed, the doctor did tighten the top of my abdomen, but left the big sagging mess.  What should I do? Is there any hope for me that insurance will pay for this?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding excess skin after your hernia repair surgery. It sounds like you’ve undergone a major procedure to repair multiple hernias, and while the repair helped tighten the top of your abdomen, the excess skin you’re dealing with now is a common issue after significant surgeries, particularly in the abdominal area.

The best surgical option to address this excess skin is typically a tummy tuck (abdominoplasty) or a panniculectomy. Both procedures remove the sagging skin and improve the overall contour of your abdomen.

Here’s a breakdown of your options:

Tummy Tuck (Abdominoplasty): This procedure removes excess skin and fat from the abdomen and also tightens the abdominal muscles, giving you a more sculpted and flat appearance. Since your muscles were tightened during your hernia repair, the tummy tuck would primarily focus on removing the sagging skin.
Panniculectomy: This is a more functional surgery that focuses solely on removing the overhanging apron of skin (pannus) that may cause rashes, infections, and hygiene problems. It does not include muscle tightening. Many patients with excess skin after hernia surgery are good candidates for this procedure, especially if they’re dealing with discomfort or difficulty wearing clothing.
In terms of insurance coverage, some insurance companies will cover a panniculectomy if it can be proven to be medically necessary. For example, if you’re experiencing skin infections, rashes, or other hygiene-related issues due to the excess skin, your surgeon can document these issues and submit them to your insurance provider for approval. However, if you're looking for a more comprehensive cosmetic result (like a full tummy tuck), insurance may not cover it.

To explore your options further, I recommend consulting with a board-certified plastic surgeon who can evaluate your situation and help determine whether you might qualify for insurance coverage based on your symptoms and medical history.

Sincerely,
Dr. Katzen

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. It is hard to provided with a valid medical opinion without photos.  I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.
Kind Regards,Dr. Emmanuel Mallol Cotes.-

Jeffrey E. Schreiber, MD, FACS · Answer

Excess skin after a hernia can be removed with either a tummy tuck, a panniculectomy, or reverse abdominoplasty.  Whatever procedure is required depends on how much skin is remaining and where it is.  The unfortunate thing is that insurance will most likely deny paying for anything because it will be considered cosmetic.  However, it may be worth a try.  Have your plastic surgeon send in a letter and pictures to support your case.  If it's still denied, you could explore financing options or check our your local plastic surgery residency office...their cosmetic prices are usually the lowest in town.

Michael Diaz, MD · Answer

Hello,
Although I am not sure why you have had the problems you have had, you can of course have your implants removed. Without seeing you it is difficult for me to tell you what you might look like afterward. It is highly probable that the problems you are having are not related to the implants, but it is your body.

What to Do with Excess Skin After Hernia Repair?

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What to Do with Excess Skin After Hernia Repair?

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