Can you get a tummy tuck because of medical reasons?

A TT is considered a cosmetic procedure which is not covered by insurance. If deemed medically necessary, in some cases, health insurance will cover a panniculectomy.  Both the TT and the panniculectomy target the abdominal region of the body.  However, a TT removes excess fat and skin and tightens the abdominal muscles, whereas a  panniculectomy targets the area of excess tissue located underneath the belly button. A hanging pannus can cause difficulties with back pain and hygiene, making day-to-day tasks difficult as it hangs in the way.Recommend that you select your plastic surgeon by credentials, before and after pictures, reviews, accreditation of facility, board certification of surgeon, ease of contact and treatment particularly after surgery, etc.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

A tummy tuck is considered a cosmetic procedure. However, you’ve mentioned that you have issues with skin folds. If you have a pannus (an apron of skin hanging below the waist) this can be covered by OHIP. The procedure is known as a panniculectomy.

Absolutely. While it is technically considered a cosmetic procedure, a tummy tuck can have considerable medical benefits as well. During a tummy tuck, damaged or separated abdominal muscles are often repaired. This can help reduce back pain and correct posture issues in many cases by improving spinal support. However, it’s important to remember that despite its medical benefits, many insurance providers still consider a tummy tuck to be a cosmetic procedure and will not typically cover the surgery.

Thank you for your question. You will be unlikely to get insurance coverage for a tummy tuck, but you may get coverage for a panniculectomy.  This is the removal of only the skin hanging below the fold.  It does not address the muscle laxity, the belly button, or any excess skin around or above the belly button.  In my opinion, this operation performed by itself generally results in a less than aesthetic outcome.   Typically I require any patient who wishes a medical insurnace panniculectomy to pay out of pocket for the remaining portion of the cosmetic tummy tuck to get the best possible result.  Best to see a board certified plastic surgeon for optimal advice. Good luck. 

Hello and thanks so much for your question. You will require a consultation and examination in order to assess and submit a possible OHIP covered panniculectomy. The surgeon will explain what exactly is covered and what is not. Be sure to visit surgeons that specialize in this type of procedure. Best of luck!!

Thank you  for your awesome question! Your bio is very helpful, however without the benefit of knowing your full health history and an in person exam it's impossible to say for certain. 
  I would recommend you have an in person consultation with a plastic surgeon with these credentials: *Board Certified by the American Board of Plastic Surgery -- The gold star symbol*A member of the ASPS (American Society of Plastic Surgeons) -- The circle symbol*A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) -- the Queen Nefertitti symbol with a Triangle  *On faculty at local plastic surgery teaching program -- in our office we are affiliated with both Duke and UNC schools of plastic surgery.    Feel free to contact our office, it would be our pleasure to answer your questions in person. I hope this is helpful and wish you all the best in your journey.  My sincere best, Brian S. Coan, MD, FACS 

Thank you for the question.
The tummy tuck operation is an  abdominal wall contouring operation that serves to reapproximate the abdominal wall muscles that have spread with pregnancy and remove the “excess skin” of the lower abdomen.  It is generally consider an "aesthetic" procedure, compared to the panniculectomy operation (involves primarily removal of the lower abdominal wall apron) which may be considered more of a “medically necessary” procedure. 

The panniculectomy operation involves excision of the lower abdominal wall pannus or  overhanging skin/adipose tissue. It is not considered an  aesthetically driven procedure;  it is often performed to help with concerns such as skin breakdown, infections/rashes… 
  Ultimately, careful selection of your plastic surgeon will be the most important decision you make.  Careful physical examination and careful communication of your goals will allow for you and your plastic surgeon to plan the appropriate operation. 
I hope this, and the attached link, helps.  Best wishes.