Extended tummy tuck: what happens to upper thigh/butt skin & can I get OHIP coverage?

Question

32, 2 C-sections, Significant weight loss - Does the skin on the upper thigh and love handle area get pulled tight during an extended tummy tuck? Also, does anyone know if you can get OHIP or Private coverage for any part of a tummy tuck? I was thinking that the abdominal muscle repair might be? Has anyone ever heard of this or had a patient that has?

Daniel Barrett, MD · Answer

Dear stephie.laurie,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Peter D. Geldner, MD · Answer

I wish you the best luck while recontouring you body after substantial weight loss. Extended abdominoplasties/tummy tucks are typically an abdominoplasty plus posterior body lifts. The extent of surgery is based on your existing skin excess and your health (how much surgery is safe for you). Sometimes, additional areas are included in a single procedure, sometimes not. I would suggest you address these with a board certified plastic surgeon to discuss your options. 
As for as insurance coverage; it depends. Every private insurance provider stipulates what is a covered and what is not in their insurance policy. If you call them, they will tell you what is required for coverage. I am not familiar with Ontario's health insurance plan. 
Your first step is to seek a consultation and discus how best to proceed. The second step is to see how to make it happen. That involves the cost and the payor. All the best.

Connie Hiers, MD, FACS · Answer

With a tummy tuck, your thigh and buttocks are not changed. I know you can pull your own skin and these areas appear to improve. However, surgery on the abdomen does not change other areas.  In the US, insurance companies may possibly approve a tummy tuck if over 100 pounds of weight has been loss and a medical doctor has documented treatment for things like rashes for at least 3 months. Diastasis or widening of the abdominal muscles after childbirth is not covered. Childbirth is an elective choice in the eyes of insurance companies.

Camille Cash, MD · Answer

Congratulations on your weight loss! Depending on the length of your incision there may be some improvement in the hip area.  If the incision goes all the way around the body (circumferential tummy tuck or lower body lift) the buttocks will also be addressed.  The thighs are not addressed during a tummy tuck, but rather through a thigh lift.  This procedure is considered cosmetic and is not covered by insurance.  To learn more visit with a board certified plastic surgeon near you.

Mats Hagstrom, MD (license on probation) · Answer

Without including pictures for context, is difficult to give you a meaningful answer. A tummy tuck is not considered medically necessary, and is not covered by medical insurance. The only medical coverage for this procedure is skin excision on weight loss patients who have chronic skin infections that cannot be treated without surgery. Muscle tightening is not an necessary medical condition and is not covered by medical insurance. 
Medical insurance is a communal effort to help individuals deal with unusually high cost. Medical care. Financial resources from medical insurance companies should be spent in a manner that creates the most good for the members of the plan. Medical insurance should not pay for cosmetic surgical procedures because it takes resources from those who need proper needed medical care.
I suggest having multiple in person, consultations for local board-certified plastic surgeons in your community to get an assessment and get your questions answered properly.
Best,
Mats Hagstrom, MD

Extended tummy tuck: what happens to upper thigh/butt skin & can I get OHIP coverage?

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