Who Should Pay for Further Surgery? Flat Breast After Partial Mastectomy Filled by Fat Transer.

I had a partial mastectomy as a result of breast cancer. I was left with a small area of the breast that was flat. I opted for a fat transfer to fill this in. Since the transfer, I have what I describe as a kangaroo pouch, about 10 inches across the lower abdomen, almost pelvic bone to pelvic bone. The surgeon says this is because I had a hysterectomy scar there causing the skin to bulge. This is worse than the slight flatness of the breast was. Who has to pay for the tummy tuck to fix this??

Doctor Answers 3

Pouch on Abdomen after Harvest for Fat Transfer to Breast

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   The amount of fat needed to graft a small flat area on a breast would be no more than 100 cc.  This amount should not cause a real change in skin laxity.  Is it possible that there was skin laxity present before the procedure?  Kenneth Hughes, MD Los Angeles, CA

Charge to treat donor site defect

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Th answer to this question varies widely between insurance companies, specifics of the defect, and circumstances of the procedure.  If a significant deformity resulted from a procedure intended to treat a reconstructed breast (i.e., donor site for fat transfer), your insurance company may indeed cover a revisional procedure to address the donor site.  If, however, you elected to have cosmetic liposuction performed in conjunction with the fat transfer, this may be considered a complication of a cosmetic procedure, and this would not be covered by your insurance.

Please talk with your doctor and to your insurance company about your options.  You may even consider getting a second opinion if you feel your questions are not getting answered.  I can assure you that a full tummy tuck will not be covered by your insurance, but a scar revision or panniculectomy procedure directed at reducing redundant lower abdominal tissue might be possible.

All the best,

Dr. Skourtis


Mia E. Skourtis, MD
Portland Plastic Surgeon

Who pays for unexpected results from donor sites?

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I'm afraid this is and should be your responsibility.  There are many other issues that could influence this and these are usually clarified with your doctor before surgery.  If your doctor charged you for liposuction of your tummy at the same time, then a revision policy usually applies here.  If he did not charge you for that and only charged your insurance for the fat grafting, then the tummy issues should be your responsibility.  

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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