My c-section scar still burns and hurts after 7 years. Will a tummy tuck help or worsen this? Will insurance pay?

Question

I've had 2 c-sections, my last 7 years ago. I have a decent amount of sagging and overhang skin. I understand there is a surgery to cut out scar tissue, but in wonder if a tummy tuck would make more sense? If so, will insurance cover it if it's aiding the reduction of pain due to my c section? I'd hate to get 2 surgeries. Is there any circumstance that an insurance company will cover a tummy tuck?

Richard H. Fryer, MD · Answer

Insurance companies will not cover tummy tucks even if it is for a symptomatic scar. The only thing they would pay for is a scar revision (which doesn't achieve anything like a tummy tuck for your appearance).I would suggest investigating a tummy tuck. No one can guarantee that it will improve the pain (just like a scar revision may or may not improve the pain), but at least you will get the added benefits of a tummy tuck.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.If the scar hurts it might be a keloid.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.best of luck!Dr Schwartz

Alan Muskett, MD · Answer

Sometimes releasing a tethered scar will help chronic discomfort.  No guarantee certainly, but I've seen it often enough that I wouldn't discount it.  Getting insurance to pay for it is unlikely,  frankly.  If you really want a tummy tuck tell your SO to forget the motorcycle and get you that abdominoplasty.

Sugene Kim, MD, FACS · Answer

Hi, cassiamyers.  If you have handling skin, you may be a good candidate for tummy tuck.  c-section scar can be removed and replaced by tummy tuck scar.  Tummy tuck is an elective cosmetic surgery; tummy tuck is not covered by insurance.  If your c-section scar is hypertrophic, scar excision may be covered by insurance.  Please consult a board-certified plastic surgeon to see whether you are a good candidate for tummy tuck.

William H. Sabbagh, MD · Answer

Hi cassiameyers, If you have a tummy tuck it will remove your C-section scar.  However if you are a scar former which may be why your scar still hurts your tummy tuck scar may also cause problems. During your consultation the surgeon will evaluate the scar to determine if you may be a scar former and discuss this with you. I do not think insurance will cover this procedure.

Brian K. Brzowski, MD, FACS · Answer

......but NOT for a tummy tuck. A tummy tuck is a cosmetic surgery procedure designed to improve appearance and is not a functional operation. I'd suggest you contact your insurance company to ask if they'll cover treatment for a painful scar. If they answer yes, then you certainly could consult with a surgeon regarding treatment.If your goal is to instead remove excess skin, then you may be a candidate for a tummy tuck. This decision will best be made in consultation with a board certified plastic surgeon. The tummy tuck is likely to remove the scar and potentially eliminate the discomfort that you are currently experiencing. Best of luck.

Kelly R. Kunkel, MD · Answer

During a c-section, in addition to the transverse skin incision, muscles that run up and down from the rib cage to the pubic bone are also cut.  A tummy tuck, on the other hand, does not include cutting those muscles.  I frequently do tummy tucks on women who have previously had a cesarean section (or two, or three).  Usually the incision for a tummy tuck is made an inch or two below the old c-section scar.  The old c-section scar is removed during the tummy tuck, but the scar that was originally created in the muscle is not removed.  If a woman has pain from a c-section scar, the pain could be related to the scarring that occurred in the skin and fatty tissue, or the pain could be related to the scar in the muscle.  If the pain is related to the scar in the muscle, a tummy tuck will not improve that pain because the muscle scar is not removed.  It seems very unlikely to me that an insurance company would cover a full tummy tuck for pain related to a c-section scar.  Sometimes an insurance company will pay for a scar revision, but that is a far different thing than a full tummy tuck.  Visit with a plastic surgeon and have an in-person evaluation.  The surgeon may be able to send a letter with photographs to the insurance company to see what they might cover.  It would surprise me if they covered a tummy tuck or panniculectomy.  However, as I tell my patients here in Fort Worth, if the Texas Rangers can go to the World Series two years in a row (which they did a few years ago), anything is possible!

Tom J. Pousti, MD · Answer

I am sorry to hear about the problem you are experiencing. Good advice would necessitate a complete history and physical examination to determine  the most likely source of discomfort/pain. If the C-section scar is the culprit, it is possible that removal of the scar ( either with a scar revision or tummy tuck surgery) may be helpful. Given the presence of "overhanging skin", it sounds like you may be a good candidate for tummy tuck surgery in general.  Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.  You will likely find that insurance companies will not cover the tummy tuck procedure. I hope this, and the attached link, helps.  Best wishes.

Ronald V. DeMars, MD (Retired) · Answer

IF the C-section scar is the culprit, revising it with or without a TT will probably take care of your symptoms, but there is no way to be sure. Insurance does not pay for TTs but may pay for the scar revision.

Robert E. Zaworski, MD (retired) · Answer

Insurance companies do not cover tummy tucks.  Consult with a Board Certified Plastic Surgeon to discuss your options.

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