Does the Patient Have to Pay for Tummy Tuck Revision Cost?

When a plastic surgery (abdominoplasty) revision is necessary, does the patient have to pay?

I paid for a full Tummy Tuck, but the result I have been left with is pretty hideous by anyone's standards. My plastic surgeon attempted to right his wrong by performing laser skin tightening on my upper abdominal area, which did absolutely nothing. After finally expressing my unhappiness to my PS, when I realized that my end result was what you see here, it was decided that I needed a revision. Is it fair that I'm being forced to pay the hospital and anesthesiology fees for my revision surgery, now scheduled for March 31st?

I compensated this surgeon very well at the time of the original surgery, and I am now the one who must undergo a SECOND surgery, with all of the risks, downtime, and discomfort associated with that. I realize that if I were asking the surgeon to 'tweak' something, my payment of these fees would be a no-brainer. Unfortunately, this is hardly just a tweaking; my results were unsightly and unacceptable, and I didn't receive what I paid for - a FULL TT. What are your thoughts on this? Additionally, am I an idiot for letting this surgeon have a second shot at me? Thanks in advance for your consideration.

Doctor Answers 21

Charges for Revision Surgery

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Thank you for your question.
Every surgeon's office differs with how they deal with revisionary surgery and the charges involved.  It is standard that if the surgeon waives his/her surgeons fee, that the patient pay the fees associated with returning to the operating room (OR fees, anesthesia, supplies, etc).  
Best Wishes!

Are you sure you had a full tummy tuck?

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I can understand your disappointment. Plastic surgeons generally strive to communicate realistic outcomes and deliver satisfactory results.

It is hard to tell from this picture but it is my impression that you underwent a mini tummy tuck and not a full judging from your picture. In a full tummy tuck the umbilicus is completely inset all the way around. There does not appear to be a scar around the umbilicus but it is difficult to tell. Did you have stitches around your belly button? If you did have stitches, you healed excellently. Your lower belly demonstrates excelllent overall appearance. However, the upper abdominal skin seem disproportionately loose. It does appear to have sun damage and poor elasticity which may have contributed to the laxity seen in this picture. Did you suffer a hematoma? The problem is your upper abdominal skin which may require a reverse abdominoplasty.

If not, then you may have undergone a mini or a hybrid/marriage abdominoplasty. In either of these procedures the skin of the upper abdomen remains untreated which appears to be the case.

In regards to fees, this is a difficult question. I don't think that you are going to improve the appearance without additional surgery. In this event, there are different fees that will be incurred: the surgeon's fee, the operating room, and the anesthesiologist. As plastic surgeons, we always seek to meet or exceed our patient's expectations. Many surgeon's waive the surgeon's fee but have the patient pay for the operating room and anesthesia as needed. Clearly, you will need to set forth the terms of any additional procedures after that. If you search for another surgeon, you will likely have to pay for all the fees.

I urge you to continue discussions with your plastic surgeon and if you are not satisfied with their explanation, seek second opinions and proceed only if someone can assure you of a reasonable outcome.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Revisions after tummy tucks should be rare. ...

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Revisions after tummy tucks should be rare. Occasionally a tiny dog ear at the corner of the incision needs to be repaired and this is usually at no charge. Charges, however, are at the discretion of your surgeon.

In general, if the result is something that falls short of what your surgeon anticipated and you followed all appropriate post-op instructions, a revision will usually be done at no charge. If the result is somewhat less than hoped for but it is because of the patient's body, revisions might be offerred at cost. If the patient wants more than that, but the surgeon feels that result is otherwise good, there may be more charges involved.

Again, revisions are rare and charges are up to the doctor.

Tummy tuck revision

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I can appreciate your disappointment from this picture. Most plastic surgeons communicate what can be expected from a given surgery and will discuss your personal expectation. Form this photo, it appears that you had a mini-tummy tuck. However, you may have been a more appropriate candidate for a full tummy tuck. All of these should have been discussed with you before the first surgery.

Who Pays The Cost Of A Revision Abdominoplasty?

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There can be many reasons that a revision of an abdominoplasty is performed.  While a technical problem with the surgery may be one reason, it may also be the case that the patient's own ability to heal was suboptimal; or the patient engaged in activities in the immediate postoperative period, which she should not have done; or postoperative instructions were not properly followed; or the patient's expectations of the result of the surgery were not properly aligned with the surgeon's; or the patient's expectations of the result of the surgery actually changed from what they were prior to the surgery; or any one of the dozens of minor complications attendant with such a surgery, from a dog ear, to an asymmetry of subcutaneous fat, to a small region of widened scar occurred.  

The point to be made here is that the performance of a revision of an abdominoplasty is not a statement or an indication that anyone, surgeon or patient, is necessarily at fault, but merely a recognition that it is reasonable to try to improve some aspect of the postoperative result.  This being the case, it is customary for the surgeon to waive his customary fees to perform the revision abdominoplasty, and for the patient to cover the cost of the OR, anesthesiologist, and supplies.

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Does the Pay for Tummy Tuck Revision Costs?

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The revision policy varies from surgeon to surgeon. Although revisions sound like a black and white issue, they are not. 

Because surgery is performed on humans, not something predictable like paper, complications can arise that are no one's fault. If a surgeon sees that he/she clearly could have done a better job during the original surgery, he/she might sometimes absorb some of the operating room costs. (It sounds like the surgeon isn't charging for his own services.)

However, factors beyond the surgeon's control can also impact the final result, such as a patient's poor skin tone, poor tissue tone, thick layer of fat, lack of compliance with postoperative instructions, or simply from known risks, such as deflation of a saline implant. 

If a doctor's policy is not to charge for revisions, he/she may be more likely to cut corners for revisions to be able to cover the costs. How? By doing revisions under local anesthesia in a treatment room under conditions that aren't safe and are less likely to take care of the problem.

You sound angry. Discuss your feelings with your surgeon before surgery. Was the wrong surgery done and you never got the full tummy tuck you expected and paid for? Of were the results less than you expected?

If you've lost faith in your surgeon's ability, find another surgeon, even it means paying more money. Don't have surgery with a surgeon you don't trust, even if he/she is cheaper. 

Click on the link below to see why it's best to have surgery done safely rather than cheaply.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

This is dependent upon the surgeon. Common practice is...

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This is dependent upon the surgeon.

Common practice is that if a revision is performed within 1 yr of surgery, many physicians will waive their surgical fee and only charge for the facility: to pay the anesthesiologist, nursing staff, and for supplies.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Cost for Revision of Tummy Tuck Surgery

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Thank you for your question. I'm sorry to hear that you are unsatisfied with the results of your tummy tuck surgery. The issue of revision of tummy tuck, or any plastic surgery for that matter, is always a sensitive one. The question of whether to have the same surgeon perform the revision is one that only you can answer. If you obtained your surgery from a Board-certified plastic surgeon, then in my opinion it is best to address the issue with him/her. If you obtained your surgery from anyone else, then in the very least you should get an opinion from a BCPS, and make the best decision from there. The best chance of reducing costs is, of course, with the same surgeon. In this case, just like surgical costs in general, there is great variability. Typically, most surgeons would be willing to waive the surgical fee, leaving the patient responsible for the anesthesia and facility fees. Some surgeons, however, would take on all the fees to accommodate treatment and make for a happy patient. There are no laws or regulations regarding this issue, so all that you can really do is consult with your and other surgeons to see what the standard of care is. Best to keep in good communication and maintain a good rapport with your surgeon. That is the best way to reach a reasonable solution. Hope this helps. Good luck and fare well.  

Revision costs should be spelled out in your original quote if it is patient responsibility or surgeon.

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Thank you for your post.
Revision costs should be spelled out in your original quote if it is patient responsibility or surgeon.  Normally there is a cost, including facility fee and anesthesia at a minimum for revisions. In considering the cost of a Tummy Tuck, you should look at the components of the cost:
1. Surgeons Fee. This is usually the greatest part of the overall cost and can vary immensly from location to location (just like the cost of living varies in each location) as well as in the same location, it can vary from surgeon to surgeon. Usually, a surgeon commanding a higher price is very experienced and has very good results reliably, and is very busy due to the above.
2. Anesthesia Fee. This can vary depending on if a board certified MD anesthesiologist is used, vs. a nurse anesthetist, vs. a non-certified nurse, vs. only local anesthesia (an awake procedure). Obviously, the further you go down the line, the cheaper the price. You do get what you pay for.
3. Facility Fee. This can vary if it is a a state/medicare certified facility, vs. the back of a doc's office.
4. Accessories. This includes things like a pain pump, Exparol injections (72 hour long lasting numbing), garments, tissue glues, etc. These are not necessary for a great result, just add to the comfort of a result.
5. Revision. Usually a revision such as dog ears or lowering the scar, or a seroma, is much less that the original surgery, but this depends entirely on what exactly is being done.
As with anything in life, buyer beware of risks of cutting corners in surgery.
Real Self has average costs of every operations in your location that you can peruse before seeing a surgeon, but keep in mind that the above quality can change from office to office. Choose a surgeon that you are very comfortable with and is board certified.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Typically patients do not pay revision costs.

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Although it depends on the specifics, based on the details you’ve listed above (and your photos), the surgeon is not likely to charge a fee for the tummy tuck revision. However, the surgeon’s fee is not the only cost associated with surgery. There’s also the fee for the anesthesiologist and the facility to consider, which may or may not be covered by your surgeon. Since you have loose skin through the upper abdomen, a full tummy tuck is likely required for smoother contours overall. If you don’t trust the previous surgeon to perform the second surgery correctly, definitely consider getting a second opinion. Tummy tuck revision can be a challenging procedure, so it may be worth finding a specialist.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.