I am a paraplegic (T5) 30+ years. My abdominal muscles have atrophied. Would an abdominoplasty be medically necessary?

Atrophied abdominal muscles are a common/normal occurrence with para- or quadriplegia. Tightening the abdominal fascia would not be of much assistance with no muscle tone. It also would be tough to achieve a great result with an abdominoplasty on you because of this. Regardless abdominoplasties are considered cosmetic. Panniculectomies (when only the excess skin below the navel is removed) are considered medically necessary with extreme weight loss and sometimes for other abdominal issues.

The operation that you are describing is a purely cosmetic one. Since you have lost abdominal tone as a consequence of your paraplegia your final outcome will not be optimal. The only medically necessary procedure to contour the abdomen is called a panniculectomy. This is typically reserved for patients who have lost a significant amount of weight and have an apron of skin that is causing significant hygiene issues as well as interfering with activities of daily living.make sure you seek the consultation of a board certified plastic surgeon.good luck!

Thank you for your question.  An abdominoplasty is not a procedure that is ever considered medically necessary and therefore not covered by insurance.  A panniculectomy is a procedure performed for medical reasons and often covered by insurance.  A panniculectomy serves to eliminate the excess overhanging skin on the lower portion of the abdomen in order to help treat problems such as recurrent skin infections and sores within the skin fold, lower back pain, inability to fit properly into clothing, and difficulty with daily hygiene.  I recommend consulting with a board certified plastic surgeon to determine if either one of these procedure are indicated.