Does insurance cover excess skin removal after weight loss

Those who have lost a significant amount of weight are often left with sagging skin, and exercise is not the solution to that problem.

Performing the hard work to get to a healthy weight can be a fulfilling experience for many patients, but losing weight is only one part of the battle. Often, those who have lost a significant amount of weight are left with sagging skin, and exercise is not the solution to that problem.

Fortunately, the cosmetic surgery community has developed many effective procedures that help get rid of the by-product of significant weight loss. For patients who have experienced such dramatic weight loss, a body lift procedure can remove excess skin and create definition in areas that once held excess fat.

The first question I tend to get from prospective patients is, “Will my insurance cover this?” Many people believe all cosmetic procedures are elective and, therefore, need to be paid out of pocket. However that is not the case for a body lift, as the majority of health insurance companies cover at least part of the procedure.

Although insurance companies are not in the business of paying for cosmetic procedures, some body contouring procedures are considered necessary to improve a patient’s overall health. While I have found that the qualifying criteria for such procedures can be strict, the option is still available. Therefore, I walk my patients through the following list to determine whether their health insurance may pay for part — or all — of a body lift.

Bariatric surgery

If the patient underwent surgery at least one year ago, a health insurance policy may help cover body-contouring surgery.

Significant weight loss

Patients who have lost more than 100 lbs are more likely to have their insurer help cover the costs of a body lift procedure.

Stable weight

Many health insurers require proof that a patient has not only lost the weight, but also managed to keep it off. If a patient has maintained a stable weight for 6 months or more, it is likely that the insurer will assist in paying for the surgery.

Skin disorders

Excess skin can create health concerns such as chafing, rashes, ulcers, and infections. If a patient experiences any of these issues, and other forms of medical treatment have been unsuccessful, then one’s insurer may cover the removal of excess skin.

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Still, other aspects of a body lift procedure such as breast augmentation are considered elective surgery and would be an out-of-pocket expense. Since each health insurance policy is different, the only way to find out whether a patient’s body sculpting procedure would be covered is to consult with the insurer.

Regardless of the method of payment, it is our job to help patients take the next step in their weight loss journeys to truly look and feel their very best.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at www.robertgrantmd.com.

Over the past few decades, weight loss surgery, also known as bariatric surgery, has become increasingly common. As such, we’ve begun to see more patients who could benefit from an additional procedure after weight loss: skin reduction surgery. Almost everyone who has weight loss surgery will have some excess skin. When a patient loses 100 pounds or more, the skin can’t always bounce back and firm up. Some people aren’t bothered by this at all because they feel so much healthier. Others might be uncomfortable with how the excess skin looks. But for some patients, excess skin can cause painful or even debilitating health issues. The amount of weight lost after bariatric surgery may cause a little bagging and sagging or can result in 40 to 60 pounds of excess skin. Skin reduction surgery (or excess skin removal) is elective, which means it’s totally up to the patient to have it or not. About 20 to 30 percent of our bariatric surgery patients choose to have skin reduction surgery, including both men and women.

Why do patients choose to have skin reduction surgery?

The majority of our skin reduction patients choose to have the procedure for cosmetic reasons. If a person’s excess skin issues are small or purely cosmetic, they can wear support garments to keep the skin up and tight. But when a patient has gone through all the hard work of preparing for and recovering from bariatric surgery and has lost a lot of weight, it can be hard to see all that excess skin in the mirror. Taking off those pounds of excess skin can be tremendously helpful for a patient’s self-esteem and can make exercise and hygiene easier.

When a patient has done all it takes to go through #bariatric surgery and has lost a lot of weight, taking off extra pounds of excess skin can help with self-esteem. https://goo.gl/eBG1Vw via @MedStarWHC

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For some patients, excess skin causes physical health problems. The skin folds can become a warm, wet environment that is prone to yeast infections or bacterial infections that can result in painful irritation, especially during exercise or work. Severe cases can be debilitating. Patients can help their excess skin from becoming a health concern by keeping it clean and dry, and by using antifungal powders to prevent rashes. But for long-term health, skin reduction surgery is a safe and easier option for many patients. I’ve never had a patient tell me they regret having had bariatric surgery because of excess skin issues. Almost always, they feel so much better emotionally and physically once they lose a lot of weight. Their joints hurt less, their overall health improves and they can start exercising again. Still, a significant number of patients eventually want to have their excess skin removed as the next step to their healthier, more confident life.

How does skin reduction surgery work?

During the procedure, we surgically remove the excess skin by making incisions in the affected areas of the body. To remove excess skin on the stomach area, we make an incision at the bikini line. On the arms and legs, we make incisions on the inside of the limbs. There will be some scarring, and the surgeon will work to keep the scars as small and hidden as possible. Patients should see doctors who are specifically trained in skin reduction surgery procedures and who do it often. Because we perform so many bariatric surgeries at MedStar Washington Hospital Center, our plastic surgeons are experienced in excess skin removal, and our cosmetic and bariatric surgeons partner closely together to ensure our patients get the best care. We usually recommend waiting at least a year after having bariatric surgery before skin reduction surgery. Patients often continue to lose weight during this time, and if they get the surgery and then lose another 30, 40 or 50 pounds, they’ll have more excess skin and will be back where they started.

Is skin reduction surgery covered by insurance?

Health insurance coverage for skin reduction surgery varies. Many insurances only cover the procedure if a patient is having documented health issues, such as rashes, infections or irritation. Even then, it’s often covered only for the stomach area and not the arms or legs. We understand the documentation insurance carriers require to get coverage for the procedure, and if you qualify, we can help with this process. Many patients who don’t qualify under their insurance still opt to get the procedure, paying for it out of pocket because of how much the excess skin affects their quality of life. If you choose to have bariatric surgery, it’s important to go to a bariatric center like we have at MedStar Washington Hospital Center. You’ll have access to an entire team of surgeons, dietitians, psychologists and cosmetic surgeons who understand how to make weight loss surgery a success and are knowledgeable about living your best life after surgery.

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