Archive for the ‘Body Surgery’ Category

Breast Reduction Surgery: Is it Cosmetic Surgery, Reconstructive Surgery, or Doesn’t It Matter?

Wednesday, January 3rd, 2018 by doctor

Breast Reduction Surgery: Is it Reconstructive Surgery, Cosmetic Surgery or Doesn’t It Matter? Will my health insurance cover the surgery?

I recently saw a female college student, as a new patient consultation concerning “Breast Reduction Surgery”. This procedure also known as “Reduction Mammaplasty” is indicated for the treatment of symptomatic macromastia (large breasts). The commonly reported symptoms related to macromastia are that of: neck, shoulder and back pain secondary to the weight of the large breasts upon the musculoskeletal system. Other secondary symptoms include: breast pain and dermatitis or rashes beneath the breasts.
This above patient was referred by her gynecologist and arrived with a “prescription” recommending a consultation with a “plastic surgeon”. The patient believed, as many do, that since she was referred by her physician, that the surgery would be covered by her health insurance plan. She was requesting that the surgery be scheduled in four weeks, during her “winter recess” from college.
After completing a patient history and regional breast examination, my staff proceeded to explain to her the procedure necessary to try and obtain insurance authorization for her requested and indicated surgery. She had no other medical treatment or consultations concerning her macromastia. No history of being referred for physical therapy, chiropractic treatment, orthopedic consultation, or dermatology exam. The patients understanding of the “health insurance system” was that, if her referring physician recommended her for treatment, it must be a medically indicated and covered procedure.
Reconstructive Surgery vs. Cosmetic Surgery: It is universally believed by patients, that if a surgery is classified or considered “reconstructive”, it is medically indicated and an insurance covered procedure. This usually means to patients, that all fees related to that procedure will be paid by their health insurance. And if a procedure is considered “cosmetic”, it is not a medically indicated and covered procedure. It is my opinion that for years, breast reduction surgery has been thought of as a “Hybrid”. It is considered “reconstructive” in attempts to obtain insurance coverage for the surgery. It is considered “cosmetic” in that patients expect meticulous aesthetic expertise in the surgery and the post-surgical results. In our practice, it has recently become extremely difficult to obtain insurance coverage for breast reduction surgery. Insurance companies frequently require 2-3 documented reports from other referred specialists. Also the insurance companies commonly requests 6-12 months of documentation and treatment by either a: physical therapist, chiropractor, dermatologist or orthopedist.
Do Your Homework: The intent of this blog is simple and I hope that everyone who reads it understands one point. If you feel that you are a candidate for breast reduction surgery, and requesting coverage under your health insurance, it is important that you contact your health insurance carrier, and have them forward to you in writing, what their criteria are for coverage. Every insurance company has difference, independent criteria and indications, and one should not confuse the fact that “my friend” got it covered by her insurance, and she had “smaller breasts” than me. On the average, it takes between 3-6 months of preparation, seeking secondary consultations with other healthcare providers and possible therapy (physical therapy or chiropractics). Notify your primary care physician as soon as possible concerning any symptoms which may be related to your macromastia. It is never too early to start the process, and remember that what the insurance company’s criteria are this year might not be the same next year. Please contact our office concerning any questions you might have that relate to breast reduction surgery and coverage through your health insurance.

Male Cosmetic Surgery- Body Contouring

Monday, March 27th, 2017 by doctor

Men and Plastic Surgery
Male-Specific Considerations

Information for men contemplating plastic surgery for cosmetic reasons.
Find a Plastic Surgeon
Patient Safety
Liposuction and body contouring

The ideal male body shape is considered to be trim and athletic-looking, with broad shoulders and chest, a flat abdomen, and a narrow hip-thigh area. However, as men age, areas of fat tend to accumulate around the abdomen, the flanks (“love handles”), the breast area (a condition called gynecomastia), and along the chin and neck. Men sometimes seek liposuction to remove these fatty areas that are resistant to diet and exercise.

In many cases, liposuction alone can effectively correct these problem areas. Men retain their skin elasticity longer than women do, and the areas of fat beneath the skin tend to be firmer and more vascular than those in women. Because of these and other factors, liposuction in men is usually very effective.

Men who have some loose, hanging skin, as well as areas of excess fat, may opt for a traditional excision procedure (surgical skin removal) in addition to liposuction. An excision may also be performed on gynecomastia patients whose breast enlargement results in excess skin.

Abdomen reduction: A full abdominoplasty (or “tummy tuck”) may be chosen by men who have hanging abdominal skin (usually the result of massive weight loss), loose abdominal muscles, and/or neglected hernias. It is a major surgical procedure that removes excess fat, tightens the muscles of the abdominal wall, and trims the waistline. Men who have a full abdominoplasty are often surprised at the long recovery period. Some patients aren’t able to return to work up to 4 weeks after surgery.

Men with good skin elasticity who have only a moderate amount of excess abdominal fat may benefit from liposuction alone. Muscle-enhancing surgery: In recent years, plastic surgeons have developed ways of improving muscle contour with cosmetic implants and “sculpting” techniques.