Lower Body Lift & Insurace

[Luvs2live]

Hi, I got rid of 184 pounds through changing my eating and exercise, 328 to 144 pounds.  I am now at 16% body fat and in great shape.  I am 47 and was 300+ pounds from the age of 17 till I was 43 when I started my journey.  About a year and a half ago I had a tummy tuck(approx 10 pounds of tissue removed) w/muscle repair done which my insurance paid a good portion of because I had an umbilical hernia.  That was an absolute life changing experience and totally enabled me to increase my physical fitness level.  I am a body builder and cyclist.

My problem now is my backside and the skin that droops on my outer and inner thighs.  With my weightlifting, I have increased the muscle mass on my glutes but no matter what I do the skin is a real issue.  People have no clue just how painful at times it is to deal with the excess skin.  It even is an issue when I sit on the toilet because I have to make sure I pull the skin back for hygienic reasons.  I literally feel my body slipping inside my skin when I do sitting or supine workouts.  It even interferes with certain aspects of my sex life because the skin droops from the backside.  (This is hard to explain.)

Anyway, my question is if there is any way that I could make a legitimate case with my insurance company to have reconstructive surgery done in this area?  Where would I even start?! I can live with the inner thigh being wrinkly but the excess skin is a very real problem!  Any suggestions would be greatly appreciated!  Thank you!

[Howard Rosenberg, MD]

You will need a body lift procedure to rid you of the excess skin.  This should be discussed with your surgeon who can take photos and write a letter to your insurance carrier about coverage for this procedure.  Pre-authorization of the coverage for this procedure would be mandatory to be comfortable that they will cover the costs.  Insurance carriers have different criteria for coverage and often a fight is necessary tio obtain coverage.

[Luvs2live]

Thank you SO much for the prompt reply!  When I spoke to my surgeon who did my tummy tuck he basically blew me off and said no insurance company will pay for this procedure.  As you could imagine, I wasn't very pleased about that.  When I mentioned the toilet thing he blew me off when I said that I believe the hemorrhoids I have are made worse by having to pull the skin away like I do.  (This is pretty embarrassing to even bring up!)  He said that it wouldn't cause that type of problem.  Anyway, I guess maybe I should just start looking for a new surgeon who might understand this sort of problem I am having.  Thanks again for the input!