Total Body Lift
One of the most exciting things for people who have transformed their lives and their bodies with a large amount of weight loss is the completion of that transformation with plastic surgery. There are new books and resources appearing that talk about total body lifts and plastic surgery that is performed after very substantial weight loss, usually after bariatric surgery. On the previous blog post I have talked about the optimal timing to undergo a body lift or cosmetic surgery as being eighteen months or more following weight loss surgery. Basically once you absolutely reach your goal weight. But what does a total body lift mean and what will it do for you?
Well, a total body lift has different definitions depending on which surgeon you speak to, but basically some of the key components are: the panniculectomy, which involves removal of the abdominal pannus, as well as other cosmetic surgical procedures on the arms, legs, face and neck to remove excess skin and soft tissue to tighten up the skin and soft tissues to optimize the cosmetic appearance.
Usually health insurance plans do not cover this type of surgery. They view it as cosmetic in nature and therefore not “medically necessary”. With some notable exceptions this is usually, in fact, true. Exceptions to this are instability of the abdominal wall which occur when a large abdominal pannus exists in combination with a hernia stemming from congenital wall weakness or from prior surgical scarring that left the musculature muscle and tendon closure weak. Another exception is when someone has very severe skin disease stemming from the folds of the pannus rubbing together creating an opportunity for breakdown of skin, fungal infections and bacterial infections. Often times though, the insurance company directors will refuse to pay for the panniculectomy, often called a “tummy tuck” even under these circumstances despite good documentation.
I have not seen insurance plans pay for removal of the skin around the upper arms or upper legs, nor have I seen them pay for face lifts or treatment of the skin of the neck. But, there may be some cases out there where this has occurred.
So is the cosmetic surgery “worth it”? Only you as an individual can decide. I am normally quite reluctant to recommend medical and surgical interventions that carry risks for anything other than a purpose that can be scientifically demonstrated as beneficial to health. Many of my patients who have undergone total body lifts or less complete plastic surgical procedures after their weight loss have told me that they viewed it as one of the last stages of their journey toward becoming a healthier new person. Or they have viewed it as a slightly sinful reward to celebrate having reached their goal weight. Certainly many people describe benefits in terms of greater confidence and an improved self image, benefits that are hard to quantify, but none the less individually valuable.