Plastic surgery covered by OHIP

Has anyone had plastic surgery covered by OHIP? What surgery did you have and what were the cir****tance surounding the surgery

OHIP will approved breast reduction, someone I am sure will provide the exact criteria for you. They will also approve panni removal if it is medically necessary. The problem is most plastic surgeons hate working with OHIP and will not do JUST a panni removal, they say patients will not be happy with it. To get panni coverage you have to have documented problems with it, like rashes and infections. Pictures help.

Some people on here have had OHIP covered breast reducations and lower body work, I am sure they will provide the info they can.

Bev

I had a breast reduction covered by OHIP.  I had to be refered to a plastic surgen by my family doctor.  There had to be medical problems associated with heavey breasts.  I had back pain, skin irritation and breakdown, shoulder indents from bra straps....It was actually a pretty simple process.

Ohip has APPROVED ME for breast reduction/lift... on February 19th, 2009!!!

I just need to save the $12,000 for the lower body lift - hopefully in 2010!!!!!

 
September 16, 2008

I had a PS consult today. I will be going for a breast reduction and mastoplexy (lift) which should be covered by OHIP due to my back pain and the measurements taken (yes, there are specific amounts that the breast must hang to qualify - while he did not tell me the "goal" he did say I am 33" and that should qualify me). I will be going to a C cup from a D/DD; as well as later (after breasts healed) a Circumferential Abdominoplasty (TO THE TUNE OF $11500 plus gst). I am told between both procedures I will lose about 15lbs of skin/fat!! I will concentrate on another 10 pound loss in the next while. So, from 336 to present 215-225, that will put me right where I want to be!

To those of you who somehow managed to have the panni part of your plastics paid for within the past two years, could you please find out what code was used??? My PS told me that OHIP does NOT cover this.

I was given a letter from OHIP to plastic surgeons from two years ago that reads:

"For approval, the pannus must be large (e.g. the apron should hang below the level of the groin/pubis) . In addition, the pannus needs to be "significantly symptomatic" . This means pain, chronic skin breakdown or recurrent infections. "Poor hygiene" and "intertrigo" alone are insufficient to qualify. Low back pain is unlikely to be due to pannus, but may be a consideration in otherwise borderline cases. Please make reference to both the size/extent of the pannus and associated significant symptomatology. "

Erin, it's funny how they say that lower back pain is probably likely not the cause of having a huge pannus.  I had lower back pain since the age of 30 but because I had a serious car accident when I was 17, they had told me I would have back and neck problems in about 10 to 15 years so I always just blamed the lower back pain on my accident.  2 weeks ago, I had an extended tummy tuck, where they removed over 17 lbs, and the day after surgery, the first thing I noticed was all my lower back pain was gone and I didn't even have any pain meds in me.  It's 2 weeks later, no pain meds at all and no lower back pain so I think for me, the huge pannus was definitely the cause of my back pain.  I opted not to go through trying to get OHIP approval because I wanted the skin gone NOW and didn't want to take the chance that I might apply and wait 6 months and still have them say no.