Plastic Surgery

I saw a plastic surgeon 2 weeks ago.  I got a call to state that OHIP approved my surgery!!!!  I was so excited............and was then advised it was for a breast reduction only.  The Dr. did not apply for panni removal as she said it would not be covered.  I am grateful for the breast reduction, but disappointed about the panni removal.  Should I see another Dr. for a second option?  Or does the Dr. know who will qualify and who not to bother applying for?  I know my panni is not that big, but it is there and causes me back pain and I get rashes in the fold of it.  Thanks for listening and any suggestions.

I have heard a number of people do qualify for panni removal, but you reed to meet the guidelines, ie: panni hangs over your mons area, documented rashes and treatments for the rash. If you fall under those guidelines I would hope any plastic surgeon would apply for coverage. There are many ps out there, couldn't hurt to get a second opinion? Was this surgeon one that does many wls patients?

Yes.  I found him on this board.  He has done several WLS patients.  I went to him first as he does not use tubes!  I will be going for a second opinion in October.  Thanks for the help.

Totally get a second opinion! 

Why didn't she apply for the panni?? It usually gets covered... The drs don't know for sure who qualifies for what.. that's NOT their job! How much is your panni hanging? I know mine doesn't hang enough and I did not qualify to have surgery so I must pay for it. Unless I can get my PS to push for it since I have been maintaining for over 2yrs now.  But as of right now, it's not high on my priority list. I do want to get it done in the future tho.

Don't know how else to put this, my panni hangs and covers a bit less then half of my upper private area.  It properly wont qualify, but it would of been nice to try.  My panni has always bothered me even before WLS.  I saw a Dr. about 15 years ago for weight loss pills and he said he could cut it off.  He scared me to death the way he was saying he could do it.  I was only 18 at the time.  I wish I could find him again lol.   

You should go see Dr Nandagopal out of Scarborough. I will be getting him to do mine when I'm ready. Many WLS pts see him... come from allll over the province. 

I want to get this done fairly soon, and Dr Nandagopa has a huge waiting list.  He was the first one that I asked my family Dr. to refer me to.  Good luck when you are ready.

who is the dr you went to see??

I still think you should try for a second opinion.. she didn't even apply for a panni removal... OHIP may surprise you and cover it, you don't know until you try.

I thought OHIP only covered a portion of the panni removal?  Was I told wrong, or minsinterpret what I heard at the TWH's initial seminar?

I asked what it would cost to have all my loose skin removed and the lady giving the seminar (she didn't/forgot to? introduce herself) said $35,000.00 in total, and $15,000.00 for the pani/tummy tuck, of which OHIP might fund $5,000.00.

Yikes!

Jenn.  :)

OHIP will cover the panni removal if deemed medically necessary,  the more you have to support your case the better. 

 OHIP has have three guidelines/criteria that post-op patients must meet (which I have posted on this board several times in the past 2 weeks)..After that it is UP TO the person reviewing your case, whether or not you will be approved.

So in my personal experience..the criteria/guidelines are what is followed, but that DOES NOT mean if you meet that criteria you are automatically approved.   My tummy tuck was quoted at an additional $4,000 in addition to what OHIP would cover for the pannilectomy.

If you go for a 2nd opinion you will have to pay the consult fee..I know that as I am presently in the process of doing that (although I am approved by OHIP)