I was wondering if anyone here has been having problems with excess skin since weight loss? I have been developing a horrendous rash on my belly from the skin fold — anyone have suggestions on how to clear this up or better yet … My insurance will not cover a tummy tuck but I have been told they WILL if it’s becoming a health problem, I have no clue where to start though.
Parma, OH
Answered by Dr. Rachael Keilin, weight loss surgeon.
Excellent question and one we get asked frequently. Let me start by kind of answering the last part first: many insurance companies will pay for panniculectomy (the removal of excess skin at the bottom of the abdomen) but not a true tummy tuck which is more of a cosmetic procedure and includes tightening the muscles under the loose skin and cinching in the waist. However, insurance comp.s rarely take the surgeon’s word for whether or not it’s a medically necessary procedure – they’ll want documentation that the skin has been causing problems for some period of time, usually in the form of office visits with a primary care doctor (like a family practitioner or Ob/Gyn) stating that you needed medication like antibiotics or anti-fungal powders to treat the skin irritation caused by the overlapping skin. Those notes in combination with pictures taken by the potential operating surgeon usually convince insurance companies to pay for the procedure. So if you’re thinking about it for the future, start getting the documentation history you need with your primary doc. Those records can then be requested by the general or cosmetic surgeon who will do the actual operation when it comes time to securing pre-authorization. Remember when you make consultation(s) with surgeons to discuss the procedure that you first ask if they take insurance and if they are the ones to do the verification with the insurance company. Many cosmetic surgeons will not accept insurance or will accept insurance only if you’re the one to go through the process of getting the reimbursement (which is almost impossible to do unless you deal with them every day).
But now to answer the first part of the question :) Sometimes it’s difficult to know if it’s a yeast (fungal) infection or bacterial without actually examining you. Both of these are commonly treated with a combination of therapies including oral antibiotics or antifungals, local creams or powders that are also antibiotic or antifungal as well as keeping the area dry. Moisture is the natural friend of infection of any kind as well as a skin irritant in and of itself. If you don’t want to see a physician, you can try over the counter anti-fungal powders (such as those for “jock itch” or “athlete’s foot”) which will both decrease moisture and possibly help with the fungal infection if one is present. Sorry to be so long winded, but I hope all this gets you started in the right direction :)
Posted by Dr. Rachael Keilin+
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