Will Medicare Pay for My Extended Abdominoplasty?

After significant weight loss or weight loss surgery, you may require an abdominoplasty or extended tummy tuck to remove excess skin or repair weakened abdominal muscles. While this operation is usually done for cosmetic reasons, it is often integral for patients to correct abnormalities after surgical weight loss procedures.


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Are You Considering Abdominoplasty?

Many patients feel a great deal of pressure to appear perfect. Abdominoplasty can improve your appearance and your quality of life. However, it is also a major surgery and is not suitable for everyone. If you are obese, consider if you have done all you could before surgery. This includes dieting and exercise.

Will Medicare Cover Extended Abdominoplasty After Weight Loss?

In November 2018, Medicare made several changes to their benefits scheme. As a result, many procedures that Medicare previously covered, have reduced reimbursement or have been removed from coverage altogether.

Generally, Medicare does not cover the cost of cosmetic procedures, and some private health insurance will not cover it, either. However, if your abdominoplasty procedure is done for reconstructive reasons, part of your costs might be covered. Discuss with your specialist bariatric surgeon for more information.

Medicare will provide a modest rebate if you satisfy the weight loss criteria. You will need to demonstrate:

  • That you have had significant weight loss, defined as 5 BMI points or more
    • This must be unrelated to pregnancy
    • In women, this means a weight loss of at least 15 kgs or more without weight fluctuations in the last 6 months
  • The level of excess skin is interfering with daily living
  • Use of non-surgical treatments for skin irritation caused by excess skin, has failed to work
  • You have a hernia that can be documented in an ultrasound

Unfortunately, Medicare does not provide assistance for women suffering muscle separation or excess skin related to pregnancy. This is despite the demonstratable, significant improvements in back pain and incontinence for women that have muscle separation repaired with a tummy tuck. The government is currently reviewing their position on this, but it is uncertain if this rule will be changed.


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What Do I Need to Qualify for Extended Abdominoplasty?

Before a surgeon will perform your operation, you will need to be at a stable weight. You may be asked to postpone your operation if you still have weight to lose or you plan to become pregnant. Abdominoplasty will not prevent you from gaining weight in the future.

If you are under 18 years old, you will need to undertake a psychological assessment and wait for a cooling off period of up to 3 months before having this major cosmetic procedure. However, this will not apply if you are having surgery for reconstructive reasons.

What is the Cost of Extended Abdominoplasty

A number of factors relate to the cost of abdominoplasty surgery. These costs vary from patient to patient and include:

  • Surgeon fees
  • Anaesthetist fees
  • Hospital fees
  • Medication
  • Dressings
  • Support garments

Your surgeon and anaesthetist will provide you with information, in writing, about the cost of your abdominoplasty. This information will include:

  • The total cost
  • Details of deposits and payment dates
  • Payments for follow up care
  • Possible further costs for revision surgery or treatment

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What is an Extended Abdominoplasty?

An extended tummy tuck or expanded abdominoplasty procedure, involves a surgeon removing excess skin from the patient’s sides. It also improves muscle laxity at the flanks (love handles) and hip region.

The extended tummy tuck was developed after surgeons acknowledged that traditional tummy tucks improved the abdominal area but not the flanks or back. This procedure has been performed on thousands of patients, with excellent results.

Am I a Candidate for an Extended Tummy Tuck?

An extended tummy tuck is often effective treatment for patients wishing to refine their figure following substantial weight loss. These patients usually need help to restore tone and contours to the abdominal, hips, flanks, and back muscles and are usually suffering from excess skin. This excess skin can often weight several kilograms

Extended Tummy Tuck Surgery

An extended tuck incision spans the entire length of the abdomen and extends to the back of your hips. Your surgeon tightens muscles and creates a new navel to match your new body shape. Further, your surgeon  may also use liposuction to achieve ideal body contouring.

Once excess skin has been trimmed, the abdomen, hips, flanks and back, the incision is closed with sutures. For the best body contouring results, your surgeon may also undertake an arm lift, thigh lift, or liposuction with your tummy tuck.

Expanded Abdominoplasty Recovery

Due to the large incision and dramatic physical changes, most surgeons will require patients to stay in hospital for at least one day after surgery. Depending on your surgeon’s preferences and your body needs, you may have drainage tubes placed under the skin to prevent the accumulation of fluid. This also allows the incision to heal properly.

Patients should arrange for someone to help them for a few days after returning from hospital. Swelling and bruising are normal after any body contouring procedures but the majority of swelling should subside after about six weeks. You will be provided with pain relief during this time.

Many patients are able to return to light activity within two weeks of their extended tummy tuck. However, it is best to consult with your surgeon before resuming any physical activity.

Want to know more about extended abdominoplasty procedures? Do you qualify for an extended tummy tuck?

Contact Dr Maxwell today to find out more and to book your first consultation.

Last updated: January 3, 2020
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Dr Richard Maxwell
Mr. Richard Maxwell graduated in medicine from Monash University in Melbourne in 1981. He trained in Plastic and Reconstructive Surgery at the Alfred Hospital, the Royal Melbourne Hospital and the Victorian Plastic Surgery Unit in Melbourne. He completed his training in 1989, gaining the Fellowship of the Royal Australasian College of Surgeons in Plastic and Reconstructive Surgery.

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