Update: Insurance coverage for tummy tucks and panniculectomies

I see a lot of patients who have lost weight and want their insurance to pay for their Louisville Tummy Tuck or Louisville Panniculectomy.

What I am seeing is that all of these requests for insurance coverage are denied. A Tummy Tuck is and always has been considered a cosmetic procedure. Cosmetic translates into self pay. We have been asking insurance companies to pay for panniculectomies but what we get 100% of the time is a refusal. We have not had a panniculectomy be approved since sometime back in 2007. In ’08 and ’09 we had a zero % approval rate.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

What Liposuction can’t do

When my patients request Louisville Liposuction they sometimes want every single fat cell removed from an area. Well, this just isn’t possible.

Why? For a couple of reasons. When we do liposuction we want to suction out the deeper layer of fat. If we suction the fat cells that are just underneath the skin, the patient is prone to developing noticable contour irregularities ( eg a “dent”). While this is a known problem that can result from any liposuction case, our aim as the surgeon is to keep this to a minimum.

The second reason is that if we try to liposuction all of the fat out, we would probably injure the blood supply to the skin. This could result in areas of skin death resulting in an open wound on the skin and a resultant scar. Obviously this is not a good thing.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

What is liposuction?

Liposuction is a technique Louisville Plastic Surgeons use to remove unwanted fat.

We do this using instruments we call a cannula. This is a hollow metal tube that can range in diameter from 1 to 5 millimeters. On the end there are a variety of shapes and hole patterns thru which the fat is suctioned.

The operation carries out something like this. The patient is anesthetized and positioned so the area of interest is exposed. The skin is sterilized and then small, and small means 2 or 3 mm, skin nicks are made. The cannula is slipped into the fatty tissue thru the skin nick and a back and forth motion is made like you are shooting pool. The cannula is attached to tubing that  connects to a suction machine and the fat is removed. Most cases can be completed in an hour or two and almost all are done as an outpatient.

Lee Corbett, MD
www.CorbettCosmeticSurgery.com

Laser Lipo

Liposuction is now being done with the aid of a laser. Louisville Liposuction has been traditionally performed using the superwet or tumescent technique. Now laser technology is being introduced.

The laser shoots out the end of the liposuction cannula. A typical cannula is a hollow metal tube that is 2 or 3 mm in diameter. The laser serves to help break down the fat and more importantly to heat up the tissue, including the skin, to produce better skin retraction and tightening.

The technology has been around for a few years so the jury is still out on its advantages vs traditional liposuction.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

All posts on this blog are presented by Louisville, KY liposuction physician, Dr. Lee Corbett

New Breast Augmentation technique

When doing a Louisville Breast Augmentation using a Louisville breast implant, usually silicone, there is a new insertion technique.

A new device called a Keller Funnel now enables us to do a Louisville breast augmentation more easily. The implant is placed in the funnel, the neck of the funnel is placed thru the incision into the breast. The implant is then squeezed thru the funnel into place.

This allows the implant to be placed without being touched or touching the skin which minimizes infection and capsular contracture.

Lee Corbett, MD

www.corbettcosmeticsurgery.com

Nipple size after surgery

Nipple size following a Louisville Breast Lift or Louisville breast reduction can be tricky.

Typically when these operations are done, the areola, the pigmented skin around the nipple, is downsized.

We do this by using a circular metal instrument, a “cookie cutter”,  that centers over the nipple. They come in different sizes, usually 38mm, 42mm, or 45mm. We then mark the skin around the cookie cutter and make the cut along the lines.

The problem is that the skin is usually cold from being exposed.  This causes the nipple to become erect and the skin of the areola contracts. If this happens differentially, it will leave the areolae different sizes after the skin relaxes and warms.

These problems are easy to fix and can be taken care of in the office.

Lee Corbett, MD

www.corbettcosmeticsurgery.com