Obesity continues to be a major health risk to our adult population and increasingly to our children and adolescents as well. The present and future risks associated with obesity are quite serious and can significantly reduce one’s life expectancy and dramatically affect one’s quality of life.
People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight in kilograms by the square of the person’s height in meters, is greater than 30 kg/m2 .
The safest way to lose weight is the classic way–consume fewer calories, make the calories you consume be healthy ones, and add moderate exercise to your daily regimen. In cases of severe obesity or where a psychological addiction to food is present, more radical approaches may be indicated. These include gastric bypass (either laparoscopic or open) and placement of a Lap Band. Both of these procedures effectively reduce the body’s ability to accept food in portions previously possible. Calories are therefore reduced and weight loss follows. These procedures are most effective when combined with nutritional counseling, psychotherapy, participation in a support group and exercise. Engagement of a personal trainer is very helpful because there are special considerations for regaining muscle mass and toning in an individual following massive weight loss.
Once weight loss is achieved and has been stable for some time, patients often continue to battle with quality-of-life issues due to severe skin excess for which they may seek the help of a New Jersey plastic surgeon. A skin apron in the lower abdomen, called a â€œpannusâ€ often contributes to a number of health concerns, including cutaneous inflammation, such as cellulitis, intertriginous dermatitis, skin abscesses, gangrene, excoriation, or folliculitis. Other related concerns include lymphedema, and difficulty with personal hygiene. Urinary stress incontinence can be aggravated by extra lower abdominal weight. A large abdominal pannus can also pose a physical obstacle to sexual activity. Patients frequently complain of debilitating low back and extremity pain. It is also difficult to resume activity in the gym with such an excess of skin all over the body, since even loose clothing fits improperly, and patients report body image concerns. A large abdominal pannus can interfere with respiratory function and lead to diminished abdominal wall integrity from weakened fascia and abdominal muscles; umbilical and ventral hernias very commonly seen.
Dr. Rosenberg performs Abdominal Panniculectomy and reconstructive abdominal surgery including extended NJ abdominoplasty and body lift to alleviate these conditions and to recontour the affected areas of the body. During your initial consultation, Dr. Rosenberg will evaluate your condition and offer a plan for staged reconstructive surgery, which usually begins with the abdomen and truncal region, followed thereafter by the thighs, arms, chest wall and breasts, face and neck when necessary and when desired by the patient.
Documentation for Insurance Reimbursement
Unfortunately, many third-party payers are reluctant to provide reimbursement, and most patients are unable to afford the procedure without some financial assistance.
Some authors contend that post-bariatric, surgical, co-morbidity issues are similar to those following radical mastectomy, where breast reconstruction has become recognized as a humane necessity. And people experiencing profound weight loss often require corrective surgery, similar to women following mastectomy. Regardless, the indications for NJ panniculectomy require documentation, which serves as a basis for appeal in the event that corrective surgery is initially denied.
Third-party payers have been known to refuse payment for abdominal panniculectomy for many reasons, one being a lack of photographic evidence, coupled with a lack of clinical evidence. Therefore, during the initial consultation, Dr. Rosenberg and his Fort Lee staff document all observed and reported clinical symptoms that are associated with a large abdominal pannus, along with dated photographs.
Some payers require that the pannus hang down far enough to obscure the pubic area. Others reportedly look for intertrigo or other signs of inflammation under the pannus. Detailed photographs are taken to document the condition as an essential part of the patient’s confidential chart and for possible later use by the patient, if he or she requires the help of an attorney who specializes in reimbursement for bariatric needs to assist them in obtaining insurance reimbursement.
New Jersey Panniculectomy
Panniculectomy excises the abdominal pannus. Dr. Rosenberg does not consider this procedure as being a cosmetic one, as it simply removes excess skin and soft tissue which cause problems. It is a “quick fix” for the medical and skin conditions mentioned above, which must later be followed by a true contouring procedure. Where possible, he prefers another NJ plastic surgery such as an extended abdominoplasty or body lift, since these procedures offer the added benefit of tightening and reshaping the abdomen, flanks, upper thighs and gluteal (buttock) region. When necessary, the addition of Power Assisted liposuction may improve the reconstructed abdominal wall and flank contour. Frequently, the patient may also require umbilical or ventral hernia repair, which can be done at the same time. It is important to note that Dr. Rosenberg NEVER uses a vertical scar in his abdominal contouring procedures, and therefore, no patient can expect an up-and-down scar following surgery by his hands. Better alternatives exist and he will be happy to discuss these with you.
Contact our Bergen County plastic surgery office for more information or to schedule your consultation. We are conveniently located in Fort Lee, New Jersey.
*Disclaimer: Surgical results are not guaranteed and vary greatly from patient to patient.