Your Questions

Q: Dr. Eppley, I have several body problems that I would like to get rid off. I have lost 100 pounds and have kept it off for 11 years. First, my large batwings are causing strain on my shoulders  I exercise five  days a week but they will  not go away. Will insurance pay for this since I am having it done to decrease my pain and not for  cosmetic reasons. Also the loose shin around my inner thighs is increasing. I also have engorgement of  my varicose veins  I am currently looking to have surgery for these three problems. Will insurance pay for this two also.

A: After a 100 pound weight loss, most patients will suffer loose and redundant skin which can not be exercised off. Such loose skin in the arms and inner thighs is common and can be removed through arm lifts (brachioplasties) and inner thigh lift procedures. It is highly unlikely that either procedure would be covered by insurance. These are viewed as procedures that largely have cosmetic benefits not functional ones. But no plastic surgeon can tell you whether any procedure would be covered by insurance. There is a process known as insurance pre-determination in which the information would be submitted by the consulting plastic surgeon on which your insurance would make the final decision. My experience has never been favorable in that regard. Conversely, the varicose veins should be covered by insurance but you will need to be evaluated and treated by a vascular surgeon for that problem. Varicose vein surgery should not be performed at the same time as the body contouring surgery. It should be done first so that your risk of DVT (deep vein thrombosis) is lessened for the body procedures.

Dr. Barry Eppley

Indianapolis, Indiana

Q: I am a 35 year old mother of two. I’m 5’4″ and 144 lbs. I have been planning my mommy makeover for a while now and have put a alot of thought and research into it. I need a breast makeover with a lift and implants and a tummy tuck. The other area that bothers me a lot is my inner thighs. I have very little fat just loose skin with a lot of stretch marks. I know an inner thigh lifts creates scars and I am not wild about that idea. I know that thse groin scars can move downward as they heal which could be a problem in a swimsuit. Would a body lift be a better option? I know the scar goes the whole way around but how well would it lift the inner thigh area? What are your thoughts?

A: Your thought process is a good one but you have an understandable misconception about what the the lower body lift or circumferential lipectomy procedure can do. By removing skin and fat all the way around (360 degrees), it will make significant changes to your abdomen, lower back, buttocks and outer thighs. But it will have little if any effect on the inner thigh area. You wouldn’t do a lower body lift if you thought one of its main advantages was improvement in the inner thighs. The only way to improve the inner thighs is to treat them directly with an inner thigh lift. This would be far easier and more effective than a lower body lift. With well-placed incisions, the scars should remain fairly hidden in the groin creases.

Dr. Barry Eppley

Indianapolis Indiana