Abdominoplasty (or “tummy tuck”) surgery is one of the most common procecures performed for both cosmetic and functional reasons. But recent changes mean fewer patients will have access to this surgery.
Just before christmas, the Australian Society of Plastic Surgeons notified members of impending changes to the item numbers applicable to abdominoplasty-style procedures. The changes, introduced suddenly, have altered the way that Medicare pays for certain surgical procedures that fall under the category of “lipectomy” (which involve the removal of skin and fat, typically from the abdomen).
So what’s going on? Why the sudden change?
Well, along with the general review of the Medical Benefits Scheme (which I should point out, I fully support), there have been specific changes to certain procedures. The thrust of the changes to the item numbers we’re talking about involve directing this type of surgery toward so-called “massive weight loss” patients (often those patients who have had gastric banding for example, who have since shed significant weight) who present with excessive, over-hanging skin.
The reason that these changes are contentious, and why many Plastic Surgeons are opposed to the changes, is that the changes seem quite deliberately to exclude women who, following child-birth, present with skin excess in the lower abdomen, with spreading (or “divarication”) of the rectus muscles. Such women benefit greatly from the removal of this excess skin, and also by tightening of the lax muscles of the abdominal wall, from both a functional and a cosmetic perspective. These women are also the most common patients seeking abdominoplasty.
It would seem that those who have made the changes to the abdominoplasty items have made the decision that this is a purely cosmetic operation when performed post-pregnancy. I (and many of my colleagues) would disagree. A story ran in the Australian on 31st December last year which is worth a quick read if you’re interested.
…abdominoplasty is typically a functional procedure (with a secondary cosmetic benefit).
The argument about whether procedures such as abdominoplasty and breast reduction are cosmetic, functional, or both, persist. I would contend that most plastic surgeons would consider these procedures functional, with a secondary cosmetic benefit. It is disappointing, for both patients and surgeons, that surgery such as abdominoplasty which can offer significant functional benefits, is now out of reach of many women.
As I mentioned above, I fully support reviewing our Medical Benefits Scheme. I agree completely that our health system cannot afford to pay for inefficient, ineffective and unnecessary surgery. Medicare should never be expected to pay for cosmetic procedures. But it seems short sighted to attempt to achieve cost savings by altering effective and worthwhile item numbers. Abdominoplasty is an effective functional procedure in many cases. Admittedly, there are some cases that are purely cosmetic. This may be a case of using a sledge-hammer to tap in a nail.
We will keep you updated.