In our current health system not all patients that require a panniculectomy get authorized by their insurance provider. One would think that if the bariatric surgery was covered by the insurance company, then the panniculectomy would be covered as well. However, it is not covered unless the patient meets All the criteria, being the numbers 1, 2, 3, 4 and/or 5 and 6 outlined below; 1. The patient should be 18 years or older. 2. The panniculus should hang below the level of the symphysis pubis as demonstrated in the medical record or pre-operative photographs. 3. Medical documentation should show a stable weight for a minimum of 6 months, post-bariatric surgery. 4. The panniculus should cause a chronic and persistent skin condition,…show more content… Truth is after having bariatric surgery, patients are left with excessive amounts of sagging skin around their abdomen area, known as the "apron" effect. This is why many patients look to have more corrective work done after bariatric surgery. Also, obese patients have a higher skin pH, so proper hygiene is very important. Patient's with obesity risk skin conditions, such as intertrigo, venous insufficiency, and/or cellulitis being just a few of them. Intertrigo is an infectious or noninfectious inflammatory condition of two opposed skin surfaces. This is usually caused by excessive moisture and friction. Most commonly found within deep skin folds or under a large abdominal pannus. With venous insufficiency in the early stages the ankles of both legs may look “dirty”, due to the veins failing to adequately circulate the blood, especially from the lower extremities. As if the patient didn't already have enough things to worry about, now they also have to worry about Cellulitis. Cellulitis is a bacterial infection of the skin and tissues beneath the skin. Not to mention, all these skin conditions if not caught in time or treated properly could be life threatening. That is why educating bariatric patients about their skin and wound care should be part of their treatment plan. As for alternatives to a panniculectomy, they would be liposuction, or an abdominoplasty. The plastic surgeon would go over all
