Is abdominoplasty a functional operation?

Published on March 5, 2018

This is interesting. Very, very interesting.

A recent report in the Journal of Plastic and Reconstructive Surgery from an Australian group has shown that post -partum women who suffered from back pain and urinary incontinence and underwent abdominoplasty (tummy tuck) achieved significant improvement in both problems. Before surgery, 51% and 42.5% of patients reported significant problems with back pain and urinary incontinence respectively. After abdominoplasty, those same patients reported only 9% and 2% residual symptoms.

Intuitively this makes sense. If your anterior core muscles are weak from being stretched and/or separated (which is what happens with pregnancy) then your back muscles have to bear the full load of maintaining posture. The result is more back pain. Under the same scenario of weakened anterior abdominal wall muscles, bladder control becomes nearly impossible.

Anecdotally, Plastic Surgeons have been noting these improvements for years. And indeed there have been earlier studies which have documented improvement in back pain symptoms following abdominoplasty.

So this begs the question. Why don’t insurance companies cover abdominoplasty if functional problems can be addressed and improved?

The problem is that for decades, abdominoplasty has been seen as a cosmetic procedure. By the doctors, by patients, and by the insurance companies. It will take a sea change for this to be seen differently. It will take many more studies like this as well as significant level of complaints from patients and doctors. It can happen. Remember that just a couple of decade ago breast reconstruction after cancer surgery was considered medically unnecessary by the insurance companies. Patients and physicians rose up and that was changed.

Until then, those women who will continue to pay for this out-of-pocket can be assured that not only will they look better, but they will be better.