Affording Plastic Surgery after Weight Loss:** Combining Procedure**** My Bariatric Life:** Affordability is a fundamental barrier for many patients to undergo body contouring surgery. Virtually all procedures are considered cosmetic and therefore not covered by health insurance. Accordingly, many of our readers have asked how they can minimize costs. Obviously when we look at reducing costs there are tradeoffs that need to be made. Some tradeoffs may increase risk to patient safety while others may not. Dr. Capella, may we please explore this further?
Dr. Capella: I don't think there is one thing consistent that I can say across the board. Frankly, my fees are very reasonable and people are surprised. Because as we discussed this patient population earlier, these are normally regular people. And I would rather be operating and developing more expertise than charging exhorbanent fees. I don't like that philosophy. And my father was like that, too.
I want to help people. That's why I try to make myself available to as many people as I can. So I can't be out-of-reach to them financially. I charge everybody the same. I don't charge for revisional work. I don't charge for scar revisions. I'd rather be working. That's my philosophy.
And I know that to get the best results you often need combinations of procedures. So if I piece-mealed your operation you could be having surgery for a year or more. I hear about two or three years of surgery. We get a lot done because we're working efficiently. And I think my fees are reasonable. So, that's my approach and not everybody takes it.
MBL: So you just mentioned piece-mealed operations. Does combining multiple procedures into one big surgery save money versus doing individual or smaller operations?
Dr. Capella: Sure, when you combine surgeries there's not that redundancy of going to sleep and waking up with each operation. So when you have several operations performed you're going to sleep once and waking up once. Plus the O.R. fee for the first hour is far more costly than the subsequent hours. So timewise it is usually a savings. By safely combining three two-hour surgeries into one six-hour surgery, the cost can be 10-20 percent less, something like that.
It also may make aesthetic sense. Doing your arms alone and then later doing your breasts may lead to a suboptimal result. The excess skin in the armpit region may end up as a dog ear. So it's almost easier to do combinations to get a good result. That's the reason to do a body lift [combination abdominoplasty, butt, and thigh lift], you do not have to worry about dog ears. So with combinations sometimes you not only save money, but aesthetically they are far better choices.
MBL: Is it more expensive to do an abdominoplasty on someone with a very large roll of abdominal fat extending past the genitals versus a patient who has a smaller pannus and just needs a "mommy makeover?"
Dr. Capella: No. That's a good question. See, I don't charge more for anything I do. I do everything by time. Sometimes there are people where the pannus is bigger and it did require a little bit more time. Not often, though.
Continue to part 9