Why aren’t abdominoplasties considered a ‘medical’ procedure and subject to rebates after pregnancy?

If you’ve lost 5 BMI points (outside of pregnancy) and have excess skin that can’t be conservatively managed, the Medicare Benefits Schedule criteria may deem you eligible for a ‘medical’ abdominoplasty – that is, one that is billed under an item number. However, since late 2015, if you’re a women experiencing rectus divarication, chronic back pain or urinary incontinence post partum, Medicare and health funds will consider the procedure to be ‘cosmetic’. So essentially, if a man undergoes extreme weight loss after bariatric surgery and has excess skin, some of his abdominoplasty costs will be reimbursed under Medicare (and private health insurance if he has an eligible policy), and yet a woman who has torn muscles, incontinence and back pain as a consequence of pregnancy cannot.

above: before and three months after abdominoplasty surgery with Dr Sharp

Abdominoplasty repairs rectus diastasis (muscle separation after pregnancy), reconstructing the abdominal wall, removing hernias and restoring core strength – as well as removing excess skin from the lower abdomen.

The authors of the 2018 Australian study highlighted the fact that this not only restores the abdomen’s shape, it can also improve core strength, and can impact back pain and pelvic floor control.

The study included 214 women undergoing abdominoplasty in Australia, with an average age of 42 and a history of two or more pregnancies. Before tummy tuck surgery, half of the patients reported moderate to severe disability from back pain, while urinary incontinence was a concern for 42.5%.

At six weeks and six months post surgery, only 2% of the abdominoplasty patients said urinary incontinence remained a significant problem, while only 9% still reported moderate disability from back pain. The study’s findings renewed calls earlier this year to add abdominoplasty to the MBS for women suffering from chronic postpartum medical issues, which would see the procedure subsidised by Medicare – and rebatable through private health insurance – if the women met the MBS criteria for medically requiring the surgery.

There are many operations performed for the relief of chronic pain and it is the Royal Australasian College of Surgeon and Australian Society of Plastic Surgeon’s position that women should not be excluded from having abdominoplasty surgery to address medical problems; it should be considered as a procedure that fixes core strength and pelvic floor instability and addresses function or pain issues.

Postpartum abdominoplasty facts:

• Approximately 1.6 million Australian women are currently suffering with chronic back pain as a result of giving birth
  More than 3 million Australian women experience discomfort, functional problems and social concerns that relate to stress incontinence
  Tummy tuck surgery can improve back pain and urinary incontinence after pregnancy or childbirth

For more information about how abdominoplasty surgery helps repair pregnancy related abdominal wall defects, hernias and excess skin call 07 3202 4744 or contact us via the form below.

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