So the title says most of it anyway. I'm a big loser like many people here and about to get a tummy tuck/abdominoplasty. I've done a lot of legwork with the process and wanted to share some of the pitfalls and successes I've had in terms of planning the surgery, finding a surgeon, costs/paying for surgery, and even how to determine if you should have the surgery (IMHO).
As a precursor, know that you're actually ready. Are you at your goal weight or a healthy weight? Has your weight been stable (i.e. 1-2 years min)? Do you know what it is you want to accomplish with a tummy tuck? Is what you're seeing actually loose skin or simply excess fat? Does what you see bother you enough you'd want to undergo surgery to correct it?
If you're still obese and considering getting the tummy tuck, please keep going until you reach a normal BMI. You owe it to yourself and a tummy tuck is not going to reveal a magical body underneath. IMO if you've lost enough weight to have loose skin, you 100% have the capacity to get to a truly healthy weight. If you still find yourself binging or emotional eating despite being at a healthy weight - this was huge for me - you also need to ask yourself if it's the right time. If your weight loss was less dramatic, is what you're seeing really loose skin? A tummy tuck scar can be 8" or around your hips. Is it worth going under the knife for that?
So after that disclaimer, tips for surgery...
- Shop surgeons. I ended up getting 4 consults and paid $300 - $150 of which was non-refundable. Absolutely glad I did it. You pay a consult fee and it's applied to the surgery if you go with that surgeon; if not, you lose it. Seeing 4 doctors let me know whose prices were in line and whose weren't - I'll get more to that soon. Seeing 4 doctors also let know which tummy tuck to decide on (e.g. mini, standard, extended, body lift/belt lipectomy). It's never bad to have a second opinion, if only to confirm. And one of the doctors I was appalled by so...
- Plan. Taking medical leave through work, applying for Short Term Disability (if applicable), arranging for a caretaker, medical followups - all take a lot of time. Your back-to-work time might be anywhere from 2-8 weeks depending on your procedure. If you're only getting loose skin removed (panniculectomy) with liposuction (included in the procedure cost), you're looking at a few weeks recovery - this is for all the big losers. If you're getting abdominal muscle repair, you'll be out much longer - this is primarily women from childbirth. You'll need a caretaker for your first week or two. Meal prep is a good thing.
- Consider all the costs and how you'll pay. I'm in the U.S. and my procedure is being performed domestically. My 4 quotes in a major Northeastern city as of late 2020 average slightly under $11k for abdominoplasty without muscle repair in a surgical center. Doctors' offices will frequently give you the option of having the procedure in a surgery center or a hospital. Regardless of the decision, the procedure is outpatient and lasts about 3-4 hours. A surgery center will cost anywhere from $1k-$2k less than the hospital. Abdominoplasty with muscle repair will cost more. Insurance will not cover your procedure. You realistically cannot obtain pre-authorization before your surgery either, unless you want to fight for it years ahead of time. Insurance will only cover panniculectomies (loose skin removal) in cases of EXTREME weight loss that include skin irritations leading to chronic infection. Quality of life considerations do not come into play. Most plastic surgeon's offices are not set up for medical insurance billing and will tell you upfront they will help you with whatever documentation you'll need, but that the fight is yours.
The biggest expense besides the surgery is lost pay. I'm fortunate in that my Short Term Disability policy covers all elective surgeries. Most seem like they don't, but it doesn't hurt to inquire. STD pays a fraction of your average wage after you've been out of work for a certain amount of days (the benefit doesn't start immediately).
I hope this next part helps people, because it's shaved thousands of dollars off my total costs had I not done otherwise. (I didn't invent capitalism.)
I recognize that this piece won't help everyone. The surgery itself is obviously a stretch purchase for the vast majority of folks. Here's what I'd recommend if your situation is similar to mine.
I saved for the entire procedure (including lost pay) and was going to pay in cash, but I'm paying with credit cards instead. If you have good credit and can afford the surgery outright, consider doing the same. Don't get 0% financing or financing through the doctor's office. This has helped me shave about $3k from my total bill.
Credit card sign up offers are golden. You might get an offer that reads, "Spend $1,000 in the first month, get $200 cashback!" or something similar. They're all the same; spend money X in 90 days and get reward Y.
I put all of my regular expenses on credit cards anyway - easier to track, I get rewards, better purchase protection. I spend $2k a month on average. But to be clear, I pay everything in full each month, so I carry no balance. So if you're planning a $11k surgery and have credit card expenses of $2k per month like me, you're looking at $17k in 90 days. How many credit cards can I sign up for then? I got 6 with an 800 credit score, but in theory anything about 750 should be fine. With all my bonus offers, minus a few with annual fees, I netted a little under $2,000.
Running multiple credit cards is going to result in multiple hard inquiries. This typically hurts people's credit. I did NOT hurt mine. This is why:
Credit score formulas are complicated and opaque, but basically you're judged off of different metrics with different degrees of importance. Paying on time is by far number one with something like number of accounts coming in last. Another key aspect is your utilization ratio. Basically, the less of your available credit you use (outstanding amounts/all credit card spending limits), the better your score. Even with 6 hard inquiries on my credit, my score did not go down. The credit limits on my new cards caused my utilization to plummet, offsetting the dip from the inquiries (evidently). YMMV.
I did all the applications online in rapid fire and got instant approvals. This part helps A LOT. I link all my bills through PayPal. Pay for your recurring bills through PayPal and set up a new card as the default. Pay for all your physical purchases on this card until you hit the minimum spend amount and then pay off the card entirely. Repeat this process for the next card and the next until your surgery. Once your surgery fees are due - typically two weeks prior to surgery - ask the surgeon to split the cost among your remaining cards that still need to hit the minimum to receive the bonus. With proper planning and financials, you shouldn't have to pay a dime in interest.
For me, STD benefits are direct deposit and eligible for new account bonuses in the same way credit cards are, "Make X amount in direct deposits in 90 days and receive reward Y!". The online portal that administers my benefits is insanely easy with direct deposit, I can actually set up multiple accounts with defined contributions per week. So I opened up 5 checking accounts with a $200 average bonus for $500 direct deposits in 90 days (or $2,500 in 90 days for all 5 total). $100 per week from STD benefits into each account will cover me after 5 weeks, for an additional bonus of $1,000.
Total "savings" of $3k. The pitfalls to watch out for are making sure you aren't paying monthly fees on the checking accounts or annual fees on the credit cards. Also, pay your entire statement off. If you were gonna pay upfront, you already have the money.
Tangent: I've learned a lot about credit cards and checking accounts too. They're definitely not all created equal. If you find a financial product you like, stick with it and don't just cancel once you've gotten your intro bonus. Similarly, don't hold onto a bad product; you tried it and it didn't work out. Don't feel bad, it's competition among banks looking for your money.
Good luck, losers.
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