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Cosmetic Surgery 

Cosmetic surgery is a type of plastic surgery that aims to improve a person's appearance, but it should be approached with caution.

Cosmetic surgery continues to grow in popularity, with 15.1 million cosmetic procedures carried out in the United States in 2013, an increase of 3 percent on the previous year.

Procedures are available for almost any part of the body, but the choice to undergo cosmetic surgery should not be taken lightly. The results are often permanent, so it is important to be sure about the decision, to use an appropriate practitioner, and to have the right motivation.

A surgeon may refer a patient for counseling before surgery if they believe there is an underlying problem that cannot be solved by the surgery, or if the patient shows signs of Body Dysmorphic Disorder (BDD).

BDD can cause a person to perceive that there is something seriously wrong with their appearance, when objective evidence suggests otherwise.

Reconstructive surgery is another type of plastic surgery. It aims to improve function and to give a normal appearance to a part of the person's body that has been damaged, for example, after a mastectomy. This article will focus on cosmetic surgery only.

Types and uses

A variety of aesthetic procedures is available for different parts of the body.

Breast surgery

Breast implants can be used to increase breast size or in reconstruction after surgery.

Women may seek breast surgery to improve their body shape. Mammoplasty procedures may include:

Breast augmentation, or enlargement, traditionally performed using saline or silicone gel prosthetics, and now occasionally with fat grafting.

It may be carried out if the woman feels her breasts are too small, if one breast is larger than the other, or if the breasts have changed after pregnancy or breastfeeding. Some older women opt for this treatment when the breasts being to droop due to the skin losing elasticity.

In some women, a breast enlargement can boost self-esteem and improve their feelings about their sexuality. In some, however, existing problems remain. This is why women are encouraged to undergo counseling first.

Breast reduction can help provide relief from physical discomfort, while the aim of augmentation more often relates to appearance. Breast reduction may also reduce the risk of breast cancer in women who are at high risk of the disease.

Mastopexy, or a breast lift, involves removing skin and glandular tissue to make the breasts smaller and rearranging the remaining tissue to make the breast appear lifted.

Depending on how much volume a patient has lost or desires, mastopexy can be combined with an implant. While it is similar to a breast reduction, which removes a much greater amount of  tissue, mastopexy is not usually covered by major insurance carriers as it is not deemed medically necessary.

Male breast reduction treats gynecomastia, an enlargement of the mammary tissue in men. It may be done by liposuction or with various scar patterns, often hidden around the nipple and areola.

Liposuction

Liposuction, or suction-assisted lipectomy, uses thin cannulas, or hollow metal tubes, to vacuum fat from various parts of the body, usually the abdomen, thighs, buttocks, hips, backs of the arms, and neck. Liposuction may also be used for male breast reduction.

Tools used in liposuction include standard, ultrasound, mechanical, and laser devices. They all tend to involve suction of fat through a tube.

To prevent complications, there is a limit to the amount of fat that the surgeon can safely remove, depending on whether the patient will be discharged immediately after surgery or admitted to the hospital.

Liposuction should not be intended as a weight-loss procedure. When performed in the right patient, the goal is to improve contour and decrease limited areas of fat deposits.

Complications are rare but possible. They include the accumulation of blood under the skin, known as hematoma, infection, changes in sensation, allergic reactions, damage to underyling structures, and unsatisfactory results. The doctor must discuss these with the patient beforehand.

Liposuction does not reduce the risk of developing diabetes, heart disease, or high blood pressure.

Vulvovaginal surgery

Labiaplasty, labioplasty, labia minor reduction, or labial reduction involves surgery of the labia majora or labia minora of the vulva, a part of the female genitalia. It aims to reduce elongated labia, usually as part of a vaginoplasty.

There is a lack of clinical or scientific evidence to guide gynecological surgeons as to the safety and effectiveness of cosmetic vaginal procedures.

Body procedures

Abdominoplasty, or "tummy tuck" reshapes and firms the abdomen. Excess skin and fat is removed from the middle and lower abdomen, with the aim of tightening the muscle and fascia of the abdominal wall.

This may be suitable after pregnancy or after losing a great deal of weight.


Procedure Of Cosmetic Surgery

 Facial contouring procedures: Some of the examples include rhinoplasty, chin or cheek augmentation, thermage treatment, lip augmentation, eyelid correction, and laser skin resurfacing. These are done to enhance the facial features and rejuvenate the face. All kinds of invasive and non-invasive facial procedures are available through MedMonks at some of the best hospitals for plastic surgery in India.

Breast procedures: Breast augmentation, breast reduction, breast reconstruction, nipple areola reconstruction, and breast lift are some of the most popular procedures among medical tourists. Medmonks works closely with some of the leading cosmetic surgeons. best plastic surgeons in delhi and other major cities perform Breast reconstruction and nipple areola reconstruction for our clients. Apart from aesthetic reasons, these procedures are often recommended to patients with complete mastectomy as a part of breast cancer treatment.

Body contouring procedures: This category includes procedures like liposuction, tummy tuck, butt lift, body lift, calf augmentation, and breast reduction (as a treatment for gynecomastia). These body contouring procedures are done to tone up the body by removing unwanted fat and skin from the body or to add volume wherever required through fat grafting or silicon (or saline) implants. Vaser is used for high-definition liposuction and non-invasive procedures like coolsculpting are also popular amongst Indians and tourists alike.

Facial rejuvenation procedures: Facelift, neck lift, eyelid lift, and brow lift are some of the most popular procedures among foreign nationals when it comes to facial rejuvenation. There are many non-invasive procedures like Thermage and Ultherapy that are used for facial rejuvenation.

Skin rejuvenation procedures: Laser resurfacing and filler treatments are conducted at some of the top plastic surgery hospitals in India.

Vaginal procedures: Hymenoplasty, labiaplasty, and vaginal tightening are some of the vaginal cosmetic surgery procedures popular among medical tourists. These procedures are conducted to rejuvenate the female genital parts and in some cases, to restore virginity.

Reconstructive procedures: Burn repair surgery, hand surgery, scar revision surgery, breast reconstruction, lower extremity reconstruction, and congenital defect repair are some of the reconstructive procedures conducted at the top plastic surgery hospitals in India by some of the best plastic surgeons in India, Delhi, Mumbai, Bangalore, Chennai, and other major cities.


Treatments Of Cosmetic Surgery

These services may or may not be covered by all HealthPartners plans. Please see your plan documents for your own coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

All requests for coverage of cosmetic surgery/treatment require prior authorization.

Submission of GA modifier wavier is required when requesting services which are always considered a cosmetic service and therefore never covered. (See Coverage section and list of non-covered indications below).

Coverage

Services that are performed to enhance or change the appearance and are not necessary to preserve the health of an individual are always considered to be cosmetic and are not eligible for coverage. This policy is meant to supplement a member’s contracted benefit plan. In the event of a conflict, a member’s benefit plan document always supersedes the information in this coverage policy. In the absence of a controlling federal or state coverage mandate, benefits are ultimately determined by the terms of the applicable benefit plan document. The provider and facility will be liable for payment unless:

  1. The provider notifies the member that a specific service has been determined by HealthPartners to be cosmetic and
  2. The member signs a waiver agreeing to pay for the specific non-covered service being rendered and
  3. The claim has been billed with a GA modifier indicating such. If the member has signed a waiver agreeing to pay for the specific service then the member will be liable for payment.

Indications that may be covered

The following are examples of procedures or treatments which, depending upon the situation, may be considered cosmetic or medically necessary. For this reason, HealthPartners has developed specific coverage policies to address them. Generally, these procedures require prior authorization. Please refer to the following individual policies for coverage criteria and documentation requirements:

  • Blepharoplasty, blepharoptosis repair, and brow lift
  • Breast surgery (augmentation/implant removal/lift)
  • Dental services - orthognathic surgery
  • Gynecomastia surgery
  • Hemangioma treatment
  • Hyperhidrosis treatment (with thoracic sympathectomy)
  • Laser treatment for skin conditions
  • Panniculectomy
  • Reduction mammoplasty (breast reduction surgery)
  • Rhinoplasty - plastic surgery to alter nasal appearance
  • Scar revision/keloids
  • Varicose vein procedures
  • Weight loss surgery

Indications that are not covered

Contractual benefits prohibit the coverage of cosmetic services, including those listed below. Please note that while this portion of the policy addresses many common procedures, it does not address all procedures that might be considered to be cosmetic. Per the member contract, the HealthPartners Medical Policy Department, in collaboration with HealthPartners Medical Directors, reserves the right to review and deny coverage for other procedures that are deemed cosmetic.

  1. Abdominoplasty or tummy tuck (See Panniculectomy coverage policy)
  2. Any skin lesion treated or removed for solely cosmetic purposes
  3. Chemical peeling (except dermal peel for treatment of actinic keratoses)
  4. Dermabrasion treatment (except for pre-cancerous and cancerous conditions)
  5. Diastasis Recti repair (See Panniculectomy coverage policy)
  6. Earlobe repair, except in the event of acute, traumatic injury.
  7. Ear or body piercing
  8. Electrolysis or laser hair removal (including treatment of pseudofolliculitis barbae).
  9. Face lifts (rhytidectomy) or other related procedures to remove wrinkles or diminish the aging process
  10. Fat grafts to any area unless performed as an integral part of another covered procedure
  11. Hair transplants or repair of any congenital or acquired hair loss
  12. Injections of (botulinum toxin) to treat wrinkles
  13. Injections of dermal fillers to improve the skin’s contour or treat wrinkles, scars, or lipoatrophy. Examples include but are not limited to Artefill, Bellafill, Belotero, Captique, Cosmoderm, Elevess, Evolence, Fibrel, Hylaform (Hylan B Gel), Juvederm, Prevelle Silk, Radiesse, Restylane, Sculptra, Zyderm and Zyplast.
  14. Laser facial resurfacing for treatment of acne scarring
  15. Laser treatment of rosacea, a common skin condition in which certain facial blood vessels enlarge, giving the cheeks and nose a flushed appearance
  16. Laser treatment for removal of spider veins (telangiectasia or spider angioma)
  17. Liposuction of any area unless performed as an integral part of another covered procedure
  18. Mesotherapy (injection of pharmaceutical and homeopathic medications, plant extracts, vitamins and other ingredients into the tissue beneath the skin to sculpt body contours by lysing subcutaneous fat).
  19. Removal of excessive skin, thigh (thighplasty), leg, hip, buttock, arm (brachioplasty), forearm, hand, or neck (cervicoplasty)
  20. Tattoo removal
  21. Testicular implants for congenitally absent testes
  22. Treatment for correction of protruding ears, including otoplasty and mechanical-molding devices, e.g., EarWell Infant Ear Correction System.
  23. Vaginal rejuvenation procedures (including clitoral reduction, designer laser vaginoplasty, G-spot amplification, pubic liposuction or lift, reduction of labia minora, labia majora surgery or re-shaping, labiaplasty, or vaginal tightening)



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