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But despite complications both medical and psychological, many insurance companies don't cover skin removal.
The Insurance Problem Last year, almost 45,000 Americans went under the knife to re-contour their bodies after massive weight loss, according to recent statistics from the American Society of Plastic Surgeons, and the number of such surgeries grew at their fastest rate in four years.
"They’re often in the greatest need of removal of that skin." Losing The Psychological Weight Of Excess Skin In research literature, psychological distress over excess skin is clear, if understudied: One small 2014 study interviewed 11 women after their weight loss surgeries and found that none of their insurance policies would cover skin removal, though a majority described the excess skin as distressing and felt uncomfortable when naked.
Like Bobbitt, they also faced constant fungal and bacterial infections that developed between the folds of their skin.
And before approval, a patient has to prove that he absolutely needs the operation by enduring and documenting several months of skin rashes, explained Jeffrey Gusenoff, an associate professor of plastic surgery at the University of Pittsburgh Medical Center.
When Bobbitt's doctor told her she was in danger of necrosis, she knew she had to get surgery even though she didn’t have health insurance at the time.
At the same time, she acknowledges that the excess skin surgery changed her life for the better, almost on par with the weight loss surgery itself."I finally had a shape, my joint pain was more bearable.I wasn't squeezing into booths anymore or turning sideways to fit through spaces I previously couldn’t," Bobbitt told The Huffington Post."[But] I was seeing my body morph into a blob of extra skin...I traded one insecurity (being morbidly obese and fat) for another (having pounds of loose skin)." Bobbit's skin, which had lost its elasticity from years of stretching, hung low over her waist and past her groin. It caused pain and frequent infections and put her at risk of necrosis of the skin, which occurs when cells die and rot while embedded in living tissue. "I felt gross when I saw myself naked and when it came to dating, it was a big insecurity,” Bobbitt said.
“Now, there needs to be an understanding that these patients need to be covered throughout their continuum of care." Surgeon Eric Volckmann, director of bariatric surgery at University of Utah, agrees.