allycatt98

I had my first in-person plastics consult on Wednesday. It was definitely interesting. My three previous consults were virtual -- two MX docs one in DR. Wednesday I met with a Resident, Medical Student and Attending Physician over at Tampa General. There is a 50% off Resident option for plastics. I actually really liked the Resident but was less than thrilled with the Attending. At any rate, 5 out of 5 docs agree that I need a breast lift -- an implant alone isn't going to cut it. So the Attending recommended a Mastopexy in two stages occuring 6 months apart. The first for the lift, then the implants six months later. I think I'm going to put it on the back burner for now and just get the Brachioplasty. I hate my arms more than my breasts right now. I can't even buy shirts in my size. Then next year I'm having a circumferential tummy tuck in the DR with a BBL. Rock on Djmohr! Please keep us posted on your surgery and your results.

I called the member services number and told them that I wanted to initiate a Pre-Authorization request. Different Plans use different names. I was able to initiate the request and faxed over the documentation that I had from my physician's office (notes, imaging, etc.). I provided my physician's information for follow-up (name, phone and fax number). Then once the Prior Auth request was initiated, I contacted my physician's office to provide them the info. I've got a Type A Personality, so this stuff comes easy to me. If they won't do it, then dang it, I will get it done.

Well you could always submit the request yourself..... I've done that before too when I got tired of waiting. Just a thought.

Hi Goddess, I'm in Tampa, but just had a consult at USF Health. They offer a 50% discount at their Resident Plastic Surgery clinic and since they are quite familiar with the insurance process. If you're in south Florida, I would inquire about the University of Miami plastic surgery clinic if you discover that the insurance option isn't feasible. I've dealt with them in the past, and they are well versed with insurance payors. I would say that most docs, (if they're affiliated with your insurance plan) are familiar with the Prior Authorization guidelines. The best advice is for you to review, review, review your benefit plan. Some of them have a dollar limit max on procedures related to the weight loss including post-op plastics. This is such an exciting process. I'm still not sure of my next steps....... Best wishes to you! Ally

Hi Amazon, I had a consult with Dr. Sauceda a few weeks ago. I found him to be very pleasant, but was extremely surprised that he seemed unfamiliar with Von Willebrands... even the recommended treatment during surgery. In comparison, I had a totally unplanned phone consult with Dr. Carmena Cardenas last Saturday and she was well versed and familiar with the treatments. Additionally, he made it a point to tell me how African American skin keloids, has poor scar healing, etc. Kind of like he was setting me up for disappointment....

My procedures definitely won't be covered by insurance. However, I'm giving myself additional time to get down to my optimal weight. I've seen some really good results on the big girls (on realself.com), but the best results are on those with a BMI under 25. Well and the extra time to arrange funding helps too!

Snacky, Let you know what you find out about the wife/husband team. I couldn't really get a feel for them yet because they only have a handful of reviews on RS. Ally

Blue, Sometimes you just have to shake your head and laugh. You were reading my mind with your post. The IRS only gives you a hard time with your deductions if you're selected for an audit. Otherwise you just hope for the best and keep it moving. People claim deductions that they aren't entitled to all the time and they fly under the radar unless they had enough red flags to trigger an audit or they were just one of the unfortunate ones selected for a random audit. My heart goes out to ya. My BFF has been in audit hell for almost six months because the auditors are backlogged. Even though hers was a random audit, she has to justify everything and she doesn't even itemize her taxes. Three years of returns and because of the audit, she can't even submit her 2014?? taxes to get her refund. Brutal stuff. But what do we know? BariatricPal has evolved beyond even Alex's expectations: Weight Loss Support, Physician Reviews and now Tax Advice. Ouch. She's a CPA and took the time to answer your post. Is it necessary to blast people who are trying to be helpful? It seems like you are looking for a specific answer. I'm sure if you search long and hard enough you will find all sorts of people claiming and deducting things on their taxes that wouldn't fly if they were audited. In my opinion, the plastic surgery your are speaking of doesn't qualify as a deduction. How about you claim it on you taxes and report back to us if you got audited? I will probably pass as I've already been audited once in my lifetime by the IRS. I prefer to stay under the radar

Agreed! OMG that someone (with a phone and a CPA no less) would want tax advice from random internet posters instead of the IRS.

That's awesome news! I know the type of look I want, but I'm unsure what's required to get it. TT definitely -- more than likely an extensive one. My poor rump is like a pan of Jello. I joke that I pour it into my clothes. I think grafting of some sort will be needed in order to achieve that hourglass/doll figure. I just don't want multiple surgeries. Why can't we have it all? But..... (no pun intended) I am worried about some of the potential complications if I have those two procedures done. I have Von Willebrands and will need to have Iron infusions prior to the surgery (stateside) and require DDAVP right before and after the procedure. I'm going to have a discussion with my Hemo/Onc and the surgeon I select regarding the purchase of the DDAVP. It might be cheaper to purchase it across the boarder instead of with my high-@$$ insurance. I'm going to go check out your pictures. Thanks so much for your post!

No problem Kate. I was thinking about applying for CareCredit, but I don't think they work with the Drs in MX and DR. So I'm still pacing while I try to pick out a doctor. I'm giving myself six months to reach my goal and pick a doc. Sigh...

I thought my response was clear and relevant to the post, but okay. Not everyone interprets things the same way. So I will rephrase this..... We have the ability to apply any of the available deductions when we submit our taxes. It's only if and when we are audited, that your questions would actually become relevant. There could be hundreds (or thousands) of people out there that have applied this deduction. Only the ones that were selected for an audit can honestly tell you if the IRS accepted/allowed this deduction after a manual review. That being said, the results will still vary by individual because there is a medical necessity requirement. Perhaps this is just clear to me because I have experience developing evidence-based criteria. IRS language pasted from your reply: necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease." Notice the key word "necessary." Based upon your health history, can you prove that the removal of the excess tissue was necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease? Is your excess skin (as a result of obesity) so extensive or impairing that it could be considered a disfigurement? Based upon the language you were kind enough to paste in your reply, my previous reply is still appropriate. Honestly, this would be easily remedied by just contacting the IRS and asking about the audit process related to medical deductions: "What type of documentation is required if I'm audited? Do you need documentation from my physician to support my use/application of this medical deduction?" You would probably be better off obtaining this information directly from the IRS (regarding their specific requirements) instead of relying on someone else's results (that are based upon their own personal health history). I hope you're able to get the information you need in order to move forward. JerseyCityGal, I understand your question, but everyone's situation is different. Let's say you took a deduction in 2014 for your Sleeve and were audited, would you be able to prove that it was medically necessary? That's really the issue here. You could definitely attempt to take the deduction. I've done it for dental work that was considered cosmetic. But if I were audited, I have the documentation to prove that my dental work was medically necessary even if it wasn't covered by my insurance. I don't think one answer fits all situations.... It's not the same as an itemization for home office expenses (it would be so much easier if it was ). It gets really murky when you start comparing medical procedures and services. My sleeve was approved by the insurance company on the first submission within 48 hours, but there are tons of people on the board that have been repeatedly denied by their insurance company. I think this one is going to be dependent on the documentation that you have to support your deduction in the event of an audit. I know that's not the answer you were looking for but it's the truth and audits are evil. Ally No offense, seriously, but you are not getting it.. If you have an official medical diagnosis of Obesity, yes, your VSG is deductible (% of AGI and all that). If you had it done for shits and giggles and were not obese, it won't work. "Medically necessary" does not appear in the Cosmetic section of the tax code. What does appear is " if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease." It does not seem to me that Obesity falls under any of those categories, but I did find one US tax court case that allowed a woman with an over 100 lb weight loss whose abdominal skin got in the way of her movement for her job to take the deduction. I am SPECIFICALLY asking: 1) people who have had reconstructive types of plastic surgery after massive (over 100 lb) weight loss; i.e. skin removal/LBL, arm lifts, etc (not a tiny tummy tuck but major surgery) 2) Did you claim these surgeries as a deduction on your tax returns? 3) How did it work out for you? Was it questioned?

JerseyCityGal, I understand your question, but everyone's situation is different. Let's say you took a deduction in 2014 for your Sleeve and were audited, would you be able to prove that it was medically necessary? That's really the issue here. You could definitely attempt to take the deduction. I've done it for dental work that was considered cosmetic. But if I were audited, I have the documentation to prove that my dental work was medically necessary even if it wasn't covered by my insurance. I don't think one answer fits all situations.... It's not the same as an itemization for home office expenses (it would be so much easier if it was ). It gets really murky when you start comparing medical procedures and services. My sleeve was approved by the insurance company on the first submission within 48 hours, but there are tons of people on the board that have been repeatedly denied by their insurance company. I think this one is going to be dependent on the documentation that you have to support your deduction in the event of an audit. I know that's not the answer you were looking for but it's the truth and audits are evil. Ally

@@JamieLogical, I've been lurking on the RS and "following" Dra. Cardenas. Most reviewers refer to her as the Queen in regards to TTs, but the reviews are mixed with the BBL. What are your thoughts? You had a TT and grafting to the butt done at the same time right? Were you happy with her work (especially the fat grafting) and if you had to do it all over again, would you have a TT and grafting done at the same time? Ally

JerseyCityGal, Everyone will have a different situation. Typically you're allowed either a standard deduction or you can itemize -- not both. So think about your filing status for next year vs. the amount of money that will be spent out-of-pocket (non-reimbursed) on medical care. Just for kicks and giggles, you could go to TurboTax or HRBlock and see which option is recommended. For most people, the standard deduction is usually higher. Also it's not a 1:1 match, there is a calculation utilized. Topic 502 - Medical and Dental Expenses If you itemize your deductions for a taxable year on Form 1040, Schedule A (PDF), you may be able to deduct expenses you paid that year for medical and dental care for yourself, your spouse and your dependents. For years beginning after December 31, 2012, you may deduct only the amount of your total medical expenses that exceed 10% of your adjusted gross income or 7.5% if you or your spouse is 65 or older. The 7.5% limitation is a temporary exemption starting January 1, 2013 to December 31, 2016 for individuals age 65 and older and their spouses. You figure the amount you are allowed to deduct on Form 1040, Schedule A. For more information, see Questions and Answers: Changes to the Itemized Deduction for 2014 Medical Expenses on IRS.gov. Medical care expenses include payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or payments for treatments affecting any structure or function of the body.