hi donna:
my name is karen, open rny 12 2 02... down 103 lbs... :o)
regarding the tummy tuck and insurance approval... this is very similar to our wls surgery... the more wrong with you, the less the insurance is inclined to deny the procedure.
i had a tummy tuck a few years ago before i knew about wls... insurance paid... here's how i documented:
1. i have had documented low back problems for years. i had an orthopedic doctor write a letter explaining how the hanging skin was pulling my low back out of alignment. he more or less stated that it was either relief from a tummy tuck now, or low back surgery down the line in the future... tummy tuck $6,000. low back surgery $30,000 and up.
2. i also had a hernia which needed surgery.
3. there is a condition called 'maceration'. a maceration is anything (usually skin on skin contact) that provokes irritation and eventually skin infection. my apron of skin laying over my lower tum was just such a situation. (that's pronounced 'mass-er-a-tion')
there are other situations that your plastic surgeon might find with your case to add to the list here...
good luck,
karen