Question:  I have lost over 100 lbs since the worst of my Cushing’s.  I have a lot of loose skin including some on my neck and a fat roll in the middle that affects how my clothes fit.  I’ve heard that patients in my situation can sometimes qualify for plastic surgery for medical purposes.  Have any of your patients discussed this surgery with you?

Answer 1:  I have seen patients who had cosmetic surgery to remove the skin excess after dramatic weight loss with Cushing disease in remission or after gastric bypass surgery.  I would suggest you consult a plastic surgeon who would send the appropriate paperwork to the insurance.  If the endocrinologist needs to write a letter of support I’m sure it would not be an issue.  (Dr. Georgiana Dobri, Cornell)

Answer 2:  Plastic surgery can be done to help improve the situation. It is often viewed as “cosmetic” by insurance companies that may decline to cover the cost of the procedure. However, the plastic surgeon may be able to convince the insurance to cover the cost, if they indicate that the procedure is medically necessary. For example, some people may experience discomfort or even skin infections in loose skin folds and can be helped by surgery to trim off the excess skin.  (Dr. Nicholas Tritos, Massachusetts General Hospital)

(Winter-Spring 2019)