We are once again changing our policy on over-weight patients. All of our surgeries are performed by Dr. Levin and his trusty assistant Venica. The two of them have performed many thousands of successful surgeries since the practice started in November of 1977. A lot of work and pride of workmanship have gone into these cases over the years, just as ithey do to this day. Increasingly we are being called upon to help women at very high levels of body fat which we have been happy to do. That said, the physical toll on our arms, hands and spines is making it hard to continue to do and therefore we are, by necessity going to limit the weight levels to less than 50% and above body weight range as indicated at:
If you are in the 50% over-weight level or above then Dr. Levin may consider doing your reversal on an individual basis only. He will need to see some photos sent by e-mail with both front and side view to help in making a decision. Please discuss such pictures with my staff to make sure we can see what is necessary to make a decision. If he decides that surgery is possible he will most likely do the procedure using a midline incision rather than a "bikini" cut procedure to enable the best reach to the tubes. These incisions work pretty much the same as a bikini cut incision, differing mostly in how much might show outside of a low cut bikini.
For all patients above ideal body weight it would be best to lose as much weight as possible prior to the tubal reversal surgery in an attempt to get closer to your ideal body weight. The closer you are to your ideal weight, the easier the surgery will be for both you and for Dr. Levin. This in turn will give you a higher chance of a successful surgical outcome. We have had a small number of patients who had so much belly wall fat, pelvic wall fat or omental fat (fat on the walls of the intestine) that it was impossible to even see the reproductive organs much less give a good tubal repair. Even if Dr. Levin is able to repair your tubes successfully, you may experience difficulty in getting pregnant due to the hormonal imbalances created by being overweight. Such outcomes could be prevented by weight reduction prior to surgery so please consider looking into a weight loss program in your area or even consider a surgical weight loss procedure (gastic lapband or laparoscopic roux-en-y procedure).
Why the price differences: For many years there was no difference in the charge for reversal surgery, irrespective of weight. That too changed because the hospital realized that the operative time for women at higher weights is up to twice as long as women in the normal weight range. Because of this extra time, there is longer use of the operating room, more anesthesia time and medications, more disposables used, etc. Consequently the pricing has changed to reflect these increased costs.
Sex-Lies-and Video Tapes: It has been repeatedly brought to our attention that women of extra weight have received a raw deal from a number of doctors who do reversals. You need to be cautious with their claims and be careful of how you spend your money. One such doctor says on his website:
Now if that sounds good to you then there are things for you to understand. Lipsuctions can only safely take off single digits (less than 10 pounds) of fat and then there are fluid shifts that can risk one's life (Think of the case of Kanye West's mother who died from this very issue when done as an out-patient). So if the doctor removes 5-9 pounds right in the center of your belly (leaving a big dent) will he then be able to do a better surgery? This is completely not true, not safe and will not lead to a more successful surgery but clearly risks a higher level of complications.
Another well known doctor says you should not pay more because of your weight and says he will do his procedure (using simple eye-glass-loopes, no operating microscope and using large dissolvable stitches which create a pus reaction in your tube as they dissolve) up to a weight limit of BMI=37. My surgical assistant is 67 inches and weighs 140 pounds. So this well known doctor would do a safe reversal in a free-standing clinic on her at a weight of 236 pounds but he says he will not even do a screening laparoscopy which is a much easier procedure to do with a scope that is at least 12 inches long unless her weight was less than 204 pounds. Seems odd that the easier procedure could not be done safely but the harder case can be done. Be careful when making your choice.
Keep in mind that this price includes infertility aftercare should you have trouble conceiving on your own. Such free care is not generally available from other tubal reversal doctors and could cost you thousands of dollars. In order for you to have the best chances of having a baby, such aftercare could be important to you. Please compare the level of care at Advantages of Dr. Levin.