Chloe Zhang
Plastic surgery has a long and complex relationship with the military. It emerged as a specialty in response to the horrors of World War I, and the military continues to play a role in advancing plastic surgery techniques through their medical response to warfare. The military covers plastic surgery in certain cases, such as reconstructive surgery after an injury, but there are limitations and debates around cosmetic procedures that are not deemed medically necessary. The Department of Defense (DOD) has specific policies outlining when and how service members can receive cosmetic procedures, and approval from a commanding officer is typically required. This area of military healthcare is evolving, with a growing need for plastic surgeons to support service members' physical and psychological well-being.
| Characteristics | Values |
|---|---|
| Plastic surgery coverage for military personnel | Tricare covers plastic surgery if it is deemed "medically necessary" |
| Plastic surgery coverage for military spouses | Tricare does not cover plastic surgery for military spouses |
| Plastic surgery coverage for retired military personnel | Tricare does not cover plastic surgery for retired military personnel |
| Types of plastic surgery covered by Tricare | Correction of a birth defect, restoration of a body form following an accidental injury, revision of disfiguring and extensive scars, reconstructive breast surgery, penile implants and testicular prostheses, surgery to correct pectus excavatum, panniculectomy performed in conjunction with abdominal or pelvic surgery |
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What You'll Learn
Plastic surgery for military spouses
Tricare, the military's health care system, has strict policies regarding what procedures are covered. In terms of plastic surgery, Tricare's policy states that it will cover procedures deemed medically necessary. This includes the correction of birth defects, restoration of the body after accidental injury, the revision of extensive scars, and reconstructive breast surgery following a mastectomy, among other specified procedures.
Plastic surgeons have long been a part of military medical teams, providing support to service members and their families. Their role has evolved to meet the unique challenges of each conflict, with a recent increase in the proportion of reconstructive procedures. Plastic surgery is often required to treat soft-tissue injuries to the head, neck, and extremities that are common in combat.
Military spouses do not receive special treatment or priority when it comes to plastic surgery. The availability of plastic surgery for military spouses is the same as for any other dependent or family member of a service member. The procedure must meet Tricare's strict criteria of being medically necessary.
In conclusion, while plastic surgery is not freely available to military spouses, it may be an option in certain medically necessary circumstances as determined by Tricare. The idea that every military spouse is entitled to free plastic surgery is a myth, and the reality is that Tricare's policies dictate a much more limited scope of coverage.
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Plastic surgery for active-duty personnel
Plastic surgery has a long history with the US armed forces. The specialty emerged from the horrors of World War I, with the military institution being responsible for creating a demand for better techniques. The US Department of Defense (DOD) has specific policies for plastic surgery, outlining when and how service members can receive cosmetic procedures. Plastic surgery for active-duty personnel is free, but it must be deemed ""medically necessary"" and the surgeon must obtain approval from the patient's commanding officer, which is not frequently granted.
The DOD's plastic surgery policies cover a range of procedures, including the correction of birth defects, restoration of the body after accidental injury, revision of disfiguring scars, reconstructive breast surgery, penile implants, and surgery to correct a sunken chest. Military cosmetic surgery intertwines with medical care, addressing restoration and enhancement within the confines of military healthcare systems.
The DOD aims to support its personnel with cosmetic surgery benefits to improve morale, help soldiers recover from injuries, and maintain a professional appearance. Military healthcare policies evolve, and treatments once considered cosmetic may now be recognised as beneficial for mental health and covered under military healthcare plans.
Plastic surgery plays a crucial role in military medicine, with a growing proportion of reconstructive procedures. Rapid advancements in field care and evacuation during conflicts like Operation Iraqi Freedom have increased the number of surviving personnel requiring complex reconstruction. Plastic surgeons are needed closer to the front lines to maximise functional limb outcomes and perform life-saving decisions.
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What procedures are covered by Tricare
Tricare, the health care program for military service members, retirees, and their families, covers procedures that are deemed "medically necessary". This means that the procedure must be appropriate, reasonable, and adequate for the patient's condition.
Tricare covers plastic surgery in the following cases:
- Correction of a birth defect, including cleft lip or pectus excavatum (sunken chest).
- Restoration of a body form following an accidental injury.
- Revision of disfiguring and extensive scars resulting from neoplastic surgery, which involves the removal of a tumor or cyst.
- Reconstructive breast surgery following a medically necessary mastectomy or due to a congenital anomaly (birth defect).
- Penile implants and testicular prostheses for conditions resulting from organic origins or for organic impotency.
- Removal of excess skin after weight loss if it significantly interferes with mobility or causes physical functional impairment, such as uncontrollable inflammation or infection resulting in pain or ulceration.
- Panniculectomy (tummy tuck) performed in conjunction with abdominal or pelvic surgery when a medical review determines that the procedure significantly contributes to the safe and effective correction or improvement of bodily function.
It is important to note that Tricare does not cover all types of plastic surgery. Non-medically necessary procedures, such as tummy tucks or the removal of excess skin due to weight loss without a functional impairment, are typically not covered. Additionally, there may be out-of-pocket costs for care that is not fully covered by Tricare, and services received at military hospitals are dependent on space availability.
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Wartime plastic surgery
Plastic surgery and military conflict have been linked as far back as the 1500s, when Italian surgeon Gaspare Tagliacozzi, considered the "father of plastic surgery", developed the "Italian method" for rhinoplasty. In Renaissance Italy, duelling by rapier was common, and Tagliacozzi would graft tissue from the shoulder to the face in a series of surgeries.
However, it was the First World War that saw the birth of plastic surgery as we know it today. The use of heavy artillery, machine guns, and poison gas, as well as the circumstances of trench warfare, caused a dramatic rise in facial injuries. Surgeon Harold Gillies developed a new method of facial reconstructive surgery in 1917, pioneering the "pedicle tube" technique. This involved partially removing a section of tissue from the arm, leg, or buttock, rolling it into a tube, and attaching one end to the donor site and the other end higher up on the body. Over time, this process was repeated, "walking" up the body, until the donor tissue had a healthy blood supply to the face, where it could be reshaped into a new nose, cheek, or lips.
By World War II, plastic surgery had advanced even further, with surgeons creating new treatments and procedures that are still used today. These techniques improved soldiers' physical appearance and morale, restoring their sense of pride and confidence. One such hospital was Valley Forge General Hospital in Phoenixville, Pennsylvania, which specialised in plastic surgery, jaw reconstruction, and tissue diseases.
Today, the military's healthcare system, Tricare, will cover plastic surgery if it is deemed "medically necessary". This includes the correction of birth defects, restoration of the body after an accidental injury, and revision of disfiguring scars from surgery.
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Plastic surgery as a military career
Plastic surgery is a highly skilled and rewarding career option within the military. It offers a unique opportunity to serve one's country while also gaining diverse clinical experience and contributing to the restoration of form and function for military personnel and their families.
The military covers plastic surgery in specific circumstances, as outlined by Tricare's policy. The coverage extends to cases deemed \"medically necessary,\" including the correction of birth defects, restoration of body form after accidental injury, revision of extensive scars, reconstructive breast surgery, and certain penile and testicular procedures. Military plastic surgeons play a crucial role in providing these medically necessary procedures, ensuring that service members and their families have access to essential care.
Pursuing a career as a military plastic surgeon comes with a range of benefits. The Army, for instance, offers a comprehensive package that includes competitive pay, healthcare benefits, and opportunities for bonuses. Additionally, the Army provides support for education, student loan repayment, housing, and living expenses. This career path also offers the chance to gain diverse surgical experience, as general surgery residency training is highly valued and amplifies the range of procedures one can perform.
A career in military plastic surgery provides unique and challenging experiences. Dr. Valerio, an active-duty member at Walter Reed during a peak period of war, described having the opportunity to participate in a wide range of reconstructive procedures, dealing with various unusual combat injuries. This career choice also enables global outreach, with plastic surgeons serving in medical leadership positions to address international crises, such as the Ebola epidemic.
For those interested in becoming a military plastic surgeon, it is important to note that the Army has a waiver process to address disqualifying issues. Additionally, general surgery residency training can be an excellent pathway, as it enhances one's surgical skills and can lead to subspecialty surgical Fellowships within the military context.
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Frequently asked questions
The Department of Defense (DOD) has specific policies for plastic surgery. Military personnel may seek cosmetic surgery, but it must first be approved by their commanding officer, which is not easy to obtain. The DOD's policy outlines when and how service members can receive cosmetic procedures. Only those deemed ""medically necessary"" or that improve a soldier's ability to perform their duties are covered.
Plastic surgeries that are covered by the military include:
- Correction of a birth defect, such as cleft lip
- Restoration of a body form following an accidental injury
- Revision of disfiguring and extensive scars from neoplastic surgery
- Reconstructive breast surgery following a medically necessary mastectomy
- Surgery to correct pectus excavatum, a birth defect that causes a sunken chest
Although there is a widespread rumor that military spouses or dependents get free plastic surgery, this is false. While active-duty personnel may seek cosmetic surgery, it is not free for their dependents.
Plastic surgery has been used to perform reconstructive operations for injured sailors and Marines during Operation Iraqi Freedom. During World War I and II, advancements allowed for craniofacial and hand reconstruction to be performed closer to the point of injury.
The DOD's plastic surgery benefits aim to support its personnel in various ways. These include improving morale, helping soldiers recover from combat-related injuries, and ensuring troops maintain a professional appearance if required by their role.
