I'm planning to have a mommy makeover 2018. Yes, because the time spent working in the light-duty position does not count against the employee's FMLA leave entitlement. You have successfully saved this page as a bookmark. The regulations do say that, Restorative dental or plastic surgery after an injury or removal of cancerous growths are serious health conditions provided all the other conditions of this regulation are met.. The FMLA and the CFRA both entitle qualifying employees to up to 12 weeks of unpaid leave per 12-month period for an employees own serious health condition that prevents them from performing their essential job functions. In recent years there has been an increased focus on how employers address requests from employees for a leave of absence. Virtual & Washington, DC | February 26-28, 2023. Your employer is required by law to grant you a leave of absence under FMLA. ol{list-style-type: decimal;} These forms are electronically fillable PDFs and can be saved electronically. In cases where an individual does not meet the definition of disability, the employee would not be entitled to leave under the ADA. A serious health condition is defined broadly as an illness or injury that involves inpatient care, a period of incapacity of more than three consecutive calendar days that also involves treatment by a health care provider, or a chronic condition requiring treatment. Connective tissue (fascia) that lies over the abdominal muscles is then tightened with permanent sutures. Does "light duty" work count towards FMLA? Your employees may be entitled to federally protected medical leave for their tummy tucks, nose jobs and face-lifts. Your doctor will explain how to care for your scar. Im a trial-tested, experienced litigator that has represented companies of all sizes in a veritable alphabet soup of employment law claims, such as the ADA, ADEA, CEPA, FMLA, FLSA, NJLAD, PHRA, Title VII, and USERRA. .agency-blurb-container .agency_blurb.background--light { padding: 0; } It follows then, that elective procedures in and of themselves do not qualify as a serious health condition that would require protected medical leave, absent some complication (discussed below). if(currentUrl.indexOf("/about-shrm/pages/shrm-china.aspx") > -1) { To have a disability under the ADA, a person must first have an impairment. vacation or sick time) are available to the individual these could be offered. It seems silly to have a mesh applied instead of a tummy tuck, when the tummy tuck would also repair my diastasis. In general, short-term disability insurance and plastic surgery do not cover cosmetic procedures such as breast augmentation, face lifts, and angioplasties since they are not medically necessary. Learn how SHRM Certification can accelerate your career growth by earning a SHRM-CP or SHRM-SCP. Use the first week in PTO and the second will be covered by state disability. Requests for leave to undergo cosmetic or elective surgeries can sometimes fall under the ADA and should not automatically be dismissed or denied. These include: A tummy tuck can remove loose, excess skin and fat, and tighten weak fascia. The other is to see a PS and have an abdomnioplasty. You'll need to schedule regular follow-up visits. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. p.usa-alert__text {margin-bottom:0!important;} There are currently 7 Tummy Tuck + Fmla questions and doctor answers on RealSelf. Mental illness or allergies may be serious health conditions, but only if all the conditions of this section are met. You might choose to have a tummy tuck if you have excess fat or skin around the area of your bellybutton or a weak lower abdominal wall. Book your appointment. The FMLA definition of a serious health condition does not apply to cosmetic day surgery, which is not complicated. Mayo Clinic; 2021. Your doctor might caution against a tummy tuck if you: A tummy tuck poses various risks, including: Like any other type of major surgery, a tummy tuck poses a risk of bleeding, infection and an adverse reaction to anesthesia. Youve Got A New Wrinkle?Leave Complications. Here at cosmeticsurgerytips.com, we give you the best tips and advice on how to tend to your body in the most special way. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); The body being a beautiful work of art requires a lot of attention and tending. If the employer does not, then the employee may retain the right to a full 12 workweeks of FMLA leave, despite having already taken time off from work that qualifies for FMLA leave. Can the employee be denied this bonus? During a tummy tuck, excess skin and fat are removed from the abdomen. One option is to go to a GS and have a mesh applied to fix the hernia. There are a number of reasons you might have excess fat, poor elasticity of the skin or weakened connective tissue in your abdomen. Need help with a specific HR issue like coronavirus or FLSA? Please log in as a SHRM member. The answer is yes, it may be covered. This recontouring of JAN provides free, confidential technical assistance about job accommodations and the Americans with Disabilities Act (ADA). Abdominoplasty procedures. JAN is able to help employers and individuals during the interactive process to help ensure that requests for leave to undergo cosmetic or elective surgeries are handled appropriately. Moreover, a reasonable accommodation need not be provided if it would create an undue hardship for the employer. An employee was badly injured in a car accident as a teenager. This content does not have an Arabic version. While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. The answer to todays question is fiction. Having a nonsmoker lifestyle is a good choice for you. Review Administrator Interpretations, Opinion and Ruling Letters as well as chapters of the WHD Field Operations Handbook. Hello getting a little worried about how I am going to get time off if I don't have FMLA paper work to hand in to my HR deparment at my job my date is set for May 22 2017 and I will be getting a mommy make over and I know it's important to have time for my body to heal befor I got back to my job how can I get this paper work someone anyone plase advise me on what to do! var temp_style = document.createElement('style'); A tummy tuck can also be done in combination with other body contouring cosmetic procedures, such as breast surgery. Each of these situations can, and should, be addressed on a case-by-case basis, but can be confusing to work through. So, an employee who takes leave for a tummy-tuck procedure is not covered under the FMLA. If an employee refuses or fails to provide the certification, the leave request could be delayed or even denied. It seems silly to have a mesh applied instead of a tummy tuck, when the tummy tuck would also repair my diastasis. The information on RealSelf is intended for educational purposes only. And for those employers in the midst of conflict, I bring all of my know-how to bear as your zealous advocate. I'm interested in BBL & TT. It is different from a tummy tuck, which is a cosmetic procedure that removes excess skin and fat and tightens the abdominal muscles. Your workd doesn't even need to know why you need the time off, as long as it is medically necessary and you have a doctor's not. California courts have concluded that employers need not provide an indefinite leave of absence as a reasonable accommodation. (b) The term incapacity means inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefore, or recovery therefrom. , oxygen). they also need FMLA paperwork from my doctor saying I can return in that timeframe. Question about UCLA or Cedars-Sinai. Please purchase a SHRM membership before saving bookmarks. Its time for another edition of Fact or Fiction a/k/a Quick Answers to Quick Questions a/k/a QATQQ f/k/a I dont feel like writing a long blog post., An employee is eligible for leave under the Family and Medical Leave Act if the employee has a serious health condition that makes the employee unable to perform the functions of the position of such employee. An employee has a serious health condition if there is an illness, injury, impairment or physical or mental condition that involves inpatient care . Challenge such leave requests by asking for the second and third certifications that the FMLA allows. While employers continue to learn more about this form of accommodation and how it can be implemented, certain situations may arise that arent directly addressed in formal or informal guidance. It's best to be a non-smoker. You are eligible for FMLA leave if you have worked for one year at the same company and have worked at least 1,250 hours in the previous 12 months. In this situation, leave would need to be provided as an accommodation, absent undue hardship. .manual-search-block #edit-actions--2 {order:2;} Call for an Appointment. An employee must follow the employer's normal leave rules in order to substitute paid leave. But then it says that if you have something requiring an inpatient stay, it is covered. California employers who administer employee leave laws navigate a complicated labyrinth. The majority of people can work at a computer after about four to five days, but plastic surgeons recommend two weeks to avoid any unnecessary stress on the body after working at a computer. Helpful Todd C. Case, MD Recommended reading ADVERTISEMENT FIND THE RIGHT TREATMENT FOR YOU TAKE OUR TREATMENT FINDER QUIZ ADVERTISEMENT If a bonus or other payment is based on the achievement of a specified goal, such as hours worked, products sold, or perfect attendance, and the employee has not met the goal due to FMLA leave, then the payment may be denied, unless otherwise paid to employees on an equivalent leave status for a reason that does not qualify as FMLA leave. By removing excess skin and fat and strengthening your abdominal wall, a tummy tuck can give your abdomen a more toned and slimmer appearance. .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} Yes, absent undue hardship. Leave has always been a form of accommodation under the ADA, and employees may request a leave of absence for many reasons, including recovery from surgery. FMLA leave can be taken in one block (for example, three weeks of leave for surgery and recovery) or in multiple, smaller blocks if medically necessary (for example, occasional absences due to diabetes). . TUMMY TUCK QUALIFY FOR FMLA OR STD rsames on 1/31/13 6:03 am I had a tummy truck after 130 lbs weight loss. 7600A Leesburg Pike, West Building, Suite 300, Falls Church, VA 22043, Restorative dental or plastic surgery after an injury or removal of cancerous growths are serious health conditions provided all the other conditions of this regulation are met., Overtime Labor Law: 6 compliance tips to avoid overtime lawsuits, wage-and-hour Labor audits and FLSA exemption mistakes, How to Fire an Employee the Legal Way: 7 termination guidelines, HOW INTERMITTENT FMLA WORKS & HOW TO MANAGE IT: Guidelines on managing intermittent leave and curbing leave abuse under FMLA regulations. Abdominoplasty. Hi, I live & work in MA. Situations should be considered on a case-by-case basis and individualized assessments must be done. But if you want to get breast implants and need six weeks off work for recovery instead, FMLA wouldnt apply because its considered cosmetic rather than medical. I also am wondering if elective surgery is covered under fmla? A single copy of these materials may be reprinted for noncommercial personal use only. Tell Me What You Dont Like About California LawsThe Basics. So my question is, do you sign the Family Medical Leave Act (FMLA) forms from the patients job which will allows them to be off while they heal after a major surgery?. For more about me, my practice, and my firm. Does an employee who is absent on FMLA leave still have the right to bonuses and awards, like a perfect attendance award? Enter your email address to instantly generate a PDF of this article. The best case scenario is to take use of your accrued vacation time to recover following surgery. Under the FMLA, the employer retains the right to designate qualifying leave as FMLA. Treatment does not include routine physical examinations, eye examinations, or dental examinations. You know that scientist in the action movie who has all the right answers if only the government would just pay attention? I feel now that I have told them about me wanting the surgery, they will give me a hard time if I try to take off. Employers must consider interactions among federal laws (ADA, FMLA, Title VII), state and local laws (CFRA, FEHA, PFL), and even their own internal employer policies. (Alcazar-Anselmo v. City of Chicago, No. Recent case: Chicago city worker Gladys Alcazar-Anselmo filed an FMLA retaliation lawsuit, saying her firing came soon after she requested FMLA leave for a scheduled surgery. Your plastic surgeon will also reposition the skin around your bellybutton. Just had a 3rd baby 4 months ago. (d) Conditions for which cosmetic treatments are administered (such as most treatments for acne or plastic surgery) are not serious health conditions unless inpatient hospital care is required or unless complications develop. Hello areyanna, I agree with everyone else, I wouldn't say what the surgery is for unless you absolutely MUST. The following examples illustrate the various types of issues related to accommodation requests for cosmetic surgery. If you meet those requirements, then you can take time off work for medical treatments. You may need to pay a fee, which in most cases will go toward the surgery. Members of your health care team will help you walk as early as the first day after a tummy tuck to help prevent the formation of blood clots. Please note that all such forms and policies should be reviewed by your legal counsel for compliance with applicable law, and should be modified to suit your organizations culture, industry, and practices. (a) For purposes of FMLA, "serious health condition" entitling an employee to FMLA leave means an illness, injury, impairment or physical or mental condition that involves inpatient care as. Find the latest news and members-only resources that can help employers navigate in an uncertain economy. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. A panniculectomy is more expensive than a tummy tuck, but it's often covered by medical insurance. During the tummy tuck procedure, your surgeon may also be able to improve the appearance of previous scars, from C-sections or other abdominal surgeries. We are a team of cosmetic surgery experts at your service 247. Tell your doctor if you are allergic to any medications. I will be having aTT /MR /hernia repair and wanted to know if i qualify for FMLA and also do i have to let them know that im getting a tummy or can i just say that im having abdominal surgery hernia repair. What do I need to ask for in order to have my tummy tuck surgery covered under FMLA? If an employee suffers individual harm because the employer did not follow the notification rules and provided the notice more than five days later, the employer may be liable for damages. An agency within the U.S. Department of Labor, 200 Constitution Ave NW .paragraph--type--html-table .ts-cell-content {max-width: 100%;} Connective tissue in the abdomen (fascia) usually is tightened with sutures as well. A regimen of continuing treatment that includes the taking of over-the-counter medications such as aspirin, antihistamines, or salves; or bed-rest, drinking fluids, exercise, and other similar activities that can be initiated without a visit to a health care provider, is not, by itself, sufficient to constitute a regimen of continuing treatment for purposes of FMLA leave. One option is to go to a GS and have a mesh applied to fix the hernia. Each case must be addressed on a case-by-case basis, and there is no one-size-fits-all solution when it comes to reasonable accommodations. The reason for taking time off from work can be any of the following: FMLA is a federal law that allows you to take time off work for medical reasons. A tummy tuck is suitable for both men and women who are in good general health overall and are at a stable weight. Before I fill this out, will FMLA cover a tummy tuck? Equal Employment Opportunity Commission (EEOC) has offered guidance on the provision of leave as an accommodation under the ADA. The cost can range from $8,000 to $15,000, plus anesthesia and other extras. Mayo Clinic does not endorse companies or products. Or pto only, from previous patients. For more on this, check outDorsey v. Bellanger. During a tummy tuck, excess skin and fat are removed from the abdomen. In the previous two situations we looked at cases where a person doesnt meet the definition of disability and cases where it would easily be determined that an individual does meet the definition of disability. What are my options in being covered at work? Tummy tuck. This helps prevent fluid buildup and provides abdominal support while you heal. Neither members nor non-members may reproduce such samples in any other way (e.g., to republish in a book or use for a commercial purpose) without SHRMs permission. $('.container-footer').first().hide(); If you have a medical condition that requires a leave of absence under FMLA, your employer must grant it. Where an employee's need for FMLA leave is foreseeable, which is not the case in most instances in my experience, then the employee must provide the employer with at least 30 days of notice. Twelve workweeks of leave in a 12-month period for: the birth of a child and to care for the newborn child within one year of birth; the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement; to care for the employees spouse, child, or parent who has a serious health condition; a serious health condition that makes the employee unable to perform the essential functions of his or her job; any qualifying exigency arising out of the fact that the employees spouse, son, daughter, or parent is a covered military member on covered active duty; or. Or pto only, from previous patients. We aim to provide timely, topical information on the challenges that California employers face. Please enable scripts and reload this page. But the U.S. Department of Labors FMLA regulations say, conditions for which cosmetic treatments are administered (such as most treatments for acne or plastic surgery) are not serious health conditions unless inpatient hospital care is required or unless complications develop. (FMLA 29 C.F.R. FMLA is not an excuse to take extended time off from work, and its definitely not a way to get around your employers policies. Is breast reduction surgery covered under FMLA since it is often considered medically necessary for those whom have extremely large, heavy breasts that cause back and shoulder aches? It is to take care of yourself and I think as long as your Dr places your on disability you are covered under SDI. One possible reasonable accommodation may be a further leave of absence. But, this is balanced with a provision that the employee's right to reinstatement ends in the FMLA year used by the employer. Also on of the last drain tube wounds is now infected which burns like crazy. As stated above, in light of the ADA Amendments Act (ADAAA), any physiological disorder or condition affecting one or more body system would be considered an impairment. #block-googletagmanagerheader .field { padding-bottom:0 !important; } Talk about any medications you're taking or have taken recently, as well as any surgeries you've had. Whats next? What notice must an employer provide to an employee and when and what is the penalty for failing to do so? You'll also need to avoid positions that strain your incision line such as quickly bending at the waist to prevent the reopening of the wound. Drains might be left in place for several days after surgery. .table thead th {background-color:#f1f1f1;color:#222;} Make a donation. The Family and Medical Leave Act (FMLA) provides an entitlement of up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons: 1) birth and care of the eligible employee's child, or placement for adoption or foster care of a child with the employee; 2) care of an immediate Can FMLA be denied for cosmetic surgery? @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} 855-855-6484. So that means I would need to return to work in a week. Elective procedures fall within a broad range that includes such varied items as treatment for acne and orthodontics. Specifically with lifting, bending, reaching? $("span.current-site").html("SHRM China "); Another wrinkle that employers should know is that restorative dental or plastic surgeries after an injury or removal of cancerous growths are considered serious health conditions for which protected leave is required, provided the presence of the other conditions constituting a serious health condition. Federal government websites often end in .gov or .mil. During this stage, the doctor will explain the details of the surgery and the costs involved. My father also had pain where mesh was used to repair a hernia READ MORE 4 EXPERT ANSWERS ADVERTISEMENT Case must be done would create an undue hardship with permanent sutures enter your email address instantly... Letters as well as chapters of the skin or weakened connective tissue ( fascia ) that lies the... Employer provide to an employee refuses or fails to provide the Certification, doctor! Employer & # x27 ; s often covered by state disability after surgery your zealous advocate absent undue.. Assessments must be done is yes, because the time spent working the. Explain the details of the last drain tube wounds is now infected which like! Not be provided if it would create an undue hardship job accommodations and the involved..., be addressed on a case-by-case basis and individualized assessments must be addressed on a case-by-case basis, my! Who are in good general health overall and are at a stable weight we dont provide medical consultations diagnosis. First week in PTO and the second and third certifications that the employee 's FMLA leave.! Tuck QUALIFY for FMLA or STD rsames on 1/31/13 6:03 am I had a tummy tuck, when the tuck! Surgery covered under FMLA that california employers face provide medical consultations, diagnosis or..., absent undue hardship because the time spent working in the most way. Employee leave laws navigate a complicated labyrinth tighten weak fascia health conditions, but only if the! More about Me, my practice, and there is no one-size-fits-all solution when comes! Provide the Certification, the leave request could be delayed or even denied # edit-actions 2! Would not be entitled to leave under the ADA employees for a of. Font-Size:1.4Em ; color: # 222 ; } yes, absent undue hardship a.... Weight loss the FMLA, the employer & # x27 ; s often covered by state.! Because the time spent working in the midst of conflict, I bring all of my know-how to as... The tummy tuck, excess skin and fat and tightens the abdominal is. Day surgery, which is a good choice for you both men and women are. Range that includes is a tummy tuck covered under fmla varied items as treatment for acne and orthodontics place for several days after.. Currently 7 tummy tuck, when the tummy tuck + FMLA questions and doctor on! Fall within a broad range that includes such varied items as treatment for and! Am wondering if elective surgery is covered the doctor will explain the details of the last drain tube wounds now! After 130 lbs weight loss to have a mesh applied instead of tummy! It is a tummy tuck covered under fmla covered 7 tummy tuck + FMLA questions and doctor answers on RealSelf illness or allergies be. Elective surgery is covered under FMLA who is absent on FMLA leave still the... } 855-855-6484 $ 15,000, plus anesthesia and other extras for acne and.! From the abdomen explain the details of the last drain tube wounds is now infected burns. For your scar other is to go to a GS and have a mesh applied instead of a truck... Doctor if you are covered under the ADA be a non-smoker FMLA from... Lifestyle is a cosmetic procedure that removes excess skin and fat and the! Page as a bookmark surgery experts at your service 247 are a team of cosmetic surgery at! A specific HR issue like coronavirus or FLSA week in PTO and the Americans with Disabilities Act ADA... To provide the Certification, the doctor will explain the details of the around. Applied to fix the hernia as FMLA prevent fluid buildup and provides abdominal support while you heal movie has! Are covered under FMLA end in.gov or.mil under the ADA a perfect award... What do I need to return to work through, because the spent. Would just pay attention challenges that california employers face Commission ( EEOC ) has offered guidance on the of... Saved this page as a teenager EEOC ) has offered guidance on provision. Takes leave for a tummy-tuck procedure is not covered under FMLA a GS and have a mesh applied to the. Time ) are available to the Terms and conditions and Privacy Policy linked below I. { list-style-type: decimal ; } Make a donation mesh applied instead of serious... Have excess fat, poor elasticity of the WHD Field Operations Handbook the various types of issues related to requests... Font-Size:1.4Em ; color: # f1f1f1 ; color: # e31c3d ; } Make a donation to reasonable.... Not include routine physical examinations, or advice right to bonuses and awards, like a perfect award... State disability the right answers if only the government would just pay attention assessments! To any medications Terms and conditions and Privacy Policy linked below in recent years there has been increased... Conditions, but can be confusing to work in a week tucks, nose and... Of conflict, I bring all of my know-how to bear as your advocate... Skin around your bellybutton accommodation may be entitled to federally protected medical leave for a of. Balanced with a specific HR issue like coronavirus or FLSA saying I can return in timeframe! California courts have concluded that employers need not provide an indefinite leave absence... With Disabilities Act ( ADA ) these could be delayed or even denied provides abdominal while. Week in PTO and the costs involved refuses or fails to provide timely topical. Does not meet the definition of disability, the employer & # x27 s. Equal Employment Opportunity Commission ( EEOC ) has offered guidance on the provision of as... Of your accrued vacation time to recover following surgery chapters of the surgery a is a tummy tuck covered under fmla labyrinth the! On the challenges that california employers face the action movie who has all the right to reinstatement ends in FMLA... Provided if it would create an undue hardship it & # x27 ; s often covered medical! Addressed on a case-by-case basis, but can be confusing to work through order:2... Resources that can help employers navigate in an uncertain economy end in.gov or.mil something. Forms are electronically fillable PDFs and can be confusing to work through law. Read more 4 EXPERT answers an undue hardship for the second and third that. The time spent working in the light-duty position does not apply to day... An Appointment from $ 8,000 to $ 15,000, plus anesthesia and other extras how to tend your... For your scar { list-style-type: decimal ; } yes, because the time working! Absence as a teenager and Ruling Letters as well as chapters of the WHD Operations... $ 8,000 to $ 15,000, plus anesthesia and other extras { order:2 ; } there are 7. Your bellybutton is a tummy tuck covered under fmla for both men and women who are in good general health overall are... That can help employers navigate in an uncertain economy do I need to a. Doctors, we dont provide medical consultations, diagnosis, or advice be done enter your address. To be a further leave of absence be reprinted for noncommercial personal use is a tummy tuck covered under fmla in! Opinion and Ruling Letters as well as chapters of the WHD Field Operations.. Long as your zealous advocate tummy-tuck procedure is not complicated help employers navigate in an economy... Be provided as an accommodation, absent undue hardship both men and who... Complicated labyrinth and Privacy Policy linked below or fails to provide the Certification, the request... For cosmetic surgery experts at your service 247 that if you meet those,... Support while you heal, an employee must follow the employer retains the right reinstatement! Address requests from employees for a tummy-tuck procedure is not covered under.... Weight loss and orthodontics that removes excess skin and fat, and tighten fascia. Be serious health condition does not include routine physical examinations, or advice a good choice for you used... A tummy truck after 130 lbs weight loss am I had a tummy tuck would also repair my.... Cases where an individual does not include routine physical examinations, or dental examinations would just attention! Employer & # x27 ; s best to be provided as an accommodation under the ADA is a tummy tuck covered under fmla... Your on disability is a tummy tuck covered under fmla are allergic to any medications 26-28, 2023 explain how to for! & # x27 ; s often covered by state disability from employees for a leave of absence under FMLA that. How SHRM Certification can accelerate your career growth by earning a SHRM-CP or SHRM-SCP these materials may be a.... The answer is yes, it may be reprinted for noncommercial personal use only mesh was to..., check outDorsey v. Bellanger should not automatically be dismissed or denied explain how to care your... Even denied work through font-size:1.4em ; color: # 222 ; } Make a donation accommodations and second! Is suitable for both men and women who are in good general health overall and are at a stable.! To care for your scar so, an employee and when and what is penalty..., which in most cases will go toward the surgery and the second will be covered how to to....Dol-Alert-Status-Error.alert-status-container { display: inline ; font-size:1.4em ; color: # e31c3d ; } are... Seems silly to have a mommy makeover 2018 care for your scar you might have excess fat, poor of. Leave still have the right to bonuses and awards is a tummy tuck covered under fmla like a perfect attendance award 6:03! To substitute paid leave a cosmetic procedure that removes excess skin and fat removed!
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