Panniculectomy or Tummy Tuck After Weight Loss

After achieving success with GLP-1 medications, the spotlight has shifted to body-contouring procedures like tummy tucks for fine-tuning results. However, there’s another option for tightening the abdomen that deserves attention: panniculectomy. This procedure addresses excess skin and fat in a distinctive manner. But, which one is best after weight loss? We’ve consulted top plastic surgeons to share insights on the surgery, insurance coverage, and the benefits and risks of each option.

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What is a panniculectomy?

“With the growth of nonsurgical weight-loss options such as Ozempic we are now seeing many patients present with large amounts of excess skin of the abdomen,”  notes Portsmouth, NH plastic surgeon Anthony J. Wilson, MD. “Despite significant weight loss they are not able to lose the excess skin.”

Dr. Wilson says a panniculectomy refers to the removal of skin and fat below the belly button. “The ‘pannus’ is a latin term for ‘apron’ which is descriptive of this area,” he explains. A panniculectomy is performed to treat medical conditions caused by excess skin and overhanging tissue. “These medical conditions can be across a spectrum from musculoskeletal pain, such as lower back pain, to recurrent infections between the skin folds.”

Who is a good candidate for a panniculectomy?

Newport News, VA plastic surgeon Michael Lofgren, MD shares that a good candidate typically has recurrent infections or rashes within the skin folds of excess skin. Delray Beach, FL plastic surgeon Daniel Crane, MD adds, “A patient with skin hanging over their belt-line is a good candidate,” he explains. “They might also be a candidate for a tummy tuck, but with a panniculectomy will not receive a full restoration of the abdomen, just removal of that area of skin.”

What is the difference between a tummy tuck and panniculectomy?

The distinction between the two procedures lies in the area treated as well as the tightening of the muscles. “A tummy tuck or abdominoplasty is a cosmetic procedure that may include as a component a panniculectomy,” says Dr. Wilson. He highlights that while a tummy tuck addresses the skin and fatty tissue above and below the umbilicus, a panniculectomy solely focuses on removing excess skin and fat below the belly button to treat medical conditions. 

Dr. Crane adds that a panniculectomy primarily focuses on functional restoration. “A tummy tuck tightens skin throughout the abdomen, repairs the rectus muscles, and fixes the belly button,” he says. “Often, liposuction of the flanks and back accompanies tummy tucks, resulting in a comprehensive restoration of the abdominal silhouette.”

Is a panniculectomy covered by insurance?

“A panniculectomy is done to treat medical conditions and is therefore covered by some insurance companies,” notes Dr. Wilson. However, he highlights the need for history and documentation of the medical conditions for insurance approval. 

“An abdominoplasty is a cosmetic procedure and therefore not something insurance companies will cover. However, a panniculectomy is a functional procedure,” says Dr. Lofgren. “As a panniculectomy is a functional surgery, trying to resolve issues with recurrent infections and rashes, insurance may cover the procedure depending on their criteria and benefits.”

If it is covered, can you pay to upgrade your panniculectomy to a tummy tuck?

In some cases you may be able to still get a tummy tuck if you’re willing to pay for the cosmetic part says Atlanta plastic surgeon Carmen Kavali, MD. “These symptoms must be documented in photos and with records from treating physicians. A panniculectomy can be considered one aspect of a full abdominoplasty, so if insurance does cover the panniculectomy, the patient can choose to pay a cosmetic fee to ‘upgrade’ the surgery to a full abdominoplasty.”

In the end, whether one opts for a tummy tuck or a panniculectomy, the ultimate goal remains the same: achieving a healthier, more confident you. As we continue to seek diverse post-weight loss solutions, consulting with a board-certified plastic surgeon is vital for your journey to a more sculpted silhouette.

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