I’m really struggling with whether to have a panniculectomy. I keep hearing and reading that this isn’t a cosmetic surgery, which I understand, but does that mean I should expect a hack job? The doctor is the weight loss surgeon, not a plastic surgeon. I’m still overweight and I’m not expecting a perfect body, but the fact that I keep hearing it’s NOT cosmetic is making me wonder if I’m going to look lumpy or something afterwards. He mentioned potential “dog ears.”

Any experience you can share? Would you do this? Recovery is long! I just retired and want to live my life! But I sure would love to be rid of this thing.

Hi Writergirl, just curious: if your insurance will pay for skin removal sx, why wouldn’t you be able to choose the surgeon? Cosmetic surgeons do panniculectomies, and the results might be be aesthetically pleasing……

I’m a week out post op. I can see results already. My insurance paid for it. I was shocked that they would because although I had excess skin it wasn’t to bad. I can definitely see a difference though even through the swelling! My surgeon said that minor fixes can be discussed (ie dog ear and fluid) if need be. I’m 52 years old and my mother in law 79 yes young as well as my sister in law 66 years young are also going to get it! Lol on the meds right now so not sure if I’ve provided a little information/ personal experience to you. I think they have to refer to it this way plus liposuction and muscle repair isn’t included. I want to add that my surgeon went a little bit past my hips and I was like waaaa when I saw this!

it's not really cosmetic - I don't think they attempt to make you look "pretty" - but they do remove the excess skin. I might have been OK with it because I'm in my 60s and have been married forever, so I really didn't care what I looked like under my clothes - I did it more so my clothes would fit better and my skin didn't slap up against my body while I was exercising. But I decided to go for the whole lower body lift, not just the panniculectomy.

if you want something that looks more natural, then go for a whole lower body lift (also called a 360, I believe). They do front and back, pull up the mons area, reposition your belly button and create a new, natural-looking opening for it (so it looks like a normal belly button), etc. And as the above poster said, they usually do liposuction and muscle tightening, too. Appearance-wise, it's going to look a lot better. That is, if you care...

if your insurance covers panniculectomies (and if so, you're lucky!) but you want to do a full lower body lift, many of them will at least cover the panniculectomy part of it.

Edited January 7, 20224 yr by catwoman7

On 1/6/2022 at 6:37 PM, Elidh said:

Hi Writergirl, just curious: if your insurance will pay for skin removal sx, why wouldn’t you be able to choose the surgeon? Cosmetic surgeons do panniculectomies, and the results might be be aesthetically pleasing……

It’s a long story. My PCP gave me a referral to a breast surgeon to have breast reduction. I mentioned to the breast surgeon that I’d always thought if I did it I’d have my belly done at the same time. She said that was no problem! She works with a surgeon who does that and they can do it all in one operation. I went to see that surgeon. He told me to see a cosmetic surgeon first. Cosmetic surgeon refused to do it because my BMI is too high for elective cosmetic surgery. (8 years later, I still weigh 240.) It can be done for medical purposes, but not by a cosmetic surgeon. They all recommended I get a gastric bypass and come back. So I’m rolling that around in my head, too, but that means probably two years before I could have plastics, and I’m already 65. I just don’t know what to do. And honestly, my metabolism has been so low since I was sleeved I feel I’ll have to starve for the rest of my life just to not gain. I was tested and only burn 900 calories a day. Sigh. I’m open to all thoughts. Thanks!

On 1/6/2022 at 9:30 PM, catwoman7 said:

it's not really cosmetic - I don't think they attempt to make you look "pretty" - but they do remove the excess skin. I might have been OK with it because I'm in my 60s and have been married forever, so I really didn't care what I looked like under my clothes - I did it more so my clothes would fit better and my skin didn't slap up against my body while I was exercising. But I decided to go for the whole lower body lift, not just the panniculectomy.

if you want something that looks more natural, then go for a whole lower body lift (also called a 360, I believe). They do front and back, pull up the mons area, reposition your belly button and create a new, natural-looking opening for it (so it looks like a normal belly button), etc. And as the above poster said, they usually do liposuction and muscle tightening, too. Appearance-wise, it's going to look a lot better. That is, if you care...

if your insurance covers panniculectomies (and if so, you're lucky!) but you want to do a full lower body lift, many of them will at least cover the panniculectomy part of it.

You are so brave to have that whole body lift! You must be so happy with yourself! How in the world do you recover from that surgery with no position that isn’t painful?

Honestly, my backside isn’t that bad. I would love to have it done right so I look good afterwards, but that’s not going to happen because a cosmetic surgeon won’t touch me. It is a constant source of misery for me that in spite of trying everything, I never got to a BMI below 40. I’ve kept off 130 pounds, but now I just gain and lose the same 10 pounds.

Edited January 8, 20224 yr by Writergirl

1 hour ago, Writergirl said:

You are so brave to have that whole body lift! You must be so happy with yourself! How in the world do you recover from that surgery with no position that isn’t painful?

Honestly, my backside isn’t that bad. I would love to have it done right so I look good afterwards, but that’s not going to happen because a cosmetic surgeon won’t touch me. It is a constant source of misery for me that in spite of trying everything, I never got to a BMI below 40. I’ve kept off 130 pounds, but now I just gain and lose the same 10 pounds.

yes - lower body lifts are pretty painful. My arm lift and breast lift were much easier - but I think it has to do with the liposuction and muscle tightening they do with a lower body lift. I had to use a walker and a toilet seat riser for several days - and those first couple of nights were AWFUL. But....it does end, and in the end, the results were worth it (I had my LBL three years ago - and the arm & breast lift two years ago)

Check with other plastic surgeons. One said no, others may feel differently.

I had a panniculectomy & abdominoplasty, recovery wasn't bad or terribly long at all. Not sure why you are thinking that recovery will be long, though everyone is different. I could do pretty much all of my usual things just slower & hunched over.

On 1/6/2022 at 4:20 PM, Writergirl said:

I’m really struggling with whether to have a panniculectomy. I keep hearing and reading that this isn’t a cosmetic surgery, which I understand, but does that mean I should expect a hack job? The doctor is the weight loss surgeon, not a plastic surgeon. I’m still overweight and I’m not expecting a perfect body, but the fact that I keep hearing it’s NOT cosmetic is making me wonder if I’m going to look lumpy or something afterwards. He mentioned potential “dog ears.”

Any experience you can share? Would you do this? Recovery is long! I just retired and want to live my life! But I sure would love to be rid of this thing.

Did you ever decide what you're going to do? I'm thinking of having a panniculectomy once I'm able (mostly because my insurance will cover it) and while I know it won't tighten any muscles, I'm hoping it will be flatter and my clothes will fit better (I'll be having my surgery on May 3rd at age 43 and looking to hopefully have my surgery about a year and a half later). I've already had 2 kids, I'm a grandma of 1, and I'm not going to be wearing any bikinis or crop tops lol So I don't care so much about tummy tucks but I do want my excess skin removed and my stomach flatter. I hope it'll happen with the panniculectomy.

It is typically performed by a plastic surgeon but for insurance reasons it’s considered a medical treatment. Lots of loss skin can cause back pain and rashes. Same way a breast reduction is often considered medical for the same reasons. I am going to have a panniculectomy for medical reasons (rash and back pain) paid by insurance. My surgery will be done by a plastic surgeon.

I had a pannocolopy

I had a full tummy tuck in July 2020 which was covered in part by insurance, as others have mentioned. Typically, the panniculectomy is covered when it's pre-certified, and then the excess fees to convert to abdominoplasty are paid out of pocket. At my very first consultation with my plastic surgeon, the first words out of his mouth were 'If I do just a panniculectomy, you are not going to be happy with the results. I very rarely anymore just do a panniculectomy.' He explained the difference to me: the panniculectomy is the removal of the apron of the hanging belly, or the pannus. The abdominoplasty goes a few steps further and tightens the loosened abdominal wall, and also includes liposuction. It also improves the appearance of the upper abdominal area and the belly button, as well as helping with posture and abdominal strength by tightening the abdominal muscles. However, in the insurance world, they are concerned with the functonality part of the skin removal, and the conversion to the full tummy tuck is beyond what is considered 'medically necessary.'

I am pleased with my tummy tuck and my surgeon is very talented. He works closely with bariatric patients, and I felt comfortable with what he was telling me and knew that he knew what he was doing.

Edited August 11, 20224 yr by BAA624

On 8/11/2022 at 2:39 PM, BAA624 said:

I had a full Tummy Tuck in July 2020 which was covered in part by insurance, as others have mentioned. Typically, the panniculectomy is covered when it's pre-certified, and then the excess fees to convert to abdominoplasty are paid out of pocket. At my very first consultation with my plastic surgeon, the first words out of his mouth were 'If I do just a panniculectomy, you are not going to be happy with the results. I very rarely anymore just do a panniculectomy.' He explained the difference to me: the panniculectomy is the removal of the apron of the hanging belly, or the pannus. The abdominoplasty goes a few steps further and tightens the loosened abdominal wall, and also includes liposuction. It also improves the appearance of the upper abdominal area and the belly button, as well as helping with posture and abdominal strength by tightening the abdominal muscles. However, in the insurance world, they are concerned with the functonality part of the skin removal, and the conversion to the full tummy tuck is beyond what is considered 'medically necessary.'

I am pleased with my tummy tuck and my surgeon is very talented. He works closely with bariatric patients, and I felt comfortable with what he was telling me and knew that he knew what he was doing.

Would you mind sharing your part of the cost? Am considering going this route when I get to that point.

Sure, I paid about $6900 after my insurance paid for the panniculectomy. That was the out of pocket portion to convert to a full tummy tuck. I paid my deductible and coinsurance for the insurance approved portion (my deductible was $400).

In total, all of the skin removal (tummy tuck, arm lift, thigh lift, and liposuction of the back and neck/chin) was around $28,000.