Ask a doctor

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option? (photo)

I'm a 35 year old female and I had a weight loss of 50lbs, my beginning weight was 300lbs and I have stayed at 250 since. I exercise regularly, I'm not losing any more, and my stomach area is very bothersome...I know I am still obese and I would be interested in finding a surgeon willing to operate on me, hopefully in the Pacific NW. I have had two c-sections and a lap band, for previous surgeries, no issues with anesthesia...My blood pressure is normal and no diabetes or other health issues.

Doctor Answers 12

Panniculectomy or tummy tuck

Thank you for your question and congratulations on your weight loss.  A panniculectomy is a less invasive procedure and a full tummy tuck.  As others have stated a BMI of 30 is best if a full tummy tuck is contemplated.  Considering the fact he simply want the comfort removal of the excess abdominal skin a panniculectomy may be your best choice.  Please consult a board certified plastic surgeon.

Body contouring surgery

The best candidates for aeshtetic body contouring surgery are those with a BMI of less than 30.  Patients whose BMI os over 30 have increased surgical risks - delayed wound healing, venous thrombosis and pulmnary embolism, anesthesia complications, etc.  Patients who have a BMI of greater than 30 are sometimes a good candidate for surgery; however, both patient and surgeon should be clear about the increased risks.  As to the specific recommendations, no one can make an insightful recomendation without a through review of your medical history, a physical examination and a discussion with you about your expectations from surgery.

Best option for body contouring?

Hello and thanks for your post. For significant weight loss and excess skin there are several options. You have already mentioned panniculectomy, but you should also consider lower body lift and extended tummy tuck. These 3 techniques I have used in similar situations with good success. The decision for the best technique in your case can only be derived after a full consultation with a board certified plastic surgeon with broad experience in all 3 techniques. Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 163 reviews

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option?

Congratulations on your significant weight loss; you should be very proud of this accomplishment! Generally speaking, the tummy tuck operation provides for a more aesthetically pleasing outcome than a panniculectomy operation. The tummy tuck operation is best done once you have reached your long-term stable weight.

In my practice, I would offer patients the panniculectomy operation at any point, if they have reached a plateau with diet and exercise program, and simply wish to have the lower abdominal wall skin/adipose tissue removed. Keep in mind, that patients who undergo surgery when they are overweight, are exposed to greater risks.

My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. Then, learn about options, and the pros/cons/risks/complications associated with each option.

You may find the attached link, dedicated to patients who have experienced significant weight loss, helpful to you as you learn more. Best wishes.


A panniculectomy will not get rid of the excess skin above your belly button. Also, the six-pack muscles will not be brought back together. For your case, I would discuss a fleur-de-lis tummy tuck.
Best of luck,
Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Is a tummy tuck or panniculectomy the best option?

Hello! Thank you for your question and photos! I hope that these answers help! A panniculectomy is an excellent method for removing the excess skin and soft tissue of the lower abdomen (abdominal panniculus), often caused by weight loss. It is mainly performed to ameliorate symptoms caused by the abdominal apron such as hygiene issues, excoriations, rashes/infections, back pain, etc. A panniculectomy gives almost immediate relief from these issues as well as has been shown to stimulate additional weight loss as your activity level is increased after removal of the panniculus. An abdominoplasty is more of an aesthetic procedure in that as opposed to simply excising this excess tissue in a wedge to relieve complaints, an abdominoplasty focuses more on abdominal contouring, abdominal wall tightening, re-insetting the belly button, as well as often times the addition of liposuction.

I would highly recommend continued diet and exercise prior to any consideration for a panniculectomy or body contouring as getting down to your ideal weight prior to the procedure will certainly give you the best results as well as be the safest for you. Neither one is a weight loss procedure. Also, a continued healthy and active lifestyle will be needed in order to maintain the benefits that the procedure has given to you. You should consult with a plastic surgeon at anytime to go over options and in order to assist you in deciding which procedure(s) would be right one for you. Depending on your examination, photo documentation, and discussion of your symptoms, insurance coverage may be possible. Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Tummy tuck for overweight patients

Hi there.  And congratulations on your weight loss.  

It's super important to distinguish between healthy overweight and unhealthy overweight patients.  From your photo and your history, I would put you in the former category - healthy overweight.  It looks like most of your excess fat is on the outside of your belly as opposed to the inside, you are not hypertensive and you are not diabetic.  To me that says your excess weight is more of a cosmetic issue than a medical issue.  

You would likely need an extended tummy tuck and maybe some liposuction.  For overweight patients like you, I recommend a pain pump to help you mobilize early and also Lovenox to help prevent blood clots.  

Some of my most grateful patients are ladies just like you who have worked so hard to slim down but have just "hit the wall" with weight loss.

Good luck!

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 57 reviews

Higher BMI Increases Surgical Risks From Tummy Tuck

Because you mentioned that you "still obese" body contouring surgery may not be safe for you because of the increased risks. 

Patients should have a normal BMI, or if you're a body builder or have a muscular build, then a BMI of 30 would be fine as well.  

If you could achieve a lower BMI, a full tummy tuck would probably achieve your desired results.

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option?

   A panniculectomy may be reasonable at your current weight if further weight loss cannot be obtained.

Kenneth Hughes, MD

Los Angeles, CA

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option? (photo)

Thank you for your question.

With pictures provided you will need an extended tummy tuck with liposuction.

Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote. Choose a board certified plastic surgeon who has done a ton of Brazilian Butt Lifts and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.