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Am I a Good Candidate for a Panniculectomy/Tummy Tuck? (photo)

Here is the deal I am a 38 years old and had a VSG in August of 2011. I currently weigh 163lbs and I am 5'7. I have no children and do not plan for any. I wanted to know if I would be a candidate for insurance to cover the panniculectomy portion and I would pay out of pocket for the actual tummy tuck portion. My second question is should I get a straight tummy tuck or a fluer de lis? I do get rashes and continue to have back issues due to the excess skin. Any help would be appreciated!

Doctor Answers (10)

Tummy tuck or pannus

+2

Hi,

  You are the perfect candidate for the fleur-de-lis tummy tuck and anything short of this is going to be a disappointment in the midline tissue.  This area even with a tight pull will NOT be flat and will be "flabby".  If you are okay with that because you do not want the midline scar, then you will still be happier by far as there will be great improvement.

  A pannus excision alone will take care of the lower hanging tissue but you get just that..an excision of the lower tissue and no "global" approach to your problem

  Insurance companies are very different but you can ask them if they would help with the pannus excision. 

                      Steven M. Lynch, M.D.  Albany, New York


Albany Plastic Surgeon
4.5 out of 5 stars 15 reviews

Candidate for panniculectomy and tummy tuck? will insurance pay?

+2

Hi, thanks for posting your story and the excellent photos.  Let's break down your case into two parts:

1.  Will my insurance cover the panniculectomy?  Insurance coverage first needs to be ascertained by checking your policy to make sure that there are no riders that deny coverage of panniculectomy.  Secondly, the criteria used to establish coverage are as follows weight loss in excess of 100 lbs, and stable (generally 12-18 months post procedure), documented rashes that have been repeatedly treated medically, some carriers also want to see a pannus that hangs below the pubis (essentially covers your privates)

 

2.  What type of abdominoplasty???  In analyzing your case, a fleur di lis abdominoplasty (upside down T- incision) or corset abdominoplasty ( upside down T-incision plus an inframammary incision.  The benefit for either operation is that you have excision of both vertical and horizontal excess tissue.  The benefit of the corset over the fleur-di-lis is that you can efface the upper back roll as well as remove the upper dog ear that sometimes forms from the fleur-di-lis.  Either one of these procedures can be combined with a lower body lift to turn this into a circumferential procedure.

The benefit of insurance coverage of panniculectomy is that it helps to defray the cost of the operating room and anesthesia to a degree and you can often tack the overnight stay to go with this procedure rather than paying for this out of pocket.

When you decide that the time is right for your procedure, you should go see a board certified plastic surgeon, especially one who performs postbariatric procedures.  If you are unsure of who that person is, your bariatric surgeon (usually his or her nurse) will know the right surgeon to send you to.

 

Congrats on the weight loss and keep up the good work

Stephen M. Chen, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 16 reviews

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Am I a goo candidate for a panniculectomy?

+1

Thank you for your question and photos!  I hope that these answers help!  Tummy tuck is an excellent method for shaping the belly and create a flatter and sculpted abdomen after the procedure.  Looking at your photos, I do believe that you would be an excellent candidate for this procedure in order to remove the excess skin/soft tissue of your lower abdomen and contour the areas of your belly.  Insurance coverage would certainly depend on your symptoms/complaints as well as physical examination.  A fleur-de-lis pattern would be ideal for you to remove excess skin/soft tissue on both the horizontal and vertical directions.

I would highly recommend continued diet and exercise prior to any consideration for body contouring as getting down to your ideal weight prior to the procedure will certainly give you the best results.  Also, a continued healthy and active lifestyle will be needed in order to maintain the benefits that the procedure has given to you.  Also, I would recommend performing this procedure after you have completed child bearing, as your appearance may return with each pregnancy.  

Once you are ready for the procedure, I would likely recommend a full tummy tuck with abdominal wall tightening along with some liposuction to the hips/flanks for additional contouring.  You should consult with a plastic surgeon at anytime to go over options and then likely return once you have achieved your ideal weight  in order to assist you in deciding which procedure(s) would be right for you.  Best wishes!  

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
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Types of Tummy Tuck/Abdominoplasty procedures

+1
The short answer is that if you are a great candidate for a special type of tummy tuck called a fleur-de-lis abdominoplasty which focuses on the redudnant skin vertically orinented on your tummy

A Panniculectomy refers to simple excision, removal, of the roll, pannus, of redundant soft tissue in the lower abdomen which falls onto the thigh. Occasionally this procedure is covered by insurance if there is a documented recurrent or chronic infection and rash requiring medical treatment. It does not involve improvement to the mid or upper abdomen or tightening to the abdominal muscles, but can be done in conjunction with anAbdominoplasty which will accomplish these goals.
Abdominoplasty This procedure frees up all of the extra or redundant abdominal skin and fat by removing the excess skin around the abdomen and may be used to tighten the abdominal muscles. Liposuction often is used to lessen areas of the fat layer for an improved result. The procedure involves a side to side incision at the level of the pubic hair line. More sophisticated surgical approaches for Massive weight loss may include additional incisions such as a Fleur de lis, an additional incision in the midline up and down to remove excess skin from side to side (in addition to up and down tightening); a reverse lift leaving scars under the breasts, or a Pubic Lift for redundancy in the pubic region and other modifications that are customized to your particular needs. Because of the complexity and number of surgical options, it is key to choose your surgeon wisely. Make sure that he has experience in this type of surgery, is Board Certified by the American Board of Plastic Surgery. This is why so many of our patients choose Pacific Center for Plastic Surgery.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 44 reviews

Candidate for Tummy tuck

+1

I doubt your insurance will cover a panniculectomy as I don't think your skin hangs low enough to qualify for what insurance companies cover.  As for the tummy tuck, I think you can get away with a standard tummy tuck incision---you will likely find that the loose skin can be tightened without the midline incision required with a fleur de lis pattern. 

Christa Clark, MD, FACS
Sacramento Plastic Surgeon
5.0 out of 5 stars 35 reviews

Candidate fr Andominal operation.

+1

Yes I agree with the aggressive surgery option but as for health insurance coverage? I doubt. Best to obtain inperson evaluations. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Tummy tuck candidate

+1
I think you are a surgical candidate. Just know that insurance companies have cracked down on panniculectomy so unless you have intractable rashes which have not responded to antibiotics, you may well be denied.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tummy Tuck

+1

You have a considerable amount of loose skin with very little fat excess.  In my part of the country, a panniculectomy is only considered as an insurance case, and doing this concurrently with a cosmetic tummy tuck really does not save you any money since the tummy tuck fees remain the same, and the panniculectomy tissue would be removed by both procedures.  I would recommend that you consult with surgeons experienced in doing these procedures in massive weight loss patients.

Donald Griffin, MD
Nashville Plastic Surgeon
4.0 out of 5 stars 13 reviews

Panniculectomy/Tummy Tuck

+1

It is hard to predict which patient will have insurance coverage for panniculectomy. Some policies specifically exclude such procedures, others have varying standards of medical necessity. Having a history of rashes is a plus in your favor. 

As to the best procedure, I feel, based on the photos, that there is enough excess in both the vertical and horizontal directions that  a "fleur-de-lis" or vertical TT will be needed to get the best outcome.

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank your for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

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.