How Much Does a Panniculectomy Cost?
A panniculectomy costs $7,575 on average, according to recent reviews from RealSelf community members, though some have paid as much as $20,000 for “apron surgery.”
Read on to find out why panniculectomy prices can vary so much, whether insurance covers it, and whether real patients say it’s worth the money.
Does insurance cover panniculectomy costs?
Some panniculectomy procedures are covered by insurance, but it's not easy to qualify for coverage. Elective cosmetic procedures are not covered by insurance, so you’ll have to prove that the procedure is medically necessary.
“The situation needs to be severe for skin removal to be covered as medically necessary,” says Dr. Adam J. Oppenheimer, a board-certified plastic surgeon in Orlando, Florida. You can work with your surgeon to get your pannus removal procedure cleared.
New York City-based bariatric surgeon Dr. Daniel Rosen explains that the criteria for insurance coverage “often include documentation of a rash in the skin folds that persists, despite medical treatment with antifungal powders, and pictures that demonstrate the excess skin hanging down below the pubic bone.” Insurance companies sometimes mandate that the entire pubic area and genitals be covered by hanging skin, in order for coverage to be approved.
It’s helpful to document that the pannus is impairing your normal activities and ability to function.
You may also be required to show that you’ve maintained a stable body weight for six months after significant weight loss.
Contact your insurance provider to get clarification on their approval guidelines for the procedure and whether you’ll need to see an in-network surgeon. Then consult with a surgeon (who accepts insurance) about whether you’re a good candidate to qualify for coverage.
If your insurance coverage is approved, find out how much you’ll have to pay out of pocket. “Insurance companies often pay only a small fraction of the usual and customary fees, so the procedure may only be partially paid for… even if it’s ‘covered,’” explains Dr. Brent Moelleken, a board-certified plastic surgeon in Beverly Hills.
RealSelf Tip: It’s fairly common for a provider to discover hernias during this surgical procedure. Hernia repair is often considered a medical necessity, so insurance may cover a portion of the cost. Ask your insurance carrier in advance how they would handle this situation.
How long does it take for insurance to approve panniculectomy coverage?
The insurance authorization process takes anywhere from two weeks to two months, depending on how quickly your insurance provider processes your claim.
Your surgeon will send your medical information to your insurance company, including details about your height, weight, and why pannus removal is medically necessary in your case.
Your insurance provider will review these details and determine whether or not you meet the criteria to qualify for coverage. If they reject your case, they should provide the reasons why coverage is denied and outline the appeals process.
If your insurance provider determines that your panniculectomy will be covered, ask how much you’ll need to pay out of pocket as a coinsurance payment. Then ask your surgeon how much you’ll need to pay them, on top of insurance.
Most surgeons offer payment plans or accept third-party financing, and it’ll give you more peace of mind if you have all the financial details worked out before your procedure.
What affects the cost of a panniculectomy?
These are the biggest factors that will impact your apron belly surgery cost.
1. Your provider’s credentials and level of expertise
One of the most important aspects of booking any plastic surgery procedure is finding a qualified surgeon.
Look for a board-certified plastic surgeon who has years of experience performing panniculectomies, backed up by good patient reviews and before and after photos.
Their surgeon's fee will likely be higher than another type of physician, but those years of advanced training and experience will reduce your risk of complications and side-effects, while increasing the likelihood of a smooth healing process and good results.
Don’t be afraid to ask tough questions during your consultation, including:
- how many of these procedures they perform a year
- how many of their patients have experienced complications, and how they’ve handle it
- what kind of fees you'd have to pay in the rare event that you needed revision surgery
We can all appreciate a good deal, but your safety is more important than saving a few hundred dollars—and after doing the work of losing a significant amount of weight, you deserve to get the results you want.
2. Their practice location
Plastic surgery of any kind tends to be more expensive in upscale neighborhoods of major metro areas than it is in less desirable areas or smaller cities.
However, there’s another factor: how many qualified surgeons offer panniculectomies, compared to the level of interest in this body contouring surgery. In areas with a lot of supply and limited demand, surgeons may lower their prices to compete for patients.
Some people travel to another city or go abroad to places like Mexico for more affordable surgery. You really have to do your homework to make sure you'll be landing in good hands (during your procedure and recovery), but there are experienced surgeons doing good work in areas with a much lower cost of living.
Related: 6 Things to Do If You're Traveling Outside the U.S. for Surgery
3. Where your surgery is performed
This outpatient procedure doesn't need to be performed in a hospital setting—unless your insurance plan requires it.
If you have a choice and your surgeon has a private surgery center, you'll pay a lower facility fee there. Just be sure to ask if it has been certified for safety by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).
4. The extent of your procedure
Panniculectomy surgery removes the apron of loose skin on the lower abdomen, below the belly button. Some operations are more straightforward, while others are more complex because of the patient’s unique needs and goals.
Some people opt to combine their panniculectomy with a tummy tuck procedure (abdominoplasty). This cosmetic surgery removes excess fat and skin while repairing stretched muscles in the abdominal wall, to contour the entire midsection.
Other procedures that may be combined with a panniculectomy include:
- Diastasis recti repair to tighten and strengthen separated abdominal muscles
- Liposuction to remove excess fat in the flanks, back, or other areas
- A breast lift, to reposition sagging breasts and restore a more youthful appearance
The combination of breast and abdominal surgery is commonly called a mommy makeover.
Combining more than one surgical procedures in a single operation costs less than having each of them performed individually, because you only have to pay the anesthesia and facility fees once.
The surgeon's fee will be higher due to the additional time and work, adding to your total bill, but many surgeons offer a discounted rate on each additional procedure.
Discuss your budget and goals with your surgeon and request a personalized cost quote for your unique surgery plan.
RealSelf Tip: Combining a panniculectomy with a tummy tuck may also increase your recovery time by about a week, so take into account the cost of time off work and childcare.
5. Who administers your anesthesia
This is a major surgery that's performed under general anesthesia, which essentially puts the patient in an induced coma.
Either a nurse anesthetist (CRNA) or an anesthesiologist (MD) can administer general anesthesia. A CRNA will charge less for their services than an anesthesiologist, but some plastic surgeons prefer the expertise of an MD, particularly if you're a high-risk patient (due to underlying medical issues like diabetes).
You can also expect to pay anesthesia fees related to supplies and any additional staff that will assist your anesthesia provider.
6. Whether or not your panniculectomy is covered by insurance
As we discussed above, panniculectomy surgery costs may be covered by health insurance if it’s deemed medical necessity.
Again, even if your insurance carrier does agree to cover your plastic surgery, the amount they pay likely won’t cover the whole bill. To avoid surprises, ask your provider in advance how much you’ll still have to pay out of pocket.
7. Any additional costs
The cost estimate you get from your surgeon should include all the fees outlined above, as well as follow-up visits, pain medication, and any other recovery supplies you'll need.
Ask if you'll be provided with a compression garment called an abdominal binder, and how much that will cost.
The cost of your consultation will probably be applied toward the cost of your procedure, but it's best to confirm that up-front, too.
Is a panniculectomy worth the money?
There's no denying that this procedure is expensive, especially if your insurance doesn't cover it. That said, panniculectomy surgery gets a solid 99% Worth It Rating from reviewers on RealSelf.
Unlike some concerns, an apron of sagging skin that's left behind in the lower abdomen after bariatric surgery and massive weight loss really can't be treated effectively with nonsurgical skin tightening procedures.
The results can have a transformative impact on patients’ quality of life, resolving rashes, body odor, back pain, and even ulcers. People also report that their clothes fit better, giving them a confidence boost.
It's definitely an investment, but results are considered permanent as long as one maintains a stable weight. Losing this excess skin helps patients exercise more easily, which can help keep the weight off.