Diastasis and hernia repair during hysterectomy: will I need a panniculectomy later? (photos)

Question

36 yo Mom of three c-section babies and the first was almost 10 pounds. I am approved for surgery and am ok with a general surgeon plicating my DRAM after my hysterectomy. I have been researching, unsuccessfully, for information on getting my skin done at a later time. What would this entail since I won't need a full TT because my abdomen has already been plicated?

Kenneth Hughes, MD · Answer

The usual procedure of a panniculectomy is the removal of excess skin below the belly button. You want to make sure that you are aware of the difference between a panniculectomy VS abdominoplasty because a panniculectomy will not tighten the underlying muscles and give a contour shape.
You may want to stage the surgeries:  have the hernia repair and hysterectomy in a hospital with medical coverage. Six months or so later have the liposuction and TT with plication in a fully accredited surgery center which will be less expensive.

Camille Cash, MD · Answer

A panniculectomy is a procedure that removes a hanging apron of skin extending approximately hip to hip.  In order to have it covered by insurance it must be deemed medically necessary.  Factors that influence that is if the skin is hanging low where it covers the pubis and if chronic rashes and infections are resulting.  It will not produce the same results as a tummy tuck. You may want to consider a tummy tuck which would remove excess fat and skin, as well as abdominal wall laxity.  It addresses the areas both above and below the belly button.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your questions regarding whether you will need a panniculectomy after a diastasis and hernia repair during a hysterectomy. In regards to your specific case, you will need to examine the difference between a panniculectomy and a tummy tuck.  During a panniculectomy, the apron of abdominal skin or pannus is removed. The removal of the pannus therefore, is called a panniculectomy. This is just a removal of hanging, lower abdominal skin and fat. During a tummy tuck, the rectus abdominus muscles and rectus diastasis is corrected and plicated. Also, any hernias can be repaired. In addition, more skin and fat can be excised than during a panniculectomy. A tummy tuck is more of a cosmetic procedure than a panniculectomy. Technically, placating or suturing together your rectus abdominis muscles is already approved. However, I doubt that your insurance company would cover the panniculectomy at the same time. What I would suggest is that you undergo a tummy tuck that would include resection of excess skin and fat (more so than the panniculectomy), plication of the rectus muscles, and repair of the hernia. I would suggest the tummy tuck more so than the panniculectomy with the plication of the DRAM because the tummy tuck will obtain better cosmetic results. Thank you for your question regarding will you need a panniculectomy after a diastasis and hernia repair.  I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the panniculectomy, extended lower body lift, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or lower body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or lower body lift. Do your research.  Make sure they have performed at least 100 panniculectomies or circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, panniculectomy or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Daniel Barrett, MD · Answer

Dear tinytxdancer,
I understand your concern. It is best however that you consult with your surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Diastasis and hernia repair during hysterectomy: will I need a panniculectomy later? (photos)

Answers (4)

Answer: Combination of surgeries

Answer: Combination of surgeries

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Diastasis and hernia repair during hysterectomy: will I need a panniculectomy later? (photos)

Answers (4)

Answer: Combination of surgeries

Answer: Combination of surgeries

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Recommended reading

Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.