Dear Apruitt0114, Navigating the decision on when to have a panniculectomy amidst considerations of future pregnancies, especially following your significant weight loss and the challenges experienced during your last pregnancy, is indeed complex. Given the complications you've described, including the severe infection post-C-section attributed to excess skin, the timing of skin removal surgery warrants careful consideration. If you are uncertain about when you might plan another pregnancy, opting for a panniculectomy sooner rather than later could be beneficial for several reasons. Primarily, removing the excess skin can alleviate physical discomfort and reduce the risk of complications like infections, particularly in areas where skin overlaps. In terms of imaging and medical monitoring during any future pregnancy, having the panniculectomy done could also facilitate easier access and clearer imaging, potentially reducing some of the challenges you faced previously. Concerning the impact of future pregnancies on the results of a panniculectomy, it's reassuring to note that many patients maintain their post-surgical outcomes even after pregnancy. The abdominal area's ability to "snap back" post-pregnancy can be surprisingly resilient, especially when the panniculectomy is performed by an experienced surgeon who prioritizes not only the removal of excess skin but also the structural support of the abdominal area. It's worth mentioning that I've never had a patient need to return for corrective surgery post-pregnancy after either a tummy tuck or panniculectomy. The results have generally held up well, with patients reporting satisfaction with their stomachs' appearance and resilience after giving birth. However, each individual's body reacts differently to pregnancy, and various factors, including the nature of the skin, the extent of the panniculectomy, and overall skin elasticity, will play a role in the long-term outcome post-pregnancy. Engaging in a detailed discussion with a board-certified plastic surgeon who has experience in body contouring procedures post-weight loss and pregnancy can provide you with tailored advice. They can assess your specific situation, discuss your family planning goals, and help you make an informed decision that aligns with your health, aesthetic goals, and timing for potential future pregnancies. The goal is to ensure that you feel comfortable and confident in your decision, balancing the benefits of proceeding with the surgery sooner against any considerations for the future. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon