Dear Trustworthy4185, Thank you for your question. Yes, you can definitely have a tummy tuck after a panniculectomy. I know it might seem a bit complicated, given that you've had a panniculectomy over a decade ago. But let me assure you, it's doable. A panniculectomy primarily focuses on removing the overhanging skin and fat from the lower abdomen. On the other hand, a tummy tuck not only removes excess skin and fat, but it also tightens the abdominal muscles and can reposition your belly button to give your abdomen a more contoured, natural look. Your overall health and the current condition of your body are going to play a big role in how successful a tummy tuck could be for you. But at 5'9 and around 200lbs, it sounds like you could be a good candidate for this procedure. The best next step would be to sit down with a board-certified plastic surgeon who can evaluate your unique situation and guide you through the potential outcomes and risks. Please make sure they've performed hundreds of tummy tucks and have pictures to show for it. Thank you for reaching out with your question, and I wish you the best of luck in this journey. Remember, it's all about what makes you feel best in your own skin. Take care, Dr. Katzen.