Am I a candidate for a Panniculectomy or thigh lift? (Photo)

Question

Thank you for your time. I currently weigh 198 pounds and have been at this weight for at least 2 years. I weighed 290+ pounds when I gave birth to my twins. I am troubled by skin infections in my belly button which is an inch and a half deep and in my thighs. The weight pulls my hips forward when I walk and it causes me a lot of back pain. I can not jog because of the skin pulling. I have to wear compression pants just exercise moderately. Would this be considered a medical necessity?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question, and congratulations on your weight loss! After reviewing your photos and reading about your history, you’re an excellent candidate for both a tummy tuck and thigh lift. These procedures would significantly improve your overall contour and help alleviate the discomfort you’re experiencing, such as skin infections and back pain.

A panniculectomy would also help by removing the excess skin and fat in the lower abdomen (the pannus), which is causing infections and discomfort. However, a panniculectomy is somewhat limiting compared to a tummy tuck. While it removes the overhanging skin, it doesn’t include muscle repair or provide as much aesthetic improvement. A tummy tuck (abdominoplasty), on the other hand, not only removes excess skin and fat but also tightens the abdominal muscles, corrects abdominal separation (diastasis recti), and recontours the entire midsection. It also helps reposition the belly button to give a more natural appearance.

If you're also struggling with excess skin on your thighs, a thigh lift would address the sagging and discomfort in that area, allowing for greater mobility and relief from skin infections.

Both procedures could be considered medically necessary if they are contributing to functional issues like infections, back pain, and difficulty exercising. I recommend discussing these symptoms with your plastic surgeon to see if insurance might cover part of the surgery.

Some plastic surgeons will perform both procedures at the same time which will allow for one recovery.

Sincerely,
Dr. Katzen

Stanley Okoro, MD · Answer

Thank for your question and the photos you provided. Based on the amount of skin in your lower abdomen, you would not qualify for a panniculectomy. I would start researching lipoabdominoplasty to enhance your abdominal contour. Make sure you consult with a board certified plastic surgeon.

Larry C. Leverett, MD, FACS · Answer

The lower body lift/belt lipectomy would address your abdomen, lower back and lateral thighs. Down time is 2-3 weeks. The inner/anterior thighs would have to be addressed at a later surgery, if desired. 
No, it is considered cosmetic, not medically necessary. In order to see a flatter tummy, ore weight loss prior to surgery would be helpful because we don't usually do liposuction of the abdominal skin during this operation.

Kenneth Hughes, MD · Answer

The panniculectomy involves only the removal of excess skin/fat that hangs over the genitals and/or thighs. It does address hygiene issues, rashes/infections, etc. When a panniculectomy is done, there is no tightening of the underlying muscles and tapering of the waist so you do not get the contour shape. Panniculectomy is only the removal of the skin below the belly button, so the best aesthetic results could be attained with a TT.

Daniel Barrett, MD · Answer

Dear Anonym185752,
if your loose skin is creating health issues, then there is a chance that your insurance will cover the costs of panniculectomy. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Joshua B. Hyman, MD · Answer

Congratulations on the weight loss. You are a terrific candidate for a panniculectomy but I can not comment on the thighs without more info and exam. The procedure is not covered by insurance and we perform it in our private office based surgical center. I realize you are symptomatic but that is the way things are in our country. I am happy to answer any specific questions you may have. The procedure takes 3 hours and is done as an outpatient. There are two drains placed which come out one week later. The procedure is surprisingly painless with the use of long acting local anesthetics. Make sure you chose a board certified plastic surgeon.

Michael J. Yaremchuk, MD (license resigned) · Answer

Thank you for your question. You asked about a panniculectomy, which Would remove excess skin and fat. This would help you with your rashes, but this would not give you the best cosmetic result. Therefore, an abdominoplasty is something that you should consider which not only removes excess skin and fat from the lower abdomen but also tightens the abdominal muscles and involves liposuction for a more desired contour.   regarding your thighs, it is hard to know without examining you. Excess fat alone can be addressed with liposuction. However, excess skin can only be removed with a thigh lift, so your surgeon would need to make that determination.

Am I a candidate for a Panniculectomy or thigh lift? (Photo)

Answers (7)

More Panniculectomy Questions

WE SEND PRETTY
EMAILS

Answers (7)

More Panniculectomy Questions

Will my insurance pay for a panniculectomy and am I a good candidate? (Photo)

Could I potentially get a Panniculectomy covered by my insurance? (Photo)

Is it possible I could have a panni with so much fat left to help with rashes? (photos)

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

What is the defining factor in performing a vertical panniculectomy? (Photos)

Can all vertical scars and stretch marks on my stomach be repositioned below new belly button after a Panniculectomy? (Photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS