Thank you for your question regarding whether you will be happy after a panniculectomy if your upper abdomen is not touched. During a panniculectomy, the abdominal pannus is removed. The abdominal pannus is the area of skin and fat that hangs over the pubic region. By definition during a panniculectomy, the rectus abdominus muscle is not sutured and there is no dissection above the apron. In addition, there is no surgery done around the umbilicus. So by definition, if you only undergo a panniculectomy, the upper abdomen will not change. In my opinion, a far better surgery would be the tummy tuck. During a tummy tuck as opposed to a panniculectomy, the rectus abdominus muscle is sutured, the umbilicus is corrected, and the excess skin and fat of the abdomen are removed. You will get a far superior result. In my opinion, I would strongly encourage you to have a tummy tuck instead of a panniculectomy. I would see if you could borrow or get a line of credit for the differential in cost for a panniculectomy and a tummy tuck. When a patient comes to me for insurance coverage from a panniculectomy but really needs a tummy tuck, I charge them the difference between the panniculectomy and the tummy tuck. These are insurance and noninsurance coverage procedures which are combined. You may need to work with your plastic surgeon regarding combining insurance and noninsurance surgeries. However, this can be done. In my opinion, I do not think you will be satisfied with the upper abdomen if you just have a panniculectomy. Again, remember that a panniculectomy only addresses the lower abdomen and does not do anything per se to the upper abdomen. I hope this helps to answer your question regarding whether you'll be happy after a panniculectomy and left with loose skin of the abdomen. 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, President of the American Society of Bariatric Plastic Surgeons, 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.)