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.
