Extended Tummy Tuck or Panniculectomy?

Question

I have a Tummy Tuck scheduled for July but after all my searching I am thinking that I might need a Panniculectomy. What is the difference between a Panni and an Extended TT? What would be my best option?

Armando Soto, MD, FACS · Answer

While a Tummy tuck also involves repair of the abdominal muscles, in order to achieve a flatter, leaner look (see the gallery on this site).

	They are two entirely different procedures, with different goals, outcomes, and recovery/risk profiles.

	Your best bet is to have a conversation with your chosen surgeon about your options.

Sheila S. Nazarian, MD · Answer

A panniculectomy will not get rid of the excess skin above your belly button.  Also, the six-pack muscles will not be brought back together.  For your case, I would discuss a fleur-de-lis tummy tuck.Best of luck,Sheila Nazarian

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! I hope that these answers help! A panniculectomy is an excellent method for removing the excess skin and soft tissue of the lower abdomen (abdominal panniculus), often caused by weight loss. It is mainly performed to ameliorate symptoms caused by the abdominal apron such as hygiene issues, excoriations, rashes/infections, back pain, etc. A panniculectomy gives almost immediate relief from these issues as well as has been shown to stimulate additional weight loss as your activity level is increased after removal of the panniculus. An abdominoplasty is more of an aesthetic procedure in that as opposed to simply excising this excess tissue in a wedge to relieve complaints, an abdominoplasty focuses more on abdominal contouring, abdominal wall tightening, re-insetting the belly button, as well as often times the addition of liposuction. I believe you would be better served by a full tummy tuck, in order to address your abdominal wall laxity as well as contouring of your flanks/hips, and upper abdomen.  I would highly recommend continued diet and exercise prior to any consideration for a panniculectomy or body contouring as getting down to your ideal weight prior to the procedure will certainly give you the best results as well as be the safest for you. Neither one is a weight loss procedure. Also, a continued healthy and active lifestyle will be needed in order to maintain the benefits that the procedure has given to you. You should consult with a plastic surgeon at anytime to go over options and in order to assist you in deciding which procedure(s) would be right one for you.  Best wishes for a wonderful result!

Jerome Edelstein, MD · Answer

Panniculectomy is usually for people who have lost 100 lbs or more quickly. It can be performed at the same time as a tummy tuck. The surgery only removes the skin and fat that is hanging below the waist (pannus), and nothing is touched above.However, you should be at a stable normal BMI before pursuing surgery. This is to improve surgical outcome and safety.

Jeffrey Zwiren, MD · Answer

You are a candidate for an abdominoplasty.  When you are in the sitting position place your hands under the skin apron.  Follow this out laterally until it tapers off.  This will give you an idea of the length of the incision necessary for your abdominoplasty.  Your plastic surgeon, during an examination, will be able to advise you on the length of the incision needed to give you a full correction.

Paul Gill, MD · Answer

A Panniculectomy will only address loose skin that hangs below the pubic bone.  It does nothing to the tissues above this area.   When I evaluate the abdomen, I assess:1. The amount of loose skin2. The volume of fatty tissue3. The degree of muscle laxity.I evaluate this in each of 3 areas:1. Upper Abdomen2. Area around the Belly Button3. Lower AbdomenMINI TUMMY TUCK: If a patient has loose skin, fatty tissue, and muscle laxity limited to the Lower Abdomen, then I recommend the mini tummy tuck. In order to qualify for this, the patient must have good skin and muscle tone in their upper abdomen and area around the belly button. I will frequently perform liposuction of these areas with my Mini Tummy Tuck to enhance the overall contour.FULL TUMMY TUCK: this is for patients who have loose skin and muscle laxity of the upper abdomen, belly button area, and lower abdomen. This procedure tightens all 3 areas with a bikini line incision. I often encorporate liposuction with my full tummy tuck as I feel it offers a superb end result.EXTENDED TUMMY TUCK: This works well for patients who have loose skin that extends over the hip bone into the flank area. I will perform extensive liposuction and skin excision to the hip and flank area combined with full tummy tuck.BODY LIFT/BELT LIPECTOMY: this is essentially a 360 degree tummy tuck which involves removal of loose skin and fatty tissue of the lower back and buttocks, in addition to the extended tummy tuck.I wish you a safe recovery and amazing result!!Dr. Gill

Darryl J. Blinski, MD · Answer

The pannius is the hanging skin/fat component of the lower abdomen. Thus a panniculectomy is the removal of that component. A Full or extended tummy tuck is the panniculectomy + correction of the diastasis recti separation, and a flattening of the complete abdominal profile. It is a MUCH larger operation with better results but increased risks.

	From MIAMI DR. B

Peter A. Aldea, MD · Answer

A Tummy Tuck is NOT a Panniculectomy. The operations are different, the risks are different and their results are VERY different.

	A Panniculectomy involves removal of the lower tummy skin and fat overhang. Nothing else.It will NOT flatten your tummy. It is done to allow people to clean themselves better and prevent skin infections in the groin fold.  It is NOT a cosmetic operation.

	
	An Abdominoplasty is a much longer and more extensive operation which will remove ALL the loose tummy skin, will tighten separated muscles, narrow the waist, lift a sagging Mons pubis and relocate the belly button in the process.

	If you are healthy and want to look much better you would have to take the risks of a Tummy Tuck. On the other hand, if you would be satisfied with just the lower skin overhang being gone or were not in good medical health to have a Tummy Tuck - then the answer is Panniculectomy.

Michael L. Workman, MD (retired) · Answer

Abdominoplasty is the medical term for a tummy tuck. It involves not only removing skin and fat tissue from the abdomen but also plication or tightening of the front abdominal muscles. An extended tummy tuck just involves making a wider incision than a typical tummy tuck but still includes tightening of the abdominal muscles.  Panniculectomy is a surgery that occurs after someone has lost a massive amount of weight and needs to have the hanging skin, called a pannus, removed. This type of surgery does not involve tightening the front abdominal muscles. As far as deciding which is right for you, it depends on your body type and what you are looking for from the procedure. I recommend making an appointment with your plastic surgeon to discuss what surgery would be right for you specifically.

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