Am I a good candidate for a panniculectomy? 2 previous pregnancies left me with weak muscles and hanging apron (photo)

Question

I am wondering if I qualify for a pannoculectomy. I hate my stomach. After having two babies my muscles are so weak and I have a belly apron that hangs well below my pubis. I just want it gone so I can wear normal shirts and not try to constantly hide with long baggy shirts! It also gets in the way and is so heavy I find myself lifting it up through out day to get some relief!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for sharing your concerns. Like other plastic surgeons have advised, I also recommend that you lose some weight before considering a panniculectomy. The new weight loss medications like Ozempic and Wegovy have been shown to be very effective, and I encourage you to discuss these options with your primary care physician (PCP).

Based on your description and photos, I would also suggest that you might be a better candidate for a tummy tuck rather than just a panniculectomy. Since you mentioned your rectus abdominis muscles being weak, a tummy tuck would address both the hanging apron and the muscle weakness by repairing the abdominal muscles, providing better overall results. A panniculectomy only removes the excess skin, but it wouldn’t help with the muscle repair or improve the shape of your abdomen as a tummy tuck would.

Once you've achieved a more stable weight, I believe a tummy tuck would give you the relief you're looking for and help you feel more comfortable in your body and clothing.

Sincerely,
Dr. Katzen

Carlos Marciales, MD · Answer

I recommend to lose at least 20 pounds to have better result, more safe surgery, and less risk of complications

Eleonore Zetrenne, MD · Answer

You are a candidate for a panniculectomy but you would have much better results if you lost 30-40 pounds and then undergo an abdominoplasty, this way your rectus muscles can be tightened and the abdominal skin removed. You carry most of your weight in your abdomen.Removal of the skin can help as a temporizing measure while you loose weight, as long as you are realistic about the results. It would make you feel better and improve your quality of life.

Gary M. Horndeski, MD · Answer

Yes, you are a candidate for a panniculectomy.  Insurance companies make money by not providing services so you have to appeal to them to see if they will approve you.

Best Wishes,

Gary Horndeski, M.D.

Salvador Medina, MD · Answer

Hello Jasmine 130.To address your problem, if is very important that you first lose weight. Once you have achieved that, you will see that the excess skin is even worse!! But that is ok, because then we can do a tummy tuck to get rid of the excess skin and do an abdominal muscle repair so you can have a flat muscle.
ThanksDr. Medina

Zoran Potparic, MD · Answer

You seem to be right candidate for this procedure. However, loosing 40-60 lbs. before surgery would significantly help. Good luck.

Camille Cash, MD · Answer

From the submitted photo it appears you do have an apron of hanging skin but you also have visceral fat contributing to your abdominal contour.  This is the fat that is behind the muscle wall and surrounds your organs.  I encourage you to work with your physician to lose weight prior to considering pannus removal or plastic surgery such as a tummy tuck.

Scott C. Lindsay, DO · Answer

Hello and thank you for both your photos and question.  You could benefit from a panniculectomy now, but I would recommend you work on loosing more weight first to achieve a better result.  More weight you loose we can remove more skin and tighten the muscles.

Michael S. Wong, MD · Answer

Dear jasmine130,
Thank you for your questions and picture. 
Whether you qualify for panniculectomy depends on your insurance carrier. Some may require documentation of rashes or infections over a period of time. Some may require that the panniculus hangs a certain distance. Check with your insurance carrier to get your specifics.
From the picture, you do have a bulge. The question is, how much is due to muscle laxity and how much may be from intraabdominal fat. My guess is there is both. For muscle laxity with a separation in the midline, this benefits from muscle tightening, which is not included in a panniculectomy. This is part of an abdominoplasty or tummy tuck. This is not covered by insurance. The degree that this muscle tightening will flatten your profile view is determined by how much intraabdominal fat there is. This fat is only addressed through weight loss. Thus this portion of the aesthetic improvement from muscle tightening will be determined by your weight.
I would encourage you to seek out a consultation with a board certified plastic surgeon who can examine you, assessing your muscle separation and intraabdominal fat. Most likely you will benefit from a full abdominoplasty or tummy tuck.
Wishing you well along your body contouring journey.

Am I a good candidate for a panniculectomy? 2 previous pregnancies left me with weak muscles and hanging apron (photo)

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