I had the gastric sleeve in 2011 and have lost close to 130 lbs. I am currently at 279 and am 5 foot 6. Should I do panni or tuc

I had the gastric sleeve in 2011 and have lost close to 130 lbs. I am currently at 279 and am 5 foot 6. I have been working very close with a physical therapist/fitness therapist and nutritionist. I exercise 3 times a week. She has said that it's time to do something about the hanging skin. Would a panniculectomy be better to have or abdominoplasty? have had 5 abdominal surgeries going into the same vertical incision that goes from naval to pubic area. It's approximately 12 inches long.

Doctor Answers 5

Tummy Tuck versus Panniculectomy

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Thanks for your question! First & foremost, big congrats to you on your weight loss! That's a tough road to go down!

Lubbock Plastic Surgeon
4.9 out of 5 stars 42 reviews

I had the gastric sleeve in 2011 and have lost close to 130 lbs. I am currently at 279 and am 5 foot 6. Should I do panni or tuc

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Additional weight loss would be helpful and improve the safety.Tummy tuck may be appropriate, but pictures or an exam would be useful to provide a recommendation.
Kenneth Hughes, MD Los Angeles, CA

Panniculectomy VS. Tummy Tuck

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A Panniculectomy is a salvage procedure. It would enable you to wash better by removing the overhang but it does not tighten stretched muscles nor does it remove loose skin of the abdomen. A Tuumy Tuck can only be done safely and is apt to produce nice results once your BMI drops below 30. You have made great progress but there is something missing. After five years your BMI is at 45 which still is way too high. It sounds like you are doing everything right but if you are why are you still 100 pounds from your target? - are you keeping a food diary of everything you eat and drink? My Fitness Pal is s good app for that- how much carbs are you consuming in sodas, sweeteners, salad dressings or worse? ( I recently had a lady in my office who seemed to do everything well but after extensive interviewing remembered she had an addiction to M&Ms consuming them in her cubicle at work). - do you have an untreated of under treated medical condition which may explain the slow weight loss?
I would encourage you to look at all of these. Some of my most grateful patients are massive weight loss patients who I helped remove the last reminders of their obesity once they reached the ideal weight. 
If you can get there, s Tummy Tuck is vastly superior to a Panniculdctomy. 
Dr. Peter A. AldeaMemphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon

Congratulation on the weight loss

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The decision to do a panniculectomy (removal of extra skin) and abdominoplasty (muscle tightening with extra skin removal) depends on whether the shape of the upper abdomen is bulging due to muscle underneath being spread apart or not.  If not then a panniculectomy is probably all that is needed.

R. McIntyre Bridges, MD
Shreveport Plastic Surgeon
4.8 out of 5 stars 6 reviews

#weightloss #extendedabdominoplasty #hanging #exercise

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You would be best served by getting closer to your ideal weight before having any procedure.The only circumstance that I would recommend you doing anything prior would be if you are having hygiene issues such as recurring infections, open wounds.If that is the case, then I would do a panniculectomy now and the abdominoplasty when you get to your ideal body weight.
Most people can find adequate compression support garments to allow support to exercise. 

Jack Peterson, MD
Topeka Plastic Surgeon
4.6 out of 5 stars 47 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.