I'm nearing 50 and want to have my huge belly and sagging belly flap removed. What surgeries are needed. 100 lbs overweight.

I am nearing 50 and weight has gone up and down for years. I have a big belly . I LOOK like I'm 8 mos pregnant. I've had 2 back surgeries and multiple knee surgeries and am diabetic. The extra weight is hurting my whole body. I have a big abdominal "flap" of skin that hangs below my pelvic bone and it gets really red and sore when I walk on the treadmill or go walking with my family. I need help, I can keep it off once it's gone, but I can't get rid of it by myself. I'm in Fresno CA.

Doctor Answers 10


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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 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. Depending on your examination, photo documentation, and discussion of your symptoms, insurance coverage may be possible. Discuss our plan with your surgeon as these are two separate, but related procedures - it may be a possibility. Best wishes for a wonderful result!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Weight reduction

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The best procedure for your circumstance is either a lap band or gastric sleeve. I prefer the lap band because it is adjustable. Both work and either should be performed well in advance of cosmetic surgery. 

I'm nearing 50 and want to have my huge belly and sagging belly flap removed. What surgeries are needed. 100 lbs overweight.

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It is difficult to give you a proper answer without pictures. In your case, a consultation in person is as important.
There is a spectrum of surgeries out there based on the patient's age, weight, health status ..etc..
You may not have to be in ideal weight to qualify for surgery. Based on what you describe, panniculectomy may be one of your options pending your evaluation.

Maan Kattash, MD, FRCS, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 21 reviews

Pannus removal

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A panniculectomy will only remove the excess skin and fat that is forming the apron of skin, and won't do anything for anything above this. It may help you.

Please see an experienced board certified plastic surgeon for a physical examination to see whether this treatment would address your concerns. Best of luck!

Surgery to Remove Sagging Belly Flap in Overweight Patient with Diabetes

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Thank you for your question. Your situation is not an easy one, I'm sure. The name of the procedure to remove a flap of belly skin is 'panniculectomy'. This differs from an abdominoplasty because it is an amputation of soft tissue only. It doesn't address underlying muscle. In my practice, I find the panniculectomy rarely solves the problem it was intended to. A diabetic patient will have more difficulty healing in any surgery than a patient without diabetes. A patient with a BMI of over 40 is considered too high risk for most plastic surgery. In order to get to a safer weight, perhaps find a medically supervised weight loss program or a doctor who specializes in bariatric medicine in your area. Best of luck to you.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Huge Belly and 100 lbs. overweight : Am I candidate for Plastic Surgery ?

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First of all the most important problem to solve is your obesity. For  2  important reasons :

  1.  Improve your general health for surgery reducing your risks, and 
  2.  Get better results.

You have to put down as much weight as possible aiming  to get to your ideal weight. You should consider the traditional method of diet and exercise or the "bariatric surgeries"  performed today to obtain massive weight loss.

Remember that plastic surgery is not a surgery for loosing weight, but to correct body contour after loosing it.

Do not hesitate to begin loosing weight, you are a young woman and 100 pounds limit your life style.

Adolfo Sesto, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 48 reviews

A panniculectomy can be done to remove excess abdominal skin and fat

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Thank you for your question.  If you are 100 pounds overweight and have a very large abdominal pannus consisting of skin and fat hanging over your waist a procedure called a panniculectomy may be what you require.  The purpose of the panniculectomy is to remove the excess skin and weight but is not a tummy tuck or abdominoplasty.  It is reasonable that if you have a panniculectomy and then lose further weight and become much thinner and have loose skin a secondary abdominoplasty could be done at a later date.


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Thank you for your question and I agree with Dr Demars that you might be better served with Bariatric surgery to get your weight down.  I might also add that the complication rate with patients having cosmetic surgery with a BMI above 40 is extremely high

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 63 reviews

!00 # overweight and a large abdominal flap.

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You have a complex problem.  There are health issues that need to be addressed now.  The weight you carry adds to the back issues and the diabetic problem.  Cardiovascular health is compromised.  You are a greater risk for problems with anesthesia.  All that being said, the excision of the abdominal flap makes sense.  You will be more ambulatory, and likely to exercise.  After you have lost more weight, further contouring surgery can be done.  Yes, you may still need a gastric bypass, but hopefully the non-operative methods for weight loss will work better for you.  Have a good discussion with a plastic surgeon to look atyour specific situation.  Good luck.

H. Michael Roark, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 16 reviews

I'm nearing 50 and want to have my huge belly and sagging belly flap removed. What surgeries are needed. 100 lbs overweight.

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That procedure is called a panniculectomy and simply means amputating the overhanging flap. You would be much better off spending your money on bariatric surgery, which almost always results in a 100# wt loss, then get a true abdominoplasty (Tummy Tuck).

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 28 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.