Would a panniculectomy be good for me if I want to still have kids? (Photo)

Question

I had bariatric surgery 2 years ago and lost 110 lbs but left me with a low hanging stomach that causes low back pain and rashes and itching under my stomach. I am only 21 and hoping to have kids eventually but my hanging stomach is getting in the way of my daily activities. What would you recommend? Also would I qualify for a panniculectomy with my current condition?

J. Timothy Katzen, MD, FACS · Answer

First, congratulations on your amazing 110-pound weight loss! That’s an incredible achievement. Based on your goals and the fact that you’re hoping to have children in the future, I’d recommend considering a tummy tuck unless you’re planning to have kids within the next year or so.

I’ve had many patients who successfully had healthy pregnancies after a tummy tuck with no complications from the surgery. In fact, getting the procedure sooner will allow you to enjoy the results for as long as possible. A tummy tuck can also help your body "snap back" more easily after childbirth, as the muscle repair and skin tightening can support your body’s natural recovery.

A panniculectomy could also help by removing the excess hanging skin that’s causing discomfort and back pain, but it wouldn’t include the muscle repair or provide as much skin removal as a tummy tuck. If you qualify for a panniculectomy due to your current medical issues (like rashes and back pain), it might be covered by insurance, but the tummy tuck would offer more comprehensive results in terms of aesthetics and abdominal strength.

I recommend discussing both options with your plastic surgeon to see what’s best for your timeline and goals. Either way, you have great options ahead!

Sincerely,
Dr. Katzen

Justin Gusching, DO · Answer

In your situation in wanting to have kids still, I would pursue the panniculectomy. This way once you are done having kids you can take the next step and do a tummy tuck. If your surgeon is able to document the issues you are having with the pannus (rash, infection, irritation, etc), then insurance should cover it.

Kenneth Hughes, MD · Answer

Some insurance companies do not require a specific BMI to cover a panniculectomy. Instead, they consider medical criteria such as chronic skin rashes, wounds, infections, odor, and other medical issues. The panniculectomy will produce the best results with the lowest risk of complications during and after surgery if you have lost most of your excess weight or your weight loss has stabilized for a period of months.

Daniel Barrett, MD · Answer

Dear krobinson14,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a panniculectomy. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Alvina Won, MD · Answer

Pregnancy after panniculectomy/tummy tuck will likely affect the results of your surgery. However, if you do not have plans to get pregnant in the next 1-2 years, it may be worthwhile to pursue tummy tuck surgery if it is affecting your daily activities and lifestyle. You can expect resolution of rash and itching after panniculectomy, and possible improvement in low back pain (depending on the cause of the back pain). I would recommend a full tummy tuck for the best aesthetic results. Whether you would qualify for insurance coverage for panniculectomy is a different question, as every insurance policy has different requirements for what is considered "medically necessary." You can request details from your insurance provider, or make a consultation with a cosmetic surgeon who accepts insurance.

Robert L. Kraft, MD, FACS · Answer

Congratulations on the weight loss. Panniculectomy will remove the overhanging skin envelope and greatly enhance your body habitus. The change will be dramatic. If you have children and control weight gain, you should do well or, in the alternative, can consider additional surgery after. Hildbesring is complete.

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