Panniculectomy and Belly Button? (photo)

Question

Hello, Im going for a consult for my insurance to cover a Panniculectomy due to 2 csections and over 100lb weightloss over past several years. My concern is healing time. I dont want to do the full tummy tuck due to the extended length of healing time with abdominal walls sutured. However I want a belly button! It almost scares me to seem my body without one lol!! Will a dr do it through insurance and the patient pay out of pocket for the belly button? If so how much of an add on will that be?

Raj S. Ambay, MD · Answer

Tummy tuck is mainly to improve shape and contour by plicating your core tight then re-draping the skin. Without the core tightening (muscle repair), its not a tummy tuck, but a panniculectomy (skin and fat resection). Massive weight loss almost always requires tightening of your core but if approved for a panniculectomy only, then core will not be tightend by PS..Nothing to do with belly button. You should have one irrespective of which procedure you choose. See a board certified plastic surgeon.

Al Rosenthal, MD · Answer

Rest assured, a panniculectomy does not do anything to the belly button.  Let's look at the difference between a panniculectomy and an abdominoplasty.  In the case of a panniculectomy the only thing that is removed is the panniculus - the folded layer of skin in the lower abdomen.  The purpose is to treat either mechanical problems with the folded skin or to treat intertrigo - a skin infection between folds.  It is not considered a cosmetic procedure.  It does not include any liposuction and it does not involve the muscles or the skin above the umbilicus.  You will look exactly the same afterwards except for the fold of skin.

	An abdominoplasty is a much more involved procedure.  The skin is incised on the lower abdomen and the whole later of abdominal skin and fat is elevated up to the level of the ribs and sternum.  The belly button is left just where it is by making an incision around it.  The muscles are then brought back to the midline and then all of the extra skin and fat is removed.  Some lipoosuction is typically done to help the upper skin slide down and to taper the love handle areas.  It generally creates a very significant change and most people are very pleased.

	When you go for your consultation express your concerns to your plastic surgeon.  If you decide you want to do more than the panniculectomy then perhaps insurance can pay for that part (if they approve) and then you can pay for the rest.  Just a thought.  Good luck to you and congratulations on your weight loss!

David M. Deisher, MD (retired) · Answer

Thank you for your question.  A panniculectomy removes the excess skin and fat from the pubic area to below the belly button.  The belly button is not removed but will be positioned lower on the abdomen since the skin is pulled down.  There is a big difference btw the amount of skin removed in a panniculectomy vs full abdominoplasty vs a fleur de lis abdominoplasty.  At the time of your consultation the plastic surgeon should be able to show you in front of a mirror or on the computer the amount of skin they estimate that could be removed by each procedure.  Good luck.

John K. Long, MD (retired) · Answer

I read the previous responses from this question and I am confused.  I know those seeking the operation and a belly button must be confused as well.I believe the saving of the belly button and its presence after a panniculectomy is to be expected except in rare cases.  This aspect of the panniculectomy procedure in my practice has always been covered by insurance although I have spoken to patients who have been to previous consults and the saving of the belly button is an extra cash charge.At times the umbilicus has been injured by previous surgeries through it and can be lost during its attempt to salvage in a panniculectomy.  There also exists patients who were so large and the skin so stretched it may be medically impossible to save the belly button.  In most instances, seek a surgeon who feels the belly button is a normal part of an attractive abdomen and will save it if at all possible without additional charges.

Panniculectomy and Belly Button? (photo)

Answers (4)

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