Can I have a large amount of fat/excess skin removed from my pannus/lower abdomen, even while still severely obese?

Yes, it is possible to have a large amount of excess fat and skin removed from your pannus/lower abdomen even while still severely obese. Many patients in similar situations undergo a panniculectomy, which is a functional procedure aimed at improving mobility, hygiene, and quality of life. This procedure removes the overhanging skin and fat but does not include muscle tightening like a tummy tuck.

For patients at a higher weight, plastic surgeons carefully assess whether the benefits of removing the pannus outweigh the risks associated with surgery at a higher BMI. Many experienced, board-certified plastic surgeons will perform a panniculectomy at your current weight, especially if the excess skin is causing mobility issues, skin infections, or chronic pain.

I encourage you to watch the video below, where I explain the process, risks, and benefits of undergoing a panniculectomy while still working on weight loss. This should give you a better idea of what to expect and how to move forward.

I hope this helps! Best of luck on your journey.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FACS, FICS

With a obese BMI of 64.7 you are not yet a candidate for a panniculectomy. At your current weight, risk of postoperative complications is too high. 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.
You may qualify for weight loss surgery as your BMI is over 35 and if you have a serious weight-related health problem, such as high BP, severe sleep apnea, or type 2 diabetes.

Dear uncletbone,
generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery.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