Panniculectomy v.s. Extended Tummy Tuck - What do you guys think? (photo)

A panniculectomy is only going to remove skin and lipo 360, fat.  A TT will remove skin and allow tightening of the stretched abdominal muscle.  You may be offered a panniculectomy with the option of aesthetic abdominoplasty after weight loss.  A TT provides far superior contouring and a better long term result. 

The choice between a panniculectomy and an extended tummy tuck largely depends on your specific goals and the nature of the changes you want to make to your body. If you want more than just skin removal, especially if you also want to tighten your muscles and improve your overall abdominal shape, a tummy tuck will likely provide the best results. A panniculectomy might be more appropriate if your primary concern is just the removal of skin, particularly if you're not concerned about muscle tone or contouring.
Here are the key differences to consider, especially in terms of muscle work and skin removal:
-Panniculectomy: This procedure is designed primarily to remove excess skin (the "apron" of skin that hangs over the abdomen after significant weight loss). It does not address muscle tightening. The abdominal muscles are not repaired during this surgery, so if you have muscle separation (diastasis recti), it will not correct that. As a result, the abdomen may still protrude slightly, and you may still have loose skin or pockets of fat after the surgery.
-Tummy Tuck (Abdominoplasty): This procedure removes excess skin and also includes muscle tightening. If you have stretched or separated abdominal muscles (which is common after pregnancy or significant weight loss), an extended tummy tuck will repair those muscles, resulting in a flatter and more contoured stomach. An extended tummy tuck can also involve the area around the sides and back, offering a more comprehensive improvement to the body's contour. It can be combined with liposuction for additional fat removal and body sculpting.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Thank you for your question regarding whether to undergo a panniculectomy with 360 liposuction or a tummy tuck with mons reduction. In your case, I would highly suggest an extended tummy tuck or even a 360 circumferential lower body lift with mons reduction. During the extended tummy tuck, excess abdominal skin is removed from the top of the pubic region to well above the belly button. A large football shaped area of skin and fat is removed. Also, during a tummy tuck, the rectus abdominis muscle or abdominal wall muscles are sutured with permanent sutures. The result is a nice flat. By extending the incision towards your hips or even around your hips or even meeting in the buttock region will allow you even more body contouring.  By analyzing your pictures, you will not achieve the same results with a panniculectomy and 360 liposuction. With a panniculectomy, only a minimal amount of skin is removed. During a tummy tuck, more skin and fat is removed. Also, during a panniculectomy the abdominal muscles are not repaired, Therefore, your abdomen will still protrude after a panniculectomy. Also, based on your pictures and history, I do not think that your skin will snap back with only liposuction. In my opinion, if you have liposuction, even VASER liposuction, you will still be left with lots of loose, hanging skin. This may in fact look worse than it does now. Therefore, I would suggest an extended tummy tuck (or lower body lift) with mons reduction and not a panniculectomy with 360 liposuction. I hope that I have answered your question about whether to do an extended tummy tuck with mons reduction or a panniculectomy with 360 liposuction. I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the panniculectomy, tummy tuck, extended tummy tuck, high lateral tension tummy tuck, abdominoplasty, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or extended tummy tuck are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or extended tummy tuck. Do your research.  Make sure they have performed at least 100 panniculectomies or extended tummy tuck surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, panniculectomy or extended tummy tuck surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Thank you for your question and photos.  Your expectations will dictate the best procedure(s) for you.  A Tummy Tuck will ultimately give you the best results.  A Tummy Tuck addresses excess skin as well as repair to your abdominal wall.  Panniculectomy will address only some of your loose abdominal skin.  I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals.  Best of luck!
Dr Dhaval Patel
Double Board Certified
Plastic Surgeon
Chicago
Hoffman Estates 
Oakbrook 
Orland Park

Thank you so much for your question.A Lateral Tension Abdominoplasty is definitely the best option to achieve  the perfectly desired hour-glass shape.  I would recommend to see  more board certified plastic or cosmetic  surgeon to get the best advice.
Best of luck !
- Dr.Danovich

Dear Cherry Blossom Rose,
Thanks for your post and your helpful photos. While I cannot offer concrete advice without an in-person evaluation, it does strike me as somewhat odd that a plastic surgeon would recommend a panniculectomy in your case. Panniculectomy is mainly intended to remove the “skin apron” below the navel, rather than address and contour fat and skin across the abdomen. From your photos, you seem to have pockets of fat and stretched skin both above and below the navel, which indicates that a tummy tuck is likely your better option. A tummy tuck can also be combined with 360 liposuction to optimize the results. I would recommend ensuring that this surgeon is a board-certified plastic surgeon with experience in body procedures, and perhaps seeking a consultation with a different plastic surgeon for a second opinion. Best of luck to you!

Great question!  Understand that a panniculectomy only remove the excess skin hangover and will not change the shape your abdomen.  A tummy tuck will remove remove all the excess skin of the abdomen but will also tighten the abdominal muscles to provide you with a more flat stomach.  The tummy tuck is definitely more powerful and will provide you with a significantly better result that just a panniculectomy.  I would see a few more board certified plastic surgeon and get other recommendations and go with the one you feel best provides you with your goals.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Thank you for sharing your excellent question and photographs.  If at a stable, goal weight a panniculectomy leads to a more inferior aesthetic result than a tummy tuck and it would be best to clarify what exact procedure your surgeon is referring to.  I would also reach out to several surgeons to discuss your concerns and get the best advice. 

Hello,Options don’t make sense. Make sure you understand what was told to you, or go to an experienced ABPS certified/ASAPS member surgeon for a second opinion. If your BMI is greater than 32-33, please know that your risk for complications is significantly increased. 

you need to clarify what the surgeon means when comparing the two.  A panniculectomy often doesn’t go above       The umbilicus and can therefore give an inferior result.  Make sure you are clear in the difference and discuss with your surgeon.