Age 35, 190lbs, 5 c-section - will I qualify for a panniculectomy? (Photos)

Thank you for your question regarding whether you would be a candidate for a panniculectomy and whether your insurance would cover it. In my opinion, you would definitely benefit from a panniculectomy or better yet, a tummy tuck. Ideally, this would be covered by your insurance. Unfortunately, many insurance companies have restrictions on what they would cover and not cover. If you want insurance to cover it, they may require you to prove that you have rashes under your skin, back pain, and difficulty with exercising and walking. They also, unfortunately, may require you to be a certain BMI. These requirements are very insurance-dependent. That means every insurance policy has different insurance requirements and restrictions as to what is covered and what is not covered. It's very important for you to have your desired plastic surgeon document all of your conditions like rashes, low back pain, inability to exercise, etc., on your letter of medical necessity to your insurance company. Ideally, they cover your panniculectomy. I hope this helps to answer your question of whether you're a candidate for a panniculectomy and whether your insurance will cover it.


Sincerely, Dr. Katzen.
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

From the submitted photos you do appear to be a candidate for a panniculectomy which would remove the hanging skin along the abdomen. This is different than a tummy tuck which would remove excess fat and skin as well as correct abdominal wall laxity. See a board certified plastic surgeon near you to learn more.

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 if your BMI is over 35 and you have a serious weight-related health problem, such as high BP, severe sleep apnea, or type 2 diabetes.
Consult with a board certified PS to discuss how to prepare for the panniculectomy surgery.