Which is Best for Me, Tummy Tuck or Panniculectomy? (photo)

Question

Here is a link to some of my pictures.. http://www.realself.com/question/tummy-tuck-realisitc-time1 I am 24 years old 5ft 6 and been at a stable weight for several years. Other than being obese i have no medical problems(BP is normal, non smoker, no family history, etc.). I am also done having children. Could you please tell me which would be the best option based on my photos.

Eric Swanson, MD · Answer

You would be best served with a tummy tuck and liposuction.  A full abdominoplasty ("tummy tuck") is sometimes called a panniculectomy - which means basically removal of the big apron of tissue from your midsection.  "Abdominoplasty" implies some additional attention to detail including repair of the muscles and hiding the scar as well as possible, and proper treatment of the belly button.  You have extensive stretch marks.  The ones below your belly button will be removed and those above get moved down.  Liposuction works to further enhance your hourglass figure.  It is particularly helpful in reducing the love handles so you have a more hourglass figure, but I also use liposuction to treat the upper tummy.  If you don't do this, there is still a bulge in the upper tummy after a tummy tuck.  It's a very satsifying procedure and a common one.  Attached are photographs of examples.  Good for you that you are a nonsmoker because that reduces the risk of complications.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  I hope that these answers 
help!  A panniculectomy is an excellent method for removing the excess 
skin and soft tissue of the lower abdomen (abdominal panniculus), often 
caused by weight loss.   It is mainly performed to ameliorate symptoms 
caused by the abdominal apron such as hygiene issues, excoriations, 
rashes/infections, back pain, etc.  A panniculectomy gives almost 
immediate relief from these issues as well as has been shown to 
stimulate additional weight loss as your activity level is increased 
after removal of the panniculus.  An abdominoplasty is more of an 
aesthetic procedure in that as opposed to simply excising this excess 
tissue in a wedge to relieve complaints, an abdominoplasty focuses more 
on abdominal contouring, abdominal wall tightening, re-insetting the 
belly button, as well as often times the addition of liposuction.

I believe you would be better served by a full tummy tuck, in order to address your abdominal wall laxity as well as contouring of your flanks/hips, and upper abdomen.  I would highly recommend continued diet and exercise prior to any 
consideration for a panniculectomy or body contouring as getting down to
 your ideal weight 
prior to the procedure will certainly give you the best results as well 
as be the safest for you.    Neither one is a weight loss procedure.  
Also, a
 continued healthy and active lifestyle will be needed in order to 
maintain the benefits that the procedure has given to you.   You should 
consult with a 
plastic surgeon at anytime to go over options and  in order to assist 
you in 
deciding which procedure(s) would be right one for you.    Best wishes for a wonderful result!

Larry S. Nichter, MD, MS, FACS · Answer

The simple answer is in most cases you would look a lot better with an abdominoplasty (tummy tuck)/panniculectomy combination plus liposuction .A panniculectomy usually entalls the simple removal of the excess apron skin that hangs down without undermining or "pulling the skin" down. That is the difference (plus tightnening muscles when indicated0 with a Tummy Tuck (abdominoplasty and a panniculectomy). A panniculectomy is generally done to treat a medical condition or physical limitation (e.g. recurrent infections)Panniculectomy refers to simple excision, removal, of the roll, pannus, of redundant soft tissue in the lower abdomen which falls onto the thigh. Occasionally this procedure is covered by insurance if there is a documented recurrent or chronic infection and rash requiring medical treatment. It does not involve improvement to the mid or upper abdomen or tightening to the abdominal muscles, but can be done in conjunction with anAbdominoplasty which will accomplish these goals.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	You will be much better off with a full tummy tuck procedure.Tthis would be done ideally when you are as close to a long-term stable weight as possible.

	You should also be aware of the option for &ldquo;extended&rdquo; tummy tuck procedure  to treat the flanks and lower back areas ("muffin tops&rdquo;).  This extended tummy tuck procedure involves flank and back skin and adipose tissue excision as well as liposuction surgery. If liposuction alone is done the patient may still end up with the muffin top and require further surgery to improve the waistline in the future.

	Make sure you're working with a well experienced board-certified plastic surgeon.

	Best wishes.

J. Jason Wendel, MD, FACS · Answer

A Panniculectomy is a functional procedure that removes the excess skin and fat below the belly button and above the pubic region. It is something that may or may not be covered by insurance. It simply removed the lower "roll."

	A full tummy tuck is the panniculectomy plus the upper part of the tummy as well.  It is a cosmetic procedure and is typically not something that would be covered by insurance.

	If you want improvement in both the upper and lower part of your tummy, then tummy tuck is the way to go.

	I hope this helps.

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