Is It Necessary to Have a Tummy Tuck with a Panniculectomy?

I am a 43 year old woman. I have three beautiful children that I love very much. Along with my children came 3-c sections over the past 10 years. I went to see a Plastic Surgeon today for a consult because I have chronic infections in my scar area. I was told by the surgeon that I needed a panniculectomy and also a tummy tuck to get the best results. My question in do I need to have the tummy tuck with the panniculectomy?

Doctor Answers 5

Tummy tuck vs panniculectomy

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A panniculectomy will not get rid of the excess skin above your belly button. Also, the six-pack muscles will not be brought back together. For some cases,a fleur-de-lis tummy tuck is necessary.  Discuss these options with your board certified plastic surgeon (and beware of board certified COSMETIC surgeons as they are not the same as plastic surgeons.)
Best of luck,
Sheila Nazarian

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Not necessary

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It is not necessary, however if you are looking for recontouring of your mid-section, it is often the case that a panniculectomy alone will not achieve this improvement. This is because the surgery only deals with the skin hanging below your waist. However, you should ask your surgeon why they recommended both for you. The tummy tuck may have been recommended for a particular reason.

Is it necessary to have a tummy tuck with a panniculectomy?

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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.  A tummy tuck inherently excises the same skin/tissue, but along with the above other procedures.

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. Depending on your examination, photo documentation, and discussion of your symptoms, insurance coverage may be possible. Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Panniculectomy plus tummy tuck? Something's fishy here!

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A panniculectomy removes only the overhanging skin that is getting infected. There is no umbilical transposition, no muscle repair, and no skin tailoring. It's a minimal operation that insurance covers to deal with the infection and skin breakdown, and the result is usually not a good cosmetic outcome.

A tummy tuck also removes the same exact excess skin a panniculectomy does, plus more skin and fat, as well as including umbilical transposition and muscle repair. The usual outcomes from abdominoplasty (tummy tuck) can be seen on most plastic surgical websites, as well as in the photo gallery here on RealSelf.

The issue here is that your plastic surgeon wants to collect the insurance fee for the panniculectomy, get the operating room and anesthesia (or at least the panniculectomy portion of these fees) covered by the insurance provider, PLUS get you to pay him/her for the cosmetic tummy tuck. This may be a scam.

Have a friend call your surgeon and find out what a full tummy tuck and all operating room and anesthesia fees cost (without mentioning panniculectomy). Then, compare that to what your surgeon is charging you for the "add-on" tummy tuck. If they match or are close, you are getting the double-deal (since the surgeon is ALSO collecting insurance reimbursement for "panniculectomy").

I view your situation in this manner: If you are a candidate for elective tummy tuck and have the desire and financial resources to undergo this procedure, do not undergo panniculectomy (first, or at all, even if it is "covered" 100%). You will be dissatisfied by your result and will still need a tummy tuck, which will be more difficult because of the scarring, not to mention you having to go through another set of risks (low) and another entire recovery (this is a BIG deal!).

Simply forgo the panniculectomy and get the tummy tuck you need/want--this will completely deal with the chronic infections AND give you a good cosmetic result. Make sure you are interviewing ABPS-certified plastic surgeons (more than one).

If there is no way financially or if you believe you will never undergo an elective tummy tuck, then insurance-covered panniculectomy is appropriate for you, and is frequently performed by general surgeons--you do not need a plastic surgeon for panniculectomy alone.

Bottom line--you don't need BOTH; you simply need to decide on one of the two choices. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Panniculectomy or Tummy Tuck?

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Thanks for your question.  The answer really depends on what your desired goal is.  A panniculectonmy alone will only address the loose skin that is hanging.  This may reduce the chronic infections that you experience. 

However, this does not address the rest of your abdomen.  You will still be "fuller" in this area.  A tummy tuck will address this portion of your abdomen and will also allow for tightening of the rectus muscles giving you a flatter appearance.  We as plastic surgeons always want to achieve the best result and a tummy tuck would do so. 

You have to realize the limitations of a panniculectomy alone.  A picture of you would help better determine how much more beneficial a tummy tuck would be. 

Best Wishes,

Brian Joseph, MD, FACS

Brian Joseph, MD
Orlando Plastic Surgeon
4.8 out of 5 stars 52 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.