Tummy Tuck for Pannus Reduction?

I am 5'6" 258 lbs. I am dieting and exercising to lose weight but have a large pannus and I would like to get a Tummy tuck now. Is there a problem with that?

Doctor Answers 12

Weight loss before tummy tuck gives the best results

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During the weight loss process, the skin excesses will increase or become more apparent as the stretched skin is deflated. You have the best chance of having and maintaining a flat and smooth stomach if the weight excess is lost before you invest in the tummy tuck procedure. Choose a weight goal that is realistic and achievable so that you do not become frustrated by lack of progress. You might also combine your weight loss into a saving plan to cover your procedure as you reach your target weight.

Have courage and stick with it. Goal pictures can also motivate.

Best of luck,


Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Panniculectomy or Abdominoplasty?

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A panniculectomy is a surgical procedure in which the excess skin and fat, which hangs over the lower part of your tummy is removed. Like any surgery, it is not without risk, however it is a relatively short procedure. The scar is long and spans from hip to hip, however since it is primarily a "skin operation", the discomfort is relatively low. It is the most direct procedure, which will eliminate the weight of the skin flap, which drapes over your lower abdomen/pelvis and may cause heat rashes as well as lower back pain.

An abdominoplasty involves any of the following: a) elevating the excess skin-fat flap from a low horizontal incision made above the pubic hair line, to the bottom of the rib cage; b) making a new opening for the belly button by cutting the umbilical stalk out of its old attachment and sewing it into a higher position; c) tightening the abdominal muscles, which may have splayed apart, because of weight gain and/or pregnancy; d) trimming the excess skin-fat flap; e) liposuctioning the lateral (outside) areas of the incision, which spans from hip to hip; f) placing drains under the tightened abdominal flap; g) possibly defatting the excess fat over the pubis.

I always ask female patients whether they have finished having their children, before undertaking a body contouring operation like a tummy tuck. It is possible for a woman to carry a baby to full term, however her aesthetic results will be lost, as the abdominal skin and muscles stretch to accomodate the baby.

In evaluating women who have had abdominoplasties elsewhere and are not thoroughly pleased with their results, I have heard a recurrent theme: "Doc, I didn't loose inches around my waist." When looking at their hips and back, there is invariably some fatty excess. So as hard as it may be, I advise tummy tuck candidates to try to loose weight to a more ideal BMI before surgery. Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

A tummy tuck is not the same thing as panniculectomy

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Removal of a pannus or panniculectomy is not the same thing as a tummy tuck (abdominoplasty). If a large pannus or apron is causing problems such as low back pain, rashes or hindering movement, then you could consider removing it now. This is not, however, a tummy tuck( abdominoplasty).

A panniculectomy removes only the overlying skin and fat, while an abdominoplasty not only removes the hanging skin and fat, but the skin of the entire abdomen is tightened up and the muscles underneath are also tightened up. In some cases, insurance companies may consider a panniculectomy a covered procedure (if the pannus hangs down to mid thigh, a history of low back pain and rashes that a primary care doctor has been unable to cure even with prescription drugs are some of the criteria). An abdominoplasty is considered a cosmetic operation. That said, some patients opt to undergo a panniculectomy before losing weight and then undergo a formal abdominoplasty once their weight loss is complete.

Susan E. Downey, MD
Los Angeles Plastic Surgeon

You can do it now.

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Hi! If you have a hanging fold of skin and fat, this can be removed at any time, if you are in good health. You will be so much more comfortable, and looking better may motivate you to lose weight.

In Manhattan, we don't make patients lose weight before a tummy tuck. Losing weight is very hard. And you will look and feel better after an abdominoplasty even if you are overweight.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

You should be at a stable weight to have surgery

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In most cases, I recommend people be at their realistic weight when they have surgery. This is not the "ideal" weight that you might get on a chart at a doctor's office, but the weight at which you think you can reasonably maintain yourself. This is the best weight for you to have surgery. If you still have weight to loose, then you should weight. However, if the pannus is prohibiting you from exercising, then it would be reasonable to have it removed. Good luck.

Two approaches

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First, if you can get to your target lifestyle and weight and maintain it for at least 6 months, that will provide you with a higher level of assurance that your surgery will be more exact and long-lasting.

The second approach is to perform a panniculectomy as a "kick-start" if you and your surgeon feel it is hindering your ability to exercise or if you feel it would motivate you and remove the barrier (physical or emotional) to allow you to put in maximal effort to change your lifestyle and exercise routine. In this situation, the cosmetic result are envisioned to be temporary, albeit improved, and a possibility of a second stage, more formal, abdominoplasty, is assumed.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Staged procedure

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If your pannus is inhibiting you from exercising, you can have a panniculectomy and then continue exercising. If, however, you can lose weight without the panniculectomy, it would be far better and then have a proper tummy tuck at the end. If you do the pannus removal early, you will probably need a tummy tuck later to remove the loose skin that will come from the weight loss.

Now is not the time for a tummy tuck

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You should continue to lose weight before the procedure both to decrease risks and complications and to get the best result. 

I'm sure you could find someone to do a tummy tuck on you now, but now is not the right time.

Robert D. Goldstein, MD
Bronx Plastic Surgeon

Tummy tuck

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You will achieve better results if you wait. If you are currently dieting, exercising, and continuing to lose weight then continue with this plan and be patient. Once you reach your target weight you should maintain if for 6 - 12 months. That way you will know if your weight has stabilized. That would be the right time to consult with an American Board of Plastic Surgery certified plastic surgeon in your are re tummy tuck.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon

Pannus removal

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If you're just wanting to have your pannus removed, but nothing else, you can probably have the surgery now (as long as it's been deemed safe to do so). However, please be aware that only the pannus will be removed and nothing else. Your surgery may be covered by insurance.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 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.