Tummy Tuck vs panniculectomy? (Photo)

Question

I have lost 140 lbs, I am 5'7 285lbs been this weight for 2 years and am now starting to develop sores under the skin. Wondering which would be best.

Dustin L. Reid, MD · Answer

Thank you for photo, and congratulations on the significant
weight loss. A panniculectomy is going to address the excess skin only and will
not repair the diastasis caused by the excess fat in the abdomen prior to the
weight loss. Most people in your situation would also benefit greatly from a
tummy tuck to tighten the abdominal muscles. Of course, it would be best to
consult with a board certified plastic surgeon who has plenty of experience
with these procedures, so they can tell you if you are a candidate for both and
explain the benefits and risks associated with your particular case.

Sergio Alvarez, MD · Answer

The definition of a panniculectomy is direct excision of the hanging skin and fat, aka "pannus", which could include the belly button. This is not an aesthetically pleasing procedure as it is mainly reserved to treat the symptoms you are encountering. This option however could be a temporary option that will allow you to be more comfortable and give you more freedom to lose weight. As you continue to lose weight and stabilize, you then may benefit from the tummy tuck at that time. You definitely have options. Congrats on the weight loss.

Kenneth Hughes, MD · Answer

Panniculectomy may be better to reduce complications and allow for more weight loss after the procedure.  Seek out a plastic surgeon who has performed these procedures hundreds of times and has a great number of reviews and before and after pictures.Kenneth Hughes, MDBeverly Hills, CA

Carmina Cardenas, MD · Answer

You have to be very proud of yourself for the significant weight loss. Unfortunately your BMI is very high 44 and very risky to perform any type of procedures. In order to have a safer procedure your BMI must be below 30 so your weight around 190. Skin sores will not kill you, but complications during or after surgery will represent an unacceptable risk of your life and health. So continue your efforts to lose weight or consider a Bariatric procedure in order to have a wonderful outcome. Be encouraged. Dr. Cardenas

Nelson Castillo, MD · Answer

Thank you for your question and photograph.  In my opinion I think you would most benefit from a panniculectomy.  This procedure will help remove the apron of excess skin demonstrated in your picture and help prevent the formation of sores and skin ulcerations you are currently experiencing.  Once this skin and adipose tissue is removed you may find continued diet and exercise easier to resume weight loss for a later tummy tuck that will afford you an improved aesthetic appearance.  A tummy tuck currently will only provide a small amount of improvement.  Hope that this helps.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. Congratulations on your weight-loss. In my opinion, if you're having sores believe your abdominal area then you probably would need a panniculectomy. Once this is done  and you continue your weight-loss you can be reevaluated for a tummy tuck

Tom J. Pousti, MD · Answer

Congratulations on this significant weight loss.  You should be very proud of this accomplishment. Which operation you choose to proceed with will depend mainly on your goals; in other words, what you would like to achieve with the operation.The tummy tuck operation is an  abdominal wall contouring operation that serves to reapproximate the abdominal wall muscles that have spread with pregnancy and remove the “excess skin” of the lower abdomen.  It is generally consider an "aesthetic" procedure, compared to the panniculectomy operation which is more of a “medically necessary” procedure. The panniculectomy operation involves excision of the lower abdominal wall pannus or  overhanging skin/adipose tissue. It is not considered an  aesthetically driven procedure;  it is often performed to help with concerns such as skin breakdown, infections/rashes…Key will be careful selection of your plastic surgeon and careful communication of your goals. Working together you will come up with the best plan to proceed with. Best wishes.

Scott W. Vann, MD, FACS · Answer

Which procedure depends on what your goals are. It getting rid of the sagging skin alone is your goal then a panniculectomy is the right choice. However, if you would like to reshape you abdomen and tighten your waist with even more skin removal then a full tummy tuck would probably be more approperate. Discuss all with your surgeon.

Stacey Folk, MD · Answer

Dear King0907,Congratulations on your weight loss! An abdominoplasty or tummy tuck is a more aesthetic approach as your muscles can be tightened, the excess skin and fat can be removed, and this can be combined with procedures on your posterior torso (such as liposuction or a circumferential removal of fat and skin) for the best result. It is important that you are medically a good candidate for this procedure as the risks are significant.A panniculectomy is just removal of the hanging portion, and while the lower scar may look similar, it is a much less aggressive option. The stretched muscles (rectus diastasis) would not be addressed nor would any skin redundancy in the upper abdomen. This procedure is more frequently performed in less healthy patients with a medical indication for the procedure.Best of luck,

Stefano Cotrufo, MD, PhD, EBOPRAS · Answer

If you are happy with your weight and you are concerned exclusively about the skin sores I would recommend only a panniculectomy: you will heal much faster with less discomfort and with less possible complications.I would still recommend a complete assessment to exclude a divarication of recti muscles: possible looking at your picture. In that case it would be beneficial to proceed with an tummy tuck instead.

Tummy Tuck vs panniculectomy? (Photo)

Answers (20)

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