PCP won't refer me for panniculectomy / tummy tuck. Will more weight loss or creams help with skin tearing? (photos)

Question

I’ve asked questions here in the past and have gotten great answers, but I’m still running into the same problems. Even though I continuously lose weight, my pcp refuses to give me a referral. Of course I still have back pain, but the tearing of the skin I get under my “apron” is SO much worse now. Will more weight loss and creams really help with the tearing, or would a panniculectomy be the best course of action?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about whether weight loss or more creams will help with tearing the skin. I am not sure why your PCP wont refer you for a panniculectomy. These pictures indicate that you are having problems with your skin due to the excess skin and fat in your pannus. Might there be other medical conditions? Do you have a high BMI? I would consider seeking a private opinion regarding your panniculectomy. You may even want to consider changing your primary care provider for a panniculectomy consult. Usually, insurance companies only cover the panniculectomy and not the tummy tuck. However, regarding skin tearing and loss, not much will correct this area. If it becomes secondary to fungus, it may require an anti-fungus cream if a bacterial infection begins. You may need anti-bacterial cream.
All in all, this area needs air and needs to be dry. Therefore, I would suggest powders and clothing maximize air current in this area. Thank you for your question regarding techniques to minimize skin tearing and, ideally, getting a referral for a panniculectomy. 
Sincerely,
Dr. Katzen

Andrew Ray, DO · Answer

Why wouldn’t they refer to a consult at the very least just to explore options. Something else to consider is to make sure you don’t have a chronic yeast infection in the groin. That can make you sensitive to skin tears like this.

Depending on finances many of us do not work with insurance but try to do our best to make surgery affordable.

Depending on finances many of us do not work with insurance but try to do our best to make surgery affordable.

Zoran Potparic, MD · Answer

Most of panniculectomies we do in our practice are private patients; it would be very difficult to get insurance to cover your surgery at least here in Fl. Consultation with a board certified plastic surgeon will give you an opportunity not only to assess your condition but also receive information about cost and financing options. Hope this helps.

Kenneth Hughes, MD · Answer

The panniculectomy involves only the removal of excess skin/fat that hangs over the genitals and/or thighs. It does address hygiene issues, rashes/infections, etc. When a panniculectomy is done, there is no tightening of the underlying muscles and tapering of the waist so you do not get the contour shape. Panniculectomy is only the removal of the skin below the belly button, so the best aesthetic results could be attained with a TT.

Camille Cash, MD · Answer

I encourage you to visit with a dermatologist who can recommend specific topical creams or ointments to apply to protect your skin.  When you have completed your weight loss goal you can schedule a consultation with a board certified plastic surgeon near you to discuss a tummy tuck.

Darryl J. Blinski, MD · Answer

Limited views of posted photos, do not show complete abdomen.... You are asking fir insurance coverage for a cosmetic non insurance covered issue. Best to pay for consult with boarded PS and then see what surgery best either panniculectomy or full TT. Or try virtual consult with....

PCP won't refer me for panniculectomy / tummy tuck. Will more weight loss or creams help with skin tearing? (photos)

Answers (6)

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