Would a Panniculectomy flatten part of upper tummy as well as get rid of flappy lip overhang and possible slight pubic lift? (Ph

Thank you for your question. A panniculectomy will only remove the excess skin and fat hanging over your belt line, but it won’t flatten the upper tummy or provide a pubic lift. It’s a functional procedure designed to address the lower abdominal "apron" of skin, which can help with hygiene and comfort but won’t give you a fully contoured look.

The procedure that would give you the excellent results you're looking for is an extended tummy tuck. This surgery not only removes the hanging skin from the lower abdomen but also tightens the muscles and removes excess skin from the upper abdomen. It can also lift and contour the pubic area, giving you a much more streamlined and balanced appearance.

By looking at your photos, I can see that you have a small frame underneath the excess skin. An extended tummy tuck would help reveal that and give you the flatter, more contoured shape you're hoping for.

Sincerely,
Dr. Katzen

The short answer is that a TummyTuck is going to give you a better outcome than a simple Panniculectomy. First of all, a Panniculectomy is not a cosmetic procedure, but one that would be approved by insurance, but it does not appear that you would qualify. Most insurances (can vary state to state) require substantial documentation regarding skin fold issues, rashes and yeast, and that those issues have been being monitored and treated by a physician for a period of time. They also require that the abdominal skin hang below the pubis for it to be considered a medical necessity. From your photos, it does not appear the skin hangs down far enough for most insurances to agree that this was obstructing your daily life and therefore would be a medical necessity. 
  The other reason that a TummyTuck would be better in your circumstance, is that the cosmetic portions of that procedure will ensure you have an outcome that is aesthetically pleasing. By this I mean that most Plastic Surgeons would include correction of the belly button, additional liposuction of the upper/lower/flank abdomen so that the transition between skin is smooth, and they would excise skin more laterally than a typical Panniculectomy addresses (this helps to ensure you do not have excess "muffin top" around the backside).  Make a consultation appointment with a local Board Certified Plastic Surgeon to show you in person the difference between a Panniculectomy and a Tummy Tuck or Abdominoplasty.

A panniculectomy is an insurance procedure to remove excess overhanging skin that is causing rashes, excoriations, infections under the skin flap.  It is meant to address these symptoms by just excising the overhang.  A tummy tuck is a cosmetic operation to flatten the entire abdomen (top and bottom), lift the mons puts and provide the best cosmetic contour.  They are different surgeries.  That being said, in patients that meet criteria for a panniculectomy, there are ways to have a part insurance/part cosmetic surgery which does significantly cut down on the cost of surgery. I would recommend consulting with a board certified plastic surgeon in your are who has experience working with massive weight loss patients and who works with insurance in order to give you all the potential options.