Panniculectomy vs. Abdominoplasty

Panniculectomy vs. Abdominoplasty

So what’s the difference between these two procedures? This is one of the most common questions I get from patients.

Let’s start with a definition. A pannus is the lower abdominal skin and fat that overhangs the pubic area and the upper thighs. Most commonly it is seen in patients who have had massive weight loss. If you do not have skin and fat that hangs over your pubic area, then you do not have a pannus.

Panniculectomy Explained

Panniculectomy surgery is designed to remove this overhanging skin and that’s it. It is intended to get rid of the fold where sweat trapping occurs and rashes ensue. Most patients that I see that have a pannus have legitimate complaints about rashes, hygiene, and difficulty with physical activities due to to their pannus.

Pannicultectomy can be covered by insurance if certain criteria are met. These are different for each insurance company. I advise patients to call the customer service line for their insurance and request a copy of their company’s requirements to qualify for “panniculectomy.” One common requirement is that a patient must be 12-18 months out from bariatric surgery and have lost at least 100 pounds. Other requirements include that weight loss has stabilized and that the patient has medical problems secondary to their pannus that have not responded to medical measures. This means that you have tried everything and you still are having problems. These problems need to be documented in your medical chart by your physician.

Panniculectomy is not a cosmetic procedure. It is not intended to improve the appearance of your midsection, although it often does to some extent.

Abdominoplasty (Tummy Tuck) Explained

An abdominoplasty or tummy tuck is the cosmetic procedure that is performed to primarily improve the way one’s midsection looks. A tummy tuck removes as much loose skin as possible instead of just the loose skin overhanging the pubic area. It also tightens abdominal muscles that may be stretched apart.

Sometimes panniculectomy can be combined with abdominoplasty surgery. This occurs when a patient has received insurance approval for panniculectomy and would also like to improve the way their midsection looks. In this instance, insurance pays for the panniculectomy and the patient pays additional fees to have a tummy tuck at the same time. This is the most common scenario I see for patients who have undergone massive weight loss.