Question:
Doctor wants to do panniculectomy instead of tummy tuck?

Hi. I went for a consult with a plastic surgeon yesterday because I am interested in having a tummy tuck. After feeling my stomach, he said that he would perform a panniculectomy instead of a tummy tuck on me. He said that since I've never had children (and don't plan to ever have any)and my muscles were very strong that I wouldn't need any tightening of my stomach muscles. He said that I probably won't need any lipo because most of what is hanging is skin. He assured me that I would have the same appearance and that people wouldn't be able to tell that I had a panniculectomy instead of a tummy tuck. I will be paying myself and the cost was several thousand cheaper. Okay, my concern is that my stomach won't be as flat as if I had a tummy tuck. I would assume that my recovery would be easier, but I want to be satisfied with the result. Any input would be appreciated.    — Alicia K. (posted on September 8, 2004)

September 8, 2004
I went in to have a tummy tuck 3 weeks ago, but during surgery the surgeon discovered my muscles were very tight and needed no work, so he just removed the hanging skin. My incision looks the same as a tummy tuck, hip to hip. He did not have to do the upper either because it flattened out when the skin was pulled down, so I am getting a refund on the payment I made for that. I would trust your surgeon if he feels it is only skin. If you have doubts go for a second opinion.
   — ckreh

September 8, 2004
It sounds to me like the surgeon is an honest guy. He could easily take your money for a procedure you apparently don't need. If you're really not sure whether to believe him or not, get a second opinion. I understand not wanting to go through the surgery to have a less-than-desired outcome, but if you don't need muscle tightening, then you don't need it. Best wishes.
   — Vespa R.

September 8, 2004
Hmmm...I recently had a consult with a plastic surgeon as well, except that I was the one who told HIM that I doubted I would need any muscle tightening since I have not and will not be having any kids. He said he couldn't tell what my muscles are like until he gets in there. Hmmm. I wonder if I am being scammed. Have you seen any other plastic surgeons for their opinions?
   — lizinPA

September 8, 2004
I had a panniculectomy 4 1/2 weeks ago. The Dr. decided after he went in that my muscles were in great shape and needed no tightening. I had requested that he do no more than was needed. No need for a longer recovery than necessary! My stomach is now completely flat and does not protrude out past my hip bones. I am thrilled with the outcome. I would be happy to find a surgeon that is honest enough to offer you a less expensive procedure. He is obviously not trying to sell you anything you dont need.
   — missysworld

September 8, 2004
The opposite happened to me. I expected a hip to hip incision however when I woke up I had hip to hip and breast to pubic bone. Why because what he had felt as a small muscle repair turned out to be bigger. I was not charged extra, but the recovery was longer. I was happy he didnt just stop at not fully repairing it.
   — Connie M.

September 8, 2004
You can always get a second or even third opinion. I was really afraid I was only going to wind up with a panniculectomy. The office and the plastic surgeon kept calling it that! I had a roll above my waist as well as some hanging flab. I was really afraid I would wind up with a flat stomach with a roll above it. I also had a 13cm by 3 cm diastasis recti (separation of the upper abdominal muscles extending from my breast bone to my umbilicus.) I fully thought I would have the anchor incision. Instead, I have the hip to hip incision (and it extends around to the sides). I have no roll and a flat stomach. My PS only removed 5-6 lbs of tissue. It is amazing what they can do! If you like the PS you saw, and you feel that this person really understands what you expect of the end results, go with what they say.
   — koogy

September 9, 2004
My plastic surgeon stated that he believes that it is a better approach clinically and ethically to wait until "he gets in there" and is able to evaluate the status of the abdominal muscles first-hand, rather than to tell everyone up-front and across-the-board that they need a full abdominoplasty (a generally longer and more expensive procedure). I was so sure that I "needed" muscle tightening after two pregnancies and vertical-incision C-sections, but I agreed that he was the expert and left the decision to him. Surprisingly, my abdominal muscles were "fine" and an anchor-incision panniculectomy was done....we had agreed on the anchor-incision pre-operatively because I had always been such an "apple-shaped" person with a lot of above-the-belly-button fullness. My incision is only a fine white line...barely visible four years post-op...and I still have a tummy that you can bounce a quarter off of and an hourglass shape that only the anchor incision could have given me. I was fortunate that my insurance covered the surgery, but they are probably happy to have only had to pay for a panniculectomy as opposed to a more expensive (and longer surgical time) abdominoplasty. As a nurse, I always encourage folks to have at least two opinions before making a final decision on a surgeon for an elective procedure. Sometimes we simply have to rely on the experiences of the surgeons who do these procedures on a daily basis, rather than trying to "self-diagnose" our problems and their solutions. I couldn't be happier with my results...best wishes to you!
   — Diana T.

September 10, 2004
If this is a reputable PS and you've seen pictures of his work on previous WL patients then I would trust his judgement. No everyone needs more than a panni. I had the abdominoplasty but not as much for tightening of the abdominal muscles as the need to remove lots of skin. He did the vertical cut as well and took a huge wedge of skin out. I actually assumed he did not tighten the muscles as I never had any pain in that area or problems standing up etc. I also never had any children so the muscles were not stetched out much if any. I think he tightened mine more so because of my low back disc problems and to make sure I would have that strong support long term. <p>A 2nd opinion would certainly be worth it. No need to do or pay for more than what you need to accomplish the end goal.
   — zoedogcbr

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