Help with panniculectomy

I am posting in this forum because my bmi is over 50 and I am trying to get a panniculectomy approved... Long story short, I used to weigh 500 lbs, Lost 150 on my own, now weigh 350.. I've hit a block and cannot lose any more weight for 2 years now.. My pannus is HUGE... I have every single criteria for this to be covered (rashes, documentation, the huge overhang).. BUT the bmi part.. They won't approve this surgery because of my bmi. I NEED to have this done! I cannot lose any more weight until I can exercise and I cannot move around with this! Anyone out there have a mid journey panniculectomy and have it covered by your insurance??? Please! I have BCBS PPO of CA
Thank you!!

I did. I went to my GP and told them of my desire, they ordered several tests and found out that I had ovarian cysts (they met the criteria for surgery). They referred me to the OB/GYN and plastics guy at the same time. Insurance covered my Panni because of concerns that an incision for the required surgery might not heal if it had to go through the extra tissue. Don't know if I helped you any but that is how it worked for me. Good Luck!

Thanks for your reply! What insurance did you have? I really hope I can get this done. Thanks again.

Can you access your insurance plan on its web site? I have Anthem BCBS in Maine and it covers a panni with criteria met, but it also spells out all the criteria and such on the web site. I am actually plotting from the start here to get mine covered. I am finding that as I lose weight the overhang is getting a bit longer, but it is very squishy and it makes it easier to do some things. The last time I was trying to lose weight I bought two inexpensive waist trimmers at Wal*Mart and used them around my lower belly to keep it from flopping around.

Someone gave me a Weigh2Win DVD and the first exercise portion is primarily sitting down in a chair. I bet there are other things out there that are similar that might help. I have to do things that aren't weight bearing because of my knees. I got a little Magnetrainer that can fit under a desk for cycling, and can also be put on a table for arm cycling. 

Oh, you can also call the insurance and ask. It may be part of the issue is finding a surgeon who is comfortable doing it. They often light to get it down to less than 25 pounds that need to be removed surgically as it is less risky. I know a friend of mine did it in California mid-way in the process and it was about 30 pounds I think . . . but not sure what type of insurance she had. I forget the grading for the pannus, I think 3 or 4 is mid-thigh, and that's where she was. I'm only a two, so I think my BMI needs to be lower.

Thank you for replying!
I actually have been on the site, have the criteria they need.. Meet it all except for the lower bmi...
I have been to several PS and have gone through the horror and embarassment they have caused and finally found one, an excellent one, and he totally agrees (with my PCP and GYNO as well) that this surgery should be done. I have waited and waited for an answer from my health insurance to see if they are approving the surgery, and then I get a letter last week that said they needed more info to pre certify me for the surgery that included weight, height and bmi... That right there told me that they are going to deny me based on my weight. I called them and gave them my info since I didn't want to wait around for the PS office again (they took FOREVER) so now I'm waiting for their response again...

I have BC/BS anthien of missori and they want my weight down also. I still have 80 pounds to what they say is goal weight. I have lost 145 and trying to run and it is making it impossible. I documented all the rashes that has been going on even before surgery. I keep getting turned down I also have pics. I need help also.

Hi. I tried to message you, but your profile is private.. I wanted to ask you about the waist trimmers... Were they the abdominal biners?? I need to find an option for myself to "lift" this ugly thing up.. I can't even wear pants right.. It's huge... I wanted to ask you if the binders worked for you at all in lifting it up and keeping it out of the way.. I'd love to find something that actually worked.. The other things they sell don't work at all and make it worse feeling. You can email me at:  [email protected]  to make it easier.. For some reason OH doesn't email me when someone has left me a msg.. Thank you!!

I had a panniculectomy about 2 weeks ago. I had 20lbs removed and have an incision from hip to hip. I am not sure about insurance coverage, but mine covered it because I had a hernia in my belly button and the belly was pulling on the hernia, so my insurance company had to pay for it because it was considered a medical condition. My life was impaired due to the hernia.......I couldn't bend, lean forward, put my pants on, etc. (my fiancee had to help me put my pants on)

I am a little over 2 weeks post-op and am really sore.  But I love the way my new body looks. I now have a lap when I sit and that is something I have not had for years!  If your pannis greatly interferes with your quality of living, then your surgeon may be able to find a way for your insurance to cover it.  Good luck with everything. 

Miss Kitty, my nephew is having a panniculectomy next week.  He has had Cushings syndrome (with surgery) and has not had wls, but as a result of the resoulution of the Cushings, he has a huge pannis and still weighs around 220 pounds.  He's only 25, but because it's Cushings related, they know his pannis will not resolve on its' own. 

My question is this:  What kind of pain is normal for a panniculectomy?  I had read it wasn't too bad because they don't cut through the muscle layers, but recently I've heard otherwise.  Would you mind to share what your experience has been?  Thanks so much!  connie

Hi Connie,

To be honest with you, I am about to email my surgeon asking her what kind of pain is normal, because my pain goes from uncomfortable but bearable......to very bad, almost in tears.  I had the surgery done on Feb. 25, so I am approximatly 3 weeks out. I know to expect pain after surgery, but I thought I would be feeling better by now!  I don't know anything about Cushings, so I don't know if that would make your nephew feel or heal any different. I had a hernia in my belly button and my large pannis was pulling on the hernia causeing intense pain. My surgeon cut just above my belly button and removed the pannis, so I have no belly button. The weird thing is, the pain I feel is just like I still have my hernia!  I touch the spot where it hurts (where my belly button was) and the pain is not actually there, but further down in the incision area.  I have one very large incision going from one hip down over my pubic area to the other hip. There are several ways these incisions can be made, it all depends on your nephew's needs, and what the surgeon decides. I am on Coumadin, a blood thinner, so my surgeon chose my type of incision to minimize my bleeding.

Walking is uncomfortable.  I have a 2nd floor apartment so climbing stairs is uncomfortable and I have to take them slow.  My fiancee has to help me put my pants and socks on because I cannot bend or lean.  For a few days after coming home from the hospital (my stay was 4 1/2 days)   my fiancee had to help me wipe my backside after I used the bathroom because I could not reach to do it myself. (embarassing for us both!)  I love how my new body looks, but this recovery..........ugh!  I am so ready to have it done and over with!   If you have any more questions, feel free to ask. I am more than willing to help anyone out with this. I just wish I could find someone else who also had this done, so they can help me through it too. I feel so alone in this and I keep bothering my surgeon (who is out of Boston, MA.) and I just wish there was a support group of some kind out there to help those of us recover from these kind of surgeries.  Take care. God bless. And feel free to ask me anything. I am happy to help if I can.