What do you mean by Grade 3 or 4 Pannus?

I have seen other people refer to the size of their pannus / hanging belly as a Grade 3 Pannus. What do you mean? How do you know what grade it is? I am 5'2 & weigh 296# and am pear shaped. Has anyone else started at that size and if so how much plastic surgery did you require? I already have a belly that droops since I had my 2 kids and I am sure when I lose weight it will really droop!! I am currently waiting for approval from my insurance company (PHCS). Thanks for any info.

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