Question:
I want a panni removal done at the same time as WLS.......

I have Tricare Prime and I would like to have a panni removal the same time as my WLS. This is what is says in the handbook: Panniculectomy if performed in conjuntion with other abdominal or pelvic is covered when medical review determines the procedure significantly contributes to the safe and effective correction or improvement of bodily function. Ever since I had my son by c-section, my tummy hangs. I get horrible, painful, smelly rashes and I am afraid that with weight loss, it will only hang more. Do you thin it is possible for insurance to approve the removal of the panni the same time as the WLS? Thanks for your input!    — Tami H. (posted on February 14, 2003)

February 13, 2003
Wait tll after you loose the weight. Why do it twice. If you have lots of hanging skin presently loose another 100 pounds and qualifying will be easy.
   — bob-haller

February 14, 2003
If you think your insurance will not approve a TT after weight loss, you would be wrong, I also have Tricare Prime and that is something they do cover. I also had a hysteromey and have alot of hanging right now, I have not had surgery yet, and that is one of my major concerns, that it is hard to deal with now, but after I lose 100lbs it will be unbearable. I plan on doing documentation on every rash and yeast infection from now till I am ready for a TT. I would also like a boob reduction now, but I will wait, and just buy some really tight spandex to help hold me up. I do not know for sure, but I think there will be some tighting as we lose weight. Hope this helps
   — cindy

February 14, 2003
You might find that your rashes improve with the drastic diet changes. Mine sure did! I would wait at least a few months. Otherwise, you'll need to do it twice. I have Tricare Prime too, and my doctor said not to even ask until I was at goal. I don't know if it depends on the doctor, but I know that one wouldn't even consider it. Are you getting your surgery done at a base? I had mine done at Elmendorf, Alaska, on December 11, 2002. :)
   — Diana L.

February 14, 2003
Last year I spoke with a few women on this site who had done just what you're saying. They were positive having their tummy removed at the same time as their WLS was a good choice. I also spoke with others who had previously had tummy tucks while heavy and then had WLS. They too were still happy with themselves. Thats how I had decided to have mine removed while still heavy (324 lbs). I was self pay and physically needed it done so it was a choice for me. One thing to consider is if you've carried a lot of weight in your stomach area chances are good that you will need work done to the abdominal muscles. I was seeking removal of fat and tissue, a pannilectomy(sp?). I ended up having to have a full abdominoplasty. I had excessive damage, especially in my left side abdominal muscles. No children, only 29 years old but I had carried a lot of weight up front my entire life. The healing was long and involved. I love the result but would NOT want to do it more than once. I think you'll know whether or not you can live with your tummy another year or two. If so, I'd wait.
   — Shelly S.

February 14, 2003
hey, i also have tricare prime...and i have my appointment monday. i wanted to have the panni removed with wls too. i will tell you what my doctor says.
   — k K.

February 14, 2003
i see that you are waiting to have it done on base......god what a long wait.....you need to call tricare and ask for a off base "network" doctor......you will get it done fast and by someone who works with mostly wls. plus ANYTHING is better than having surgery on base. hahaha if you already have your approval....that is all you need you don't have to go through everything all over again...it's just a transfer to another doctor. if you stay with the base you might have to wait a year or longer...each base has a different waiting list length of time.. at some other base it might have only taken 4 months...some it is 18 months. hope this helps. email if i can help
   — k K.

February 19, 2003
Hi Tami. Here's why I'm against doing both at the same time: 1) Your body will change as you lose your weight and you may have excess skin after 6 months..a second surgery is MUCH more technically difficult and it's hard to get INS to pay for it again. 2) A tummy tuck is at LEAST a 4 hour surgery...your WLS surgeon isn't going to want that after an internal surgery like he's done...complicates the picture if you were to develop problems postop. 3) Liposuction...a great aid to body contouring, probably can't be done because of time limitations and the fact that your fat will go away unpredictably...leading to an unpredictable result. I can think of a whole lot of other reasons. I'd wait. J.L.
   — DrL

February 19, 2003
I had my tummy tuck at the same time as WLS--mostly for financial reasons. I was self pay and this way I was able to pay only once for the hospital, anesthesia, etc. I just had to pay my surgeon an extra 3500. Also, I only had one recovery period. I have lost 140 pounds, almost 2 years out and am very happy. I wouldn't have been able to afford a separate surgery for the tummy tuck. My tummy isn't totally flat, but in pretty darn good shape!
   — Brenda H.