Question:
Does Loss of 200+ Pounds Often Require 2 Tummy Tucks?

I have lost 113 pounds (32 before surgery) at almost 3 1/2 months out and have a LARGE panni. I have always carried most of my weight in my stomach. It is WAYYYY out of proportion with the rest of my body now and I know it will only get worse as I lose more weight. I researched the library and read where some surgeons are hesitant to do plastic surgery on people with large amounts of excess skin, so I am wondering if in these cases it is necessary to have more than one tummy tuck? Like have skin removal now or in a couple of months, then another one later when I reach goal. My stomach is driving me nuts. Slapping against my legs, rashes, etc. YUCK!! Just curious and hoping to hear from some of you who were in my situation and are now at goal. Thanks so much!!    — Debbie M. (posted on July 12, 2003)

July 12, 2003
Debbi, I am a fine one to say this, but try to be patient. I would wait until you are closer to a stable weight to have the TT. That is unless the PS tells you differently. It wouldn't make since to have it done 2 times when all you have to do is wait until you are stable. Besides, I doubt insurance would cover the same thing twice. In the mean time be sure to document those rashes with your pcp.
   — Tawnda C.

July 12, 2003
Original poster here - Hi Tawnda, it isn't so much that I am in a huge rush to have a TT, although I admit I would LOVE one!! I was just concerned after reading through the subject in the library where others talked about plastic surgeons refusing to do a TT on someone who has lost 200-250 pounds because of the vast amount of skin to be removed. I was wondering if it is more advisable to have two instead of one. Kind of like a two step process. I just didn't want to wait until I am almost where I want to be and then find out it is too late. Make more sense? :-)
   — Debbie M.

July 12, 2003
Hi Debbie - my RNY surgeon told me at the very beginning that I might have to have 2 plastic surgeries because of how much weight I had to lose. I've lost 160, but still have 90 to go and have seemed to hit a huge stuck point. I'm 11 months now, but at 7 months all of my doctors agreed that having a panni (just skin removal, no muscle work) now would benefit me greatly, enabling ease of movement and re-set my metabolism. The plastic surgeon estimated that a panni would be about 30 pounds for me! Clearly, I have a huge stomach and it isn't at all proportional! Cigna has denied my first request, but I am hopeful about the appeal! I talked to another girl who did it like this and after ps she lost 75 more pounds! There's also a great website that shows before and afters for people who have a lower body lift that have lost a lot of weight, but still aren't at goal: http://aboutplastic.surgery.uiowa.edu/surgery/plastic/beltlipectomypage.html
   — jen41766

July 12, 2003
i dont have an answer to your question, but my mother has a similar problem. she has only lost about 65 pounds so far, but she still needs to lose about another 200lbs. her abdominal skin was a huge problem before the surgery. her surgeon advised against 2 skin removals due to the risk of the surgeries in the first place, but i think she will seek a second opinion. there is just too much skin. i recommend taking pictures. i know its degrading, but when they have to put a face to a denial letter, i think its harder and pictures make them think about themselves having to carry around all that skin. so document the skin problems and definately send pictures to your insurance. i do know that dr fobi removes large pannis at the time of the original bypass surgery. but i am not a fan of his other than that.
   — christina K.

July 12, 2003
I lost about 200 lbs and had 1 TT. Men carry most of thier weight in thier stomach and I had a huge panni. It covered my private parts. With the help of a skilled PS I came out looking great. Good Lux
   — Robert L.

July 13, 2003
I've lost 227 lbs with no tummy tucks or plastic surgery of any kind. I had a LARGE panni, thighs and underarms... and they have been retracting with specific exercises my personal trainer gave me. I am willing to share these, I just won't post them on my profile for many reasons. If you want them, email me, okay! :~)
   — Sharon M. B.