Question:
what exactly is done when you get a pannilectomy/abdominoplasty surgury

   — HELENNOVOA123 (posted on July 5, 2008)

July 5, 2008
Body contouring after massive weight loss (MWL) is a rapidly growing area in Plastic Surgery. Panniculectomy/abdominoplasty is primarily a cosmetic procedure with some functional benefits (a large pannus may hamper mobility, prevent further weight loss, and cause recurrent skin infections) and hence many insurance companies are changing their guidelines to include this as a medical procedure. A study assesses reimbursements for a large academic institution in Massachusetts for panniculectomies/abdominoplasties performed in MWL patients. They performed a retrospective review of charges and reimbursements for panniculectomy/abdominoplasty in MWL patients performed at Lahey Clinic. Records for patients who underwent a "medical" panniculectomy by a single surgeon from August 2002 to August 2006 were reviewed with special emphasis on the charges, reimbursements, insurance carriers, and prior preauthorizations. Fifty-two patients underwent a medical panniculetomy/abdominoplasty (Current Procedural Terminology code 15831) for laxity of skin/pannus as a result of MWL. All patients except Medicare required and obtained precertification for the procedure. Patient ages ranged from 35 to 59 years, which included 42 females and 10 males. Forty-three underwent bariatric surgery; their procedures were performed between 13 and 62 months after their initial surgery. Weight loss ranged from 65 to 345 pounds. Body mass index at the time of the surgery ranged from 22 to 48. The standard surgical charge for a medical panniculectomy at Lahey Clinic is $3,086. The range of reimbursements was zero to the full amount with the mean reimbursement of $615 and the median being $899. Reimbursements for panniculectomies are remarkably low and in many instances (35% in this series) absent despite obtaining prior precertification of medical necessity. Although insurance companies have extended their indications for panniculectomy/abdominoplasty, they think that it is a cosmetic procedure. Plastic surgeons must bear these reimbursements in mind when faced with a patient requesting this. Hope this help you. Best of success to you.
   — William (Bill) wmil

July 5, 2008
From my understanding, this is not aesthics at all, it is covered by insurance and they cut off the "apron" of sking that is around your mid-section. I have even heard that they even cut the belly button. You should really check into this on different websites. Even call plastic surgeons offices, they will explain the difference and assure you that this is not for beauty but rather a procedure that your surgeon performs for medical reasons.
   — bariatricdivalatina

July 6, 2008
I had a pannilectomy done, and it is removing the skin in the abdomin by a cut from hip to hip. They pull the unremoved portion together and sew it tight. I have a 22" incision in that area, and it was a very long and painful recovery with drain tubes, but I am glad for it. It did cure me however, from wanting any other skin removed. It is a really tough recovery. I had a good recovery, it is just long and tough. Take care, Patricia P.
   — Patricia P

July 6, 2008
I have also had this done in conjunction with a hysterectomy about 18 months after RNY. Also a long and tough recovery complicated by the removal of all lymph nodes in that area. But I too am glad to have the skin gone. I have a personal theory that perhaps there is a little higher rate of regaining the weight in patients who never have the skin removed. Although my core weight is probably still roughly the same, the excess skin made me still feel fat. That's when it is easy to become discouraged and slide into old bad habits. I would not be surprised if there is greater long term success in keeping the weight off in patients who do have some of the excess skin removed. In regard to insurance coverage - despite the arguments posed by my plastic surgeon United Healthcare still considers it cosmetic and does not cover a dime. Best of luck to you!
   — sunny99