Question:
TT vs. Panni - How do I determine which surgery is the right one for me?

I have had a plastic surgery consult and the surgeon found 3 hernias. I feel that I would rather have abdominoplasty than a panniculectomy. I have had two c-sections and have quite a large panni. If the abdominal muscles aren't tightened, won't the hernias keep occurring? I don't want to have a panniculectomy and end up still having a large abdomen. The surgeon was discussing a panniculectomy, but didn't really talk about abdominoplasty. Of course, I didn't think to ask him some of these questions while I was in his office. He did state that my insurance would cover a panniculectomy but did not say anything about whether it should cover abdominoplasty. For those of you who have had either of these surgeries, what factors helped you determine which surgery you wanted. Any advice would be greatly appreciated. Thanks.    — Paulette W. (posted on June 7, 2002)

June 6, 2002
I had my panniculectomy and armlift in November, and I asked my surgeon the same question. He told me that he would ask the insurance company for approval for an abdominoplasty (which is a more extensive surgery since it involves hernia repairs and tightening of the underlying muscle structure), but would make the final decision at the time of surgery when he could directly inspect the muscles. In my case, the underlying muscles were fine and the insurance company was happy because they had to pay a lesser amount for the panniculectomy. Some surgeons charge a "blanket fee" for the abdominoplasty and the panniculectomy, and don't have differing charges for those procedures. It did make sense to me that the surgeon would make the final determination at the time of surgery on which procedure was actually needed. Even without needing the abdominoplasty, my tummy is completely flat and firm and I couldn't be happier with the results. Good luck!
   — Diana T.

June 6, 2002
I had my plastic surgery consult last month and I'm scheduled for surgery 10/1 (yea!!!) During the consult the surgeon didn't make reference to panniculectomy or abdominoplasty...she just said she would either be making an incision from hip to hip or possibly an "anchor" incision, and she would make the decision as to which she would do in my last consult before surgery. When I got my approval paperwork from my insurance company (yea!!!!) it said I was approved for a panniculectomy, I called the surgeon's office concerned because I liked the idea of having the "anchor" incision (abdominoplasty) because I have extra skin on my torso and wanted the muscles tightened. They explained to me that the insurance company references this surgery as panniculectomy but it is up to the surgeon what procedure she will actually do...so your surgeon may do the same thing...you should do what I did and just call his office and have them clarify what he will be doing..regardless of what they call it! Good luck!
   — DolcezzaVT

June 9, 2002
I had a very similar experience. Altho my Dr requested an abdominoplasty, my ins co approved a panniculectomy. I resigned myself to having the panni, then found out at the last pre-surgery consult that the procedure my PS does is the same either way. He said "of course" he would tighten the underlying musculature because "you wouldn't be nearly as happy with the results if I didn't!" Well, surprise, surprise! So, yes, I agree, definitely ASK your PS just exactly what he is planning to do and why. Mine did say they were just 2 different names for the same thing....BTW, he always referred to my procedure as a tummy tuck & not EITHER of the other names.
   — Kathy W.

June 11, 2002
My surgeon made me pay him $4000 up front to cover the additional cost of the upper portion of the surgery, the abdominoplasty. He said that part is considered cosmetic and no insurance company would pay for that. I was approved for a panniculectomy, for which they would only pay him the contracted rate of $1260. But for the time he would spend in the OR, he needed to be paid $5000 total. And the insurance sure enough, did not recognize the abdominoplasty, only the panniculectomy. I had the abdominoplasty without having the anchor incision, just the hip to hip incision. The problem with the anchor incision is that where the horizontal and vertical incisions meet (the juncture of the "T" is often a problem because the blood flow is compromised from so many directions. The skin there can die, and take months to heal over.)
   — Janice D.