Question:
Panniculectomy misconceptions??

I am a little confused. i keep seeing that the panniculectomy will leave you with a "pauch" and that only the abdominoplasty will give you the flat tummy. Please someone correct me if I am wrong. I thought the panni removed the skin from about belly button down and pulled it tight. I thought that abdominoplasty went up higher and tighted your muscles too. I am beginning to doubt my decision to have the panniculectomy in a few months. Is my interpretation right or did I hear it wrong from my doc? I don't want to be disappointed. Also--I am 25, have a flat belly, expect for the pouch below the belly. The upper torso is nice, nit Janet Jackson, but my doc said it needs no tightening. Am I still going for the wrong thing?    — Courtney W. (posted on April 2, 2002)

April 2, 2002
I would ask your doctor how he is going to do it. I've heard so many different things on this site. I had a hernia repair/panni in December and my doctor did not touch the muscles. He cut from my breast down to my crotch and then hip to hip. He also saved my belly button by cutting around it and moving it up. I had six pounds of skin removed and I am happy with my decision.
   — Helen C.

April 2, 2002
I had my panniculectomy in November, and I have a tummy that you could bounce a quarter off of :-) A panniculectomy is simply the removal of excess skin and fat with NO surgery being done to the underlying muscle structure. It can be done to tighten the upper torso as well as the lower abdomen, depending on the length and type of incision. My plastic surgeon asked the insurance provider to approve an abdominoplasty (a more involved and expensive procedure), but said that unless he found a hernia or very "relaxed muscle structure" he would only do a panniculectomy. I didn't need the abdominoplasty, and I couldn't be happier with my results. I felt that that was a very medically ethical response on the part of my surgeon....why experience and pay for more extensive surgery than is clinically indicated? In addition, if the insurance provider approves an abdominoplasty, but only has to cover a panniculectomy, they also are a winner :-) Be an informed consumer....ask your surgeon specifically what type of surgery that he has planned for you and why. Good luck!
   — Diana T.

April 3, 2002
I think Helen's definitely right--check with your doctor specifically. I think sometimes the difference between the two procedures is blurry, depends on the doctor. I was approved for a panni & assumed my Dr would just so the skin tightening part, then found out he intends to also tighten the underlying musculature as well. I talked to the billing person & said just be SURE to code & bill this as a panni, not abdominoplasty & she said, yes, they will..... I will let you all know how I come out--mine is tomorrow, 11 hours from now & I am nervous.......
   — Kathy W.