A panniculectomy can be considered a medical necessity after significant weight loss, while a tummy tuck is an elective procedure done for cosmetic reasons. Medical insurance often doesn’t cover a tummy tuck.
Panniculectomy and tummy tuck (abdominoplasty) are surgical treatments that remove excess lower belly skin. They may both be performed in cases of extreme weight loss from natural or surgical causes.
The goal of panniculectomy is to primarily remove hanging skin, while a tummy tuck also provides contouring effects to enhance your muscles and waistline. It’s also possible to have both procedures done at the same time.
Though the goals for both procedures are similar, it’s important to learn the key differences between them so you get the results you want.
Both panniculectomies and tummy tucks remove lower belly skin that can form after losing a lot of weight. This weight loss may be due to bariatric surgery, natural weight loss, or even pregnancy.
Panniculectomy
A panniculectomy is an invasive surgical treatment done with general anesthesia. It’s most helpful for people who have recently had weight loss surgery and are left with large amounts of hanging skin on the lower belly.
This type of surgery may be considered a medical necessity if the remaining skin affects your quality of life. For example, you
During a panniculectomy, your surgeon will cut into the abdominal wall to remove excess skin in the middle. Then, they will use sutures to reattach the bottom portion of skin to the top.
Tummy tuck
A tummy tuck is also intended to remove excess skin. The key difference is that this invasive surgery is usually an elective procedure done for aesthetic reasons, and isn’t considered medically necessary like a panniculectomy might be.
In some cases, a tummy tuck may help alleviate incontinence and back pain.
With a tummy tuck, you’ll be under general anesthesia, and your surgeon will cut out excess skin while also tightening your abdominal muscles. In some people, including those who have given birth or undergone large weight changes, certain abdominal muscles can stretch out and separate. Physical therapy that targets these muscles may help, but surgery can sometimes be necessary to tighten them.
The surgery itself won’t give you six-pack abs, but it will make it easier for you to build abdominal muscles on your own through physical activity. During the surgery, the belly button is often moved and reattached in a new location.
Surgeries of this nature take time. Aside from the actual time spent in surgery, you should expect to arrive at the hospital early for preoperative care. You’ll also need to stay in postoperative care while your doctor monitors your initial recovery.
Panniculectomy timeline
It may take up to 5 hours for a surgeon to perform a panniculectomy. The exact timeline depends on the length of incisions made, as well as the amount of excess skin that’s being removed.
Tummy tuck timeline
A tummy tuck may take 2 to 5 hours to complete. Though the skin cutting may be less extensive than with a panniculectomy, your surgeon will still need to shape the abdominal wall.
Both panniculectomy and tummy tuck share similar success rates. The key is to maintain a moderate weight following the procedure so you get the best results.
Results of a panniculectomy
The recovery process may be slow, but the results from a panniculectomy are considered permanent. If you maintain your weight, you shouldn’t need any follow-up surgeries.
Results of a tummy tuck
The results of a tummy tuck are also considered permanent if you maintain a moderate weight. To increase your chances for long-term results, your doctor may recommend losing or maintaining weight before the procedure.
You may be a better fit for one procedure over another. Both panniculectomies and tummy tucks are intended for adults and for people who aren’t pregnant, as well as for those who don’t smoke and have a stable body weight.
Though both surgeries target excess lower belly skin, they aren’t weight loss procedures.
Panniculectomy candidates
You may be a candidate for a panniculectomy if you:
- have recently lost a large amount of weight and have loose belly skin that you want to remove
- experience hygiene issues from excess skin hanging below the pubic region
- keep getting rashes, infections, or other related issues under the hanging skin
- have recently undergone any type of weight loss surgery
Tummy tuck candidates
A tummy tuck may be a good fit if you:
- are trying to get rid of excess skin from a recent pregnancy or other factors
- are in overall good health and are at a moderate weight
- have talked to your surgeon, and they recommend undergoing this operation after a panniculectomy
The cost of panniculectomies and tummy tucks can vary depending on many factors, including where you live and whether you have insurance that covers any part of the procedures. The costs stated in this section are estimates.
You’ll need to check with your doctor for a breakdown of all the costs before the selected procedure. Some facilities may provide a payment plan option.
Costs of a panniculectomy
A panniculectomy may cost several thousand dollars. A self-pay panniculectomy for removal of excess skin at the front of the body may be in the $5,000 to $7000 range, while a more extensive panniculectomy that removes excess skin from the entire circumference of the torso may cost $10,000 to $20,000.
These estimates may not include other associated costs, such as anesthesia and hospital care.
Many medical insurance companies will cover a portion of this procedure, especially if your doctor thinks the panniculectomy is medically necessary. To cover a panniculectomy, an insurance company can require proof of certain factors, such as failure of conservative treatments like antifungal skin treatments under the excess skin.
It’s best to contact your insurance company ahead of time to see how much they’ll cover or if you’ll need to work with a specific surgeon.
Another consideration is the cost of taking time off work. It can take several weeks to recover from this procedure, and most people have drainage tubes for a few weeks.
Costs of a tummy tuck
Because a tummy tuck is usually not covered by medical insurance and involves tightening the abdominal muscles, it can be more expensive than a covered panniculectomy. The American Society of Plastic Surgeons estimates that the average cost is a little over $8,000.
Like a panniculectomy, you’ll need to spend time off work or school after a tummy tuck surgery.
Full recovery can take up to 6 weeks, but that time may vary depending on the number and size of the incisions. You won’t be able to do any core exercise during your recovery, and you may have drainage tubes for a few weeks.
Like any type of surgery, both panniculectomy and tummy tuck can cause immediate discomfort, along with a risk of side effects. Some of these effects are common, while others are rarer and require further medical attention.
Side effects of a panniculectomy
It’s common to experience pain for the first few days after surgery. You may also experience persistent skin numbness around the surgery site.
Fluid retention is another possible side effect that may be minimized with drains inserted into the stomach after surgery.
Additionally, you may not be able to stand up straight for a week or two due to the healing process.
The following side effects are rare and may require emergency medical attention:
- infection
- heart palpitations
- excessive bleeding
- chest pain
- shortness of breath
Side effects of a tummy tuck
Immediate side effects of a tummy tuck include pain, bruising, and numbness. You might also notice persistent pain and numbness during your recovery.
Rare but serious side effects include:
- infection
- excessive bleeding
- anesthesia complications
- deep vein thrombosis
The following chart is a breakdown of the primary similarities and differences between panniculectomies and tummy tucks. Consult your doctor for further details and to determine which surgery is best for your specific circumstances.
| Panniculectomy | Tummy tuck | |
|---|---|---|
| Procedure type | surgery with a horizontal incision along the lower abdomen | surgery with a horizontal incision along the lower abdomen and an incision around the belly button |
| Cost | ranges from $5,000 to $20,000, but may be partially covered by insurance | around $8,000 on average |
| Pain | general anesthesia prevents pain during the procedure, but pain and numbness may be persistent | general anesthesia prevents pain during the procedure, but pain may be worse during recovery, particularly with abdominal muscle repair |
| Number of treatments | one procedure that can take up to 5 hours | one procedure that can take between 2 and 5 hours |
| Expected results | long-term results barring major weight fluctuations, some permanent scarring is expected | long-term results barring major weight fluctuations, some permanent scarring is expected |
| Disqualifications |
|
|
| Recovery time | around 4 weeks | up to 6 weeks |
Panniculectomies and tummy tucks are both procedures to remove excess skin on the lower abdomen, but a tummy tuck also contours the abdomen and isn’t usually considered medically necessary.
If excess skin is a concern for you, your doctor can help you understand which procedure is better for you.