Woman grabbing her abdominal area

Both a panniculectomy and tummy tuck address loose skin near the abdomen and are therefore often confused with one another. While there is some overlap in terms of the end goal of both procedures – a flatter stomach without loose, sagging skin – they are very different and you are likely a better candidate for one surgery over the other. The main difference between Panniculectomy vs Tummy Tuck is that a panniculectomy is often considered a medical necessity while a tummy tuck is typically for cosmetic purposes. More severe sagging that causes health issues like rashes and ulcers is addressed through a panniculectomy.

We will provide a breakdown of the basics of both procedures and their most important differences:

Panniculectomy: The Basics

Pannus refers to an abnormal growth of skin that forms a large abdominal flap descending over the thighs. This is not the typical type of sagging skin that may come from pregnancy or mild weight loss. A pannus is often the result of extreme weight loss of 100 pounds or more and is a common complication of procedures such as gastric bypass or gastric sleeve surgery.

A panniculectomy is performed under general anesthesia. Your surgeon will make two incisions to the abdominal wall, the length of which depends on how much skin is to be removed. Then, the excess skin is removed before bringing the remaining skin edges together and closing them with sutures. The belly button is typically not moved in a panniculectomy. 

A panniculectomy is considered major surgery and can take several hours. 

Tummy Tuck: The Basics

Also known as abdominoplasties, tummy tucks are performed under general anesthesia. Your surgeon makes an incision, usually from hip bone to hip bone. Then, they will remove excess skin and fat and tighten your underlying abdominal muscles. An absorbable mesh may also be used to reinforce the muscle repair.

Tummy tucks typically take between two and three hours. Tummy tucks are often done in conjunction with other procedures, such as during a mommy makeover. There are also many iterations of abdominoplasties ranging from mini to hybrid to full. Frequently, progressive tension sutures are also placed to facilitate healing and minimize the need for surgical drains.

Tummy tucks are cosmetic procedures and therefore not covered by insurance.

Panniculectomy Vs Tummy Tuck: Key Differences

Candidates For Each Procedure

Broadly speaking, a panniculectomy addresses more severe sagging skin in the abdomen that significantly impacts a patient’s life and leads to chronic health issues (more on that below). A panniculectomy is often performed after extreme weight loss. Tummy tucks are often performed after weight loss as well, but usually address loose skin not associated with health problems. 

A tummy tuck treats more minor loose skin issues. It is often performed after pregnancy or to address a loss of skin elasticity due to aging. In conjunction with liposuction, a tummy tuck can also help remove small fat deposits from the abdomen that do not respond to diet and exercise.

Recovery Time

Immediately after surgery, you will have steri-strips or skin glue on the incisions and likely surgical drains in place. Your surgeon will provide you instructions on how to care for drains and dressings, which you should follow closely to avoid complications.

Recovery from a panniculectomy can take up to eight weeks. During this time, you will need to refrain from heavy lifting and most strenuous activities. Talk to your surgeon about your precise recovery timeline as every patient’s needs are different.

As a tummy tuck is often done on patients with a lower BMI, recovery time is often shorter, taking between four to six weeks. As with a panniculectomy, you will have steri-strips or skin glue on the incisions and likely surgical drains in place, which you should clean carefully according to your surgeon’s instructions. You can gradually resume regular activities in the weeks following your surgery in accordance with your surgeon’s recommendations. 

Insurance Coverage

A panniculectomy is considered a medical necessity. Excessive skin hanging over the abdomen can cause health problems such as rashes, ulcers, and infections, and even hygiene issues. Because of this, a panniculectomy is more likely to be covered by insurance. (However, policies vary, so make sure to double-check with your provider.)

A tummy tuck is nearly always considered a cosmetic procedure. Therefore, in the vast majority of cases, it is not covered by insurance and you will have to pay out of pocket.

Panniculectomy Vs Tummy Tuck: The Bottom Line

Both a panniculectomy and a tummy tuck treat loose abdominal skin, but they are two vastly different procedures. While a tummy tuck is performed for cosmetic purposes, a panniculectomy is a medical necessity that helps treat issues that can substantially impact your health and well-being. The best way to determine which procedure is the right fit for you is to book a consultation with a professional. Ready to get started? Leif Rogers, MD is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. Get in touch with his team to schedule a consultation.

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