Panniculectomy vs. Tummy Tuck: Which Do You Need?

• Panniculectomies and tummy tucks are surgical procedures that remove unwanted fat and skin from the stomach
• A panniculectomy is performed to remove a pannus, an area of hanging skin and fat in the lower abdomen that can occur after massive weight loss
• A tummy tuck treats mild-to-moderate excess fat and loose skin through a less prominent incision
• A panniculectomy may be covered by health insurance; a tummy tuck is not in most cases

After the hard work of accomplishing significant weight loss or bearing children, many people are left with loose skin and stubborn fat in the lower abdominal area. This condition can be treated with one of two corrective surgeries: a panniculectomy or a tummy tuck. But which one is appropriate for you?

Here, we’re guiding you through the differences between a panniculectomy vs. tummy tuck, best candidates, insurance coverage and more. Still have questions? CONTACT  the team at Advanced Cosmetic Surgery in Greenville, SC for a consultation. 

Panniculectomy vs. Tummy Tuck: What’s the Difference?

Panniculectomies and tummy tucks are performed on the same part of the body for similar purposes, but they differ in a few ways. A panniculectomy is performed to address health issues caused by a panniculus, an area of excess skin on the lower abdomen that can form after extreme weight loss. A tummy tuck is typically performed for cosmetic purposes after pregnancy or less significant weight loss and involves removing a smaller quantity of skin or fat. 

Tummy Tuck Quick Facts

A TUMMY TUCK or abdomi noplasty contours the abdominal area through a combination of liposuction and skin removal, creating a slimmer, more athletic look. A full tummy tuck tightens and tones the abdomen from the rib cage to pubic region, whereas a mini tummy tuck only enhances the abdomen’s appearance below the belly button. Both versions may include the placement of internal sutures to tighten loose abdominal muscles, yielding a more dramatic result.

Best Candidates 

Ideal candidates for abdominoplasty are men and women who want to remove unwanted body fat and excess skin on the abdomen, regardless of its cause. Candidates should:

• Be physically healthy
• Have been at a stable weight for at least 4 months 
• Be nonsmokers or able to quit for 1 month before and after
• Consume little to no alcohol on a regular basis

For women, it’s advised to only undergo a tummy tuck when you have completed your family or do not plan on becoming pregnant. 

Insurance Coverage

Tummy tuck surgery is considered a cosmetic procedure and therefore generally not covered by insurance. Occasionally, it can be deemed medically necessary and thus covered when performed as a corrective procedure for a condition such as a ventral hernia or stress urinary incontinence. 

Recovery & Results 

Abdominoplasty is performed under general anesthesia, and you’ll need someone to drive you home after the procedure. During your recovery, expect to:

• Be able to walk the same day
• Feel sore and uncomfortable for the first few days 
• Have your stitches removed after a week
• Resume work and most daily activities after 1–2 weeks 
• Gradually increase physical activities over 4 weeks
• Be fully recovered after 4–6 weeks

For several weeks, you will need to sleep propped up on pillows to increase blood circulation and minimize swelling. You’ll also wear a customized compression garment to support the abdominal muscles and prevent fluid buildup.

Scarring 

Scarring after abdominoplasty varies depending on the version of the procedure you undergo. 

A full tummy tuck scar spans horizontally across the abdomen from hip bone to hip bone; for a mini tummy tuck, the scar is usually 3–6 inches long, similar in placement and size to a c-section scar.

Initially, your scar will be reddish-purple and raised. Over time, it will flatten and the pigmentation will noticeably fade; typically, it takes 8–12 months for a surgical scar to fully heal. If after 12 months you’re dissatisfied with the appearance of your scar, we offer laser revision therapy.

Permanence

Abdominoplasty is considered a permanent procedure as long as you maintain your current weight and healthy lifestyle. Future weight gain, weight loss and pregnancy can all change the longevity of your results. 

Possible side effects

Like any type of plastic surgery involving general anesthesia and incisions, a tummy tuck has potential side effects. These include:

• Bleeding
• Fluid accumulation
• Infection
• Nerve damage
• Poor wound healing
• Raised scarring
• Reduced sensation at incision site
• Panniculectomy Quick Facts

A panniculectomy surgery removes excess skin and fat from the abdominal area. But unlike a tummy tuck, it specifically involves excising a panniculus, sometimes incorrectly called a pannus–a flap of excess, stretched-out skin that may hang below the pubic bone or extend over the thighs.

A panniculectomy can significantly improve your quality of life, eliminating the hygiene issues, rashes, pain and other problems caused by excess skin.

Best Candidates 

Ideal candidates for panniculectomy surgery are men and women who have a large amount of hanging skin that extends below the genital area. This condition is usually caused by significant weight loss over a short period, whether due to lifestyle changes or weight loss surgery. 

To be a good candidate, you should:

• Have significant skin laxity in the lower abdomen
• Be in good overall health
• Be at a stable weight for at least 4 months
• Be nonsmokers or able to quit for 1 month before and after
• Consume little to no alcohol on a regular basis

Insurance Coverage

Insurance companies may cover this type of abdominal surgery if deemed medically necessary. A panniculectomy can be partially or fully covered if you are suffering from:

• Hygiene issues
• Interference with daily activities
• Rashes
• Skin ulcers

Recovery & Results 

Panniculectomy recovery is more intensive and prolonged than a tummy tuck. Most panniculectomy surgeries are performed as out-patient procedures, however, you may need to stay overnight depending on how extensive the removal is. 

When planning for a panniculectomy, know that you will need to take 4–6 weeks off work to fully heal. 

• While you are healing, you can expect to:
• Be unable to stand upright for several days
• Have a swollen, sore abdomen for a week
• Be unable to drive for 3 weeks after surgery
• Experience numbness for a few weeks or months
• Be unable to lift anything 10 pounds or heavier for 6 weeks

Throughout your recovery, you will need to clean and change the dressing over the incision site daily. Taking care of your stitches will help the incision heal more rapidly and can reduce the severity of scarring. Scars from panniculectomy surgery fade similarly to tummy tucks in color but can take up to two years to fully flatten.

Results

Panniculectomy surgery is considered a permanent cosmetic procedure. Unless massive weight gain occurs, it is difficult for another panniculus to form. Patients who experience weight fluctuation after a panniculectomy are usually good candidates for a tummy tuck if additional revision surgery is required.

Possible side effects

Panniculectomy surgery, like any surgical procedure, has the potential for side effects.

These include:

• Bleeding
• Blood clotting
• Fluid accumulation
• Nerve damage
• Numbness
• Poor wound healing
• Scarring
• Soreness 
• Swelling

The Bottom Line

Both tummy tuck and panniculectomy procedures are abdominal surgeries to address unwanted fatty deposits and sagging skin on the abdomen. A tummy tuck is ideal for anyone with mild-to-moderate concerns, while a panniculectomy is performed for people who have undergone major weight loss and have a panniculus, a flap of excess skin hanging from their stomach.

A panniculectomy is a more extensive surgery than a tummy tuck, thus has a longer recovery time. A tummy tuck typically takes 4–6 weeks to fully heal, whereas a panniculectomy can take up to 4 months.Both procedures can boost your self-confidence and improve quality of life. To learn more about which procedure would fit your needs, CONTACT  the expert plastic surgeons at Advanced Cosmetic Surgery.