Tummy tuck and panniculectomy are two procedures commonly mentioned in body contouring surgery after massive weight loss. While they both address the apron-like skin that hangs from the abdomen, they are “fundamentally” different, says renowned Beverly Hills plastic surgeon Dr. Tarick Smiley.
Both tummy tuck and panniculectomy remove the apron-like skin that usually follows after dramatic weight loss, providing immediate relief from rashes, infections, hygiene issues, and back pain.
But unlike tummy tuck which is generally labeled as a cosmetic plastic surgery, panniculectomy is viewed as a medically warranted procedure and thus often covered by health insurance provided that the patient presents proof that the apron-like skin is causing the aforementioned problems, says Dr. Smiley.
Nevertheless, tummy tuck provides more contouring effects than panniculectomy because the former not just removes the apron-like skin, but it also incorporates muscle and navel repair.
Simply put, tummy tuck focuses more on the aesthetic improvements, while panniculectomy aims to provide immediate relief from the symptoms of redundant skin.
Because panniculectomy is considered a medically necessary procedure, patients who are still losing weight may still opt for the surgery provided that they are experiencing significant discomfort caused by the redundant skin. And once they reach their ideal weight, they may proceed to tummy tuck for additional contouring effects.
Tummy tuck, meanwhile, being an elective body contouring surgery is quite strict when it comes to achieving one’s ideal weight.
Studies have suggested that panniculectomy could stimulate additional weight loss as the patients are able to increase their activity level after the removal of their pannus, which in some cases even reaches their pubic region and causes foul odor and non-healing skin irritation.
However, even tummy tuck that focuses on abdominal contouring can also help in long-term weight management. Previous studies have shown that the aesthetic improvements can serve as a strong motivator for patients to maintain a healthy lifestyle, which is the key to preserve their results, says Dr. Smiley.
During a tummy tuck surgery, the skin is lifted after the creation of a hip-to-hip incision to reveal the pair of muscle that runs between the breastbone and the pubic region. The idea is to suture them in the midline to further create a flatter, narrower waist.
Tummy tuck also re-insets the navel, which is done after tightening the muscle and removing the apron-like skin. The skin in the upper abdomen is then pulled down and a small hole is created for the belly button.
Tummy tuck and panniculectomy can only address the frontal aspect of the waist. However, it is important to note that due to the natural distribution of redundant skin that follows after massive weight loss, a good number of patients will require an incision that extends all the way around their back (resulting in a belt-like scar) so the back and sides will not detract from the smoother frontal abdomen.