Panniculectomy vs tummy tuck: which is best?

I'm a 45 year old male who went from 275 lbs to 195 lbs in a little under two years and I am left with a huge mass of flesh which used to house a significant beer gut--and then some! I have learned this flesh is the pannus and I have read about the procedure called a panniculectomy, which seems to be perfect, but what about a tummy tuck? Is that more for women or could I have that done instead of the panniculectomy? Maybe I'm just thrown off the names of each procedure! Tummy tuck just sounds gentler than PANNICULECTOMY. What would you suggest I do to find out what's best for me? I really am open to either no matter which sounds better!


M, 48, New York

Tags:man age 45-54 190-209 lbs loose skin massive weight loss

Great question and nice job on your successful weight loss.

In some cases a panniculectomy alone can be performed, which is where the abdominal pannus (excess fat and skin) are removed. When this “skin apron” is removed, the umbilicus and underlying muscles are left alone. A panniculectomy alone may be all you need to meet your objectives.

However, some patients request an abdominoplasty or tummy tuck (which includes tightening the abdominal muscles as well. This is a more involved procedure that provides improved abdominal aesthetics but lengthens recovery times. There are also different price points associated with both types of plastic surgery procedures.

We often receive questions from people who have lost a large amount of weight and are curious to find out whether a panniculectomy or tummy tuck is the better option for them. Panniculectomy surgery can be performed as a discrete procedure depending on the amount of weight you’ve lost and the results you’re looking for. A panniculectomy basically removes the roll (pannus) of soft tissue in the lower abdomen but won’t improve the mid- or upper-abdomen nor tighten the abdominal muscles. To accomplish that type of body contouring you’d need to investigate tummy tuck surgery (abdominoplasty), which would include a panniculectomy and tighten up the upper and lower abdominal muscles as well remove any sagging excess skin.

Weight loss surgery also varies for men and women as the latter can experience issues related to pregnancy. There is a price difference between a panniculectomy and an abdominoplasty procedure. Your best bet is to consult with a few board-certified plastic surgeons to determine the optimal solution for your particular situation, lifestyle and pocketbook.

Congratulations on losing all that weight! Great question about the difference and which is appropriate for you. A tummy tuck, or abdominoplasty, is actually two procedures. It is a panniculectomy - which is where the abdominal pannus (excess hanging fat and skin) get removed, and it is an abdominal wall plication, or tightening procedure. For someone who's issue is isolated to the abdominal pannus and their abdominal wall is not lax, then a panniculectomy is all you would need. This is very commonly indicated in massive weight loss patients, like yourself. A plastic surgeon would have to examine you in person to determine if your abdominal wall had any significant laxity that would benefit from a plication procedure. Women very commonly get a full tummy tuck procedure, especially post-pregnancy, because pregnancy generally over-stretches the abdominal wall, leaving it lax and loose. Therefore, a panniculectomy alone would not address this issue (nor would abdominal liposuction, which is frequently asked if that is an option).