What qualifies you for a panniculectomy?

Author: Domenic Cartwright  |  Last update: Friday, April 18, 2025

People of any age with excess skin and fat in the lower abdomen may be right for this procedure. Panniculectomy might be right for you have your excess skin causes symptoms such as: Fungal infections. Lower back pain.

How do you get approved for a panniculectomy?

To qualify, most insurance companies will require that you present documentation on the weight loss surgeries you may have had, the impacts on your health of not getting a panniculectomy, and evidence of any injuries, skin irritation, ulcers, or anything else that the excess skin and fat cause.

What makes a panniculectomy medically necessary?

A panniculectomy is considered medically appropriate when there is documentation of a significant functional impairment, such as persistent cellulitis, abscess, or skin ulceration that has been refractory to medical therapy, not recurrent (i.e., does not clear up then recur), for at least six months, including a ...

How long does it take for insurance to approve a panniculectomy?

information from your visit is sent to your insurance company for authorization. This process can take from 14-60 days. medical information, your insurance company will make the decision about whether to cover your panniculectomy.

What to say to get panniculectomy covered by insurance?

You may be eligible for health insurance coverage for a panniculectomy if it's deemed medically necessary due to health issues like back pain, chafing, dermatitis or infection caused by excess skin.

Tummy Tuck vs. Panniculectomy: Key Differences and Insurance Coverage

What doctor approves panniculectomy?

A panniculectomy involves many choices. The first and most important is selecting a board-certified plastic surgeon who is a member of the American Society of Plastic Surgeons (ASPS).

Who decides if you need a panniculectomy?

The decision to have panniculectomy surgery is extremely personal. You'll have to decide if the benefits will achieve your goals and if the risks and potential complications of panniculectomy surgery are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.

What is a grade 5 pannus stomach?

The size of a panniculus varies and can be graded on a scale of 1 to 5, which correlates with how far it extends. Grade 1 reaches the mons pubis, while grade 5 extends to or reaches past the knees.

How much weight is lost with panniculectomy?

The average weight of skin and fat tissue removal during panniculectomy is between 10.3 and 49 pounds.

How to get insurance to cover skin removal?

You'll need to prove that your surgery is medically necessary in order for your insurance company to pay for it, so you'll want to first speak with your doctor. Begin documenting all the steps you've taken to overcome your medical issues so that your doctor can understand that surgery is truly a last resort.

Does a panniculectomy lift the pubic area?

A panniculectomy is surgery to remove excess hanging skin and fat, called a pannus or apron, from the lower belly. It's often done after a big weight loss when the stretched skin may hang over your genitals or extend to your thighs or beyond. Some doctors call it a lower abdomen lift.

How many hours does a panniculectomy take?

About the Procedure

Most often, the surgeon will make two incisions. The first is a long incision from hipbone to hipbone, just above the pubic area. A complete panniculectomy can take from 2 to 5 hours, depending on the extent of work required.

What cost more tummy tuck or panniculectomy?

A panniculectomy is a more extensive surgery; therefore, it is more costly. The typical price range for a panniculectomy is $8,000 to $15,000. A tummy tuck is $5,000 to $11,000. Pricing will also depend on the length of the surgery and if there are any complexities or complications to address.

What questions should I ask the surgeon before a panniculectomy?

What questions should I ask my plastic surgeon about a panniculectomy?
  • Are you certified by the American Board of Plastic Surgery?
  • Were you trained specifically in the field of plastic surgery?
  • What specific training do you have in panniculectomy techniques?
  • How many years of plastic surgery training have you had?

How do I qualify for a panniculectomy?

In general, you may be a good panniculectomy candidate if:
  1. You are physically healthy and at a stable weight.
  2. You have realistic expectations.
  3. You are a nonsmoker.
  4. You are bothered by the appearance of your abdomen.
  5. You have recurring or persistent rashes or infections underneath the hanging fold of skin.

How to fix apron belly without surgery?

While exercise and diet won't completely eliminate an apron belly on their own, they can significantly help in reducing fat around the stomach area. Regular workouts focusing on core strength and a balanced diet can lead to a flatter tummy over time.

Does panniculectomy include fupa?

Also known as body contouring surgery, a panniculectomy involves changing the shape and contour of the body by removing excess skin and fat that hangs from the abdomen. Many people may find fat below the bellybutton area, which they may refer to as a FUPA, to be the most difficult type of fat to lose.

When will insurance cover panniculectomy?

If surgery is warranted because excess skin or tissue is causing persistent health issues (such as skin conditions, functional deficit, or interference with every day activities), a panniculectomy may be covered by your insurance plan.

What kind of doctor performs a panniculectomy?

A panniculectomy should be performed by a board-certified plastic surgeon who has experience in this surgical body contouring procedure. The surgery is usually performed under general anesthesia and may require several hours to complete. You may be required to stay in the hospital following surgery.

What is a 360 panniculectomy?

A traditional tummy tuck involves removing skin and excess fat from below the belly button and re-tightening abdominal muscles. The Tummy Tuck 360 does this and more. In addition to the standard abdominal tightening, this procedure also uses SAFElipo to remove excess fat from the entire trunk.

Will Medicaid pay for panniculectomy?

Medicaid coverage for abdominoplasty and panniculectomy procedures requires adequate supporting medical documentation confirming the criteria for coverage, such as functional impairment or a medical necessity.

How painful is a panniculectomy?

The first several days after a panniculectomy are often the most painful. You may feel swollen, bruised and sore. Your incisions may bleed slightly. You may feel more comfortable wearing an elastic wrap around your abdomen, but check with your surgeon before doing so.

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