Tummy Tuck vs Panniculectomy: What Does Insurance Cover?

Whether you’re considering a ‘tummy tuck’ for cosmetic purposes or your doctor has recommended a panniculectomy for medical reasons, it’s worth knowing the difference. Even though the procedures are similar, insurance coverage typically varies between the two.

What’s the Difference?

A panniculectomy involves the surgical removal of the pannus, the excess skin and tissue, or ‘apron,’ on the lower abdomen. The panniculectomy differs from the abdominoplasty, or ‘tummy tuck,’ in that the former is not a cosmetic procedure, while the latter is. The tummy tuck also involves tightening the abdominal muscles, whereas a panniculectomy typically does not.

 

A panniculectomy is called for when a person loses significant amounts of weight after surgery, lifestyle changes, or pregnancy, or when age, prior surgery, or hereditary factors result in excess skin at the lower abdomen. Excess skin can cause rashes, irritation, and other issues.

 

Panniculectomy Procedure

In the case of a panniculectomy, the surgeon makes a horizontal incision from one hipbone to the other.  After excess fat and skin are removed, the incisions are closed with stitches and tape. Drains may be inserted to remove excess fluid.

 

Abdominoplasty (Tummy Tuck) Procedure

A tummy tuck involves the surgeon making a horizontal incision from one hipbone to the other, and then contouring the skin, tissue, and muscle  as needed. The muscle fascia wall is tightened using sutures. This procedure includes the removal of the belly button, and drainage tubes are typically left under the skin for a few days. A tummy tuck tightens the skin of the whole belly and the belly button is re-positioned.

Liposuction may be used in tandem with the tummy tuck to further sculpt the abdomen.

Recovery

Recovery from either procedure will involve swelling and bruising at the incision sites, resulting in pain or discomfort. Stitches are typically removed within a week or so, and recovery can take one to four weeks, depending on the surgery.

Is it Covered by Insurance?

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. A tummy tuck is generally not covered by insurance. As always, it’s best to check with your insurance company for accurate, up-to-date coverage information.

At MSA Plastic Surgery, we focus on getting to know you and working with you to achieve your personal goals. We can help determine which procedure is best for you.

Sources:

https://www.healthline.com/health/panniculectomy

https://en.wikipedia.org/wiki/Abdominoplasty

https://www.plasticsurgery.org/reconstructive-procedures/panniculectomy