Here is my tw cents worth. Anything that hangs, swings or bounces around, sweats and gets rashes is just wrong. If your pannis is big enough to do any of the above, it's too big.
Yes you can take pictures, you can document, you can go to the docs. But what you really need to know, is what is the criteria of your insurance company before they will pay for the surgery.
I belong to Kaiser. They have their own critera. I meet all of the criteria, except one. The pannis must hang half way down your thigh to your knee. I am here to tell you that that is a bit extreme!!!
The other criteria is that you must be at your goa weight. You must have been able to maintain your weight for 6 months to 1 year. You have to be in good health. They prefer no high blood pressure, no diabetes, no nothing. You have to had rashes, hip/back aches from the weight of the hanging flesh.
Because my pannis does not hang half way down my thigh, my husband and I are paying for the surgery.
My recommendation is find out what the exact criteria for your insurance company is.
Also, when I had a ra****reated it like a burn. Because to me the tissue felt like a burn. I used Dessitin on it. It is used for diaper rash. And I also used pure aloe on it to take the fire out of it. Both worked great for me.
Also, I would take several long strips of toilet paper and lay it under the pannis. Every time I went to the bathroom, I would change it out. The toilet paper really helped with the sweating. My doctor told me that he had heard of women sticking kotex under their pannis. Toilet paper is easier and cheaper.
Good luck! I did not know that when I lost all of my weight that this would be my next problem. Don't know why? Just didn't figure it.