Panneculectomy

Okay, so this is not so much a bad complaint just some concern...I have lost 118 pounds so far!!!! Yeah I am very excited..but my question is I have a large stomach in the bottom and it has retracted some and gone down but it is very heavy still very thick and is nothing like just a little flap...I have been told by others that I can get a panneculectomy. I would love to have this but my surgeon says he will not refer me to have it done..what should I do? It is not a tummy tuck that I am after just removal of this heavy, fatty stomach. I believe that I will loose another 20 or 25 pounds if I have it done, that is how heavy it is. It gives me rashes and  weights me down all the time. I have gone from a 30 to a size 20...I could easily be in a 16 if it were gone, not looking for flat and perfect just gone. Anyone?

 Why won't he refer you!?

I have the same thing. I have been very obese all my life. I have lost tons of weight all my life. My stomach hangs half way to my knees. I started out a size 32 and 22s are getting pretty loose. I could probably wear a tight 20. I feel I would loose 25 to 35 lbs. if my panni were removed. I am only 5 months out and the Dr's. around here wont do anything until I have a year behind me on the bypass surgery. I know I could exercise better if it were removed. I too suffer from rashes and a bad odor from under my flaps as I like to call them. I know with my insurance they will pay if it is a health issue and if I have documentation from my PCP of my reoccurring problems. I also know that if I play my cards right, I might can get a full TT. You  need to talk to your primary car doctor and start the ball rolling on his side of the game. I haven't even talked to my surgeon about it.

 I don't understand. I did not ask anyone if I could do it when I had it done. I just went to a PS in town and had it done. Why are you asking? Just do it like they say. But I would wait a few months after you hit the weight you want to stay with. 

I'm kind of with Larry here. From your ticker, you still have almost 100 pounds to lose. Do you really want to go through the surgery to remove the panni twice? Mine wasn't horribly painful, but I was off work for two weeks, and getting around was difficult for a couple weeks longer, and there are compression garments you need to be wearing for a long time after that.

Seriously, consider waiting until you are done losing weight and pretty sure your able to maintain. My reconstructive guys are upfront about telling potential patients that they almost never work on WLS patients who have not been at their stable, final weight for 8-16 months.

Yes, it's frustrating. Yes, it is likely painful. But do you really want to do it twice? Because that's what you're looking to do.

What Larry said.....you don't need a referral for plastics.  If you want it done (nd insurance to pay for it) ou DO need documentation from your PCP that you have had medical issues from it such as rashes and pain.  Also, most PS want do it until your weight has stabilized a bit.  If your self pay go see one now if you want.....its totally up to them whether your in a good place to have the surgery.

Did he say he wouldn't refer you now or ever?  My surgeon removed my panni at about one year out with my first WLS.  He said my insurance automatically paid if you have lost at least 100 lbs so there were no pre auth issues or anything.  Some insurances require a lot of documentation and others won't pay no matter what.  Sometimes you will get denied and have to jump through a lot of hoops.  The thing to do is to contact your insurance and find out what their guidelines are and start crossing your Ts now.  If they need pictures of the rashes, get pictures.  If they need documentation of office visits for the rashes or records of prescriptions, get those done.  Some require you to be at a stable weight for a year or 18 months.  Find out so you know what you need to do.  While you are doing that find out if they will pay for any other skin removal.  Remember to call it "reconstructive surgery", not cosmetic surgery.  Just about no insurance company will pay for cosmetic surgery but they will pay for reconstructive surgery.  Just find out what kind and what they need.  I have heard of people having insurance pay for breast reconstruction, body lifts, thigh lifts, even eye lifts  Just depends on how the excess skin interferes with your life or causes problems or infections.
Good luck.
BTW, be sure to get the name of anyone you talk to and get all information in writing or find out where it is in the insurance information.  And also make sure that your insurance includes that coverage.  I have heard of people getting all excited because certain procedures were covered and they qualified only to find out that their employers didn't spring for the coverage that includes those benefits, so make sure you find out what is included in the plan you are covered by.

 My guess is that he will not refer you YET because you still have so much weight to lose.  The surgery is much safer and will LOOK at lot better if the surgeon is just removing excess skin and attached tissue rather than fat.  I think if you look at pictures of people who have had I done before losing all the weight (they often do it to improve mobility in people who have 300-400 pounds to lose), you will not be happy with what you see.

Also, insurance may not approve it with so much weight still to lose OR they might approve it now but won't pay for it a second time once you have all the weight off.  It really is intended to remove the excess skin once you are done losing, NOT to be a shortcut to getting the weight off.

Lora

So far you have done tremendous with losing.
Research into PS -surgeon and procedures.
Document your body and its treatment with your GP.
RECONSTRUCTIVE SURGERY not Cosmetic Surgery.
Keep doing what you are doing but hang in there for not doing the PS now as it might cause you major regret later down your journey in losing.
If you thought going private- that is an entire different story altogether.
Mikimi in Israel

 It may be that he just won't refer you yet. The plastic surgery discussion group I attended recent;y said that they won't do it until you've reached your goal weight and have maintained it for 6 months because they don't want to have you do that surgery twice. Be patient :-) Congrats on losing 118 pounds!