Question:
Has anyone had reconstructive surgery on your pannus area long before you were at

goal? How did you get approval? Do you have any sample letters you would share with me? I go for a ps consultation on April 17 in Houston. I just have to do something about this pannus, which is now hanging past my "goodies" and is causing numbness in my thighs. My PCP has documented that my pannus is hanging extremely low, causing some minor rashes, and is the cause of my thighs hurting. I am at 290 from a high of 423. I would like to lose to 160 if possible. My weight has been the same for 7.5 weeks. I hate the plateaus from hell but I have had so many that I do know they pass. I know that if I am able to get reconstructive surgery in the next six months, I may need touching up in the future. I realize that my pannus is not as bad as those who have to deal with theirs hanging to their knees. It is however in the way when I need to use the restroom. It makes dressing in pants extremely difficult. It is causing me pain and numbness from my hips to my knees. It is also is a nuisance for sexual activity. I sure need your help if you are someone who has dealt with pannus problems or can give me your advice on having surgery before reaching goal. I am not sure where to turn to except other post ops. I want to make sure I have everything when I travel to Houston on April 17 for the ps consultation with Dr LaMonaco. Thanks for any help you can give me.    — Ann B. (posted on April 4, 2004)


April 4, 2004
i had a full tt and inner thigh lift when i was 40 pounds from goal. i had all the same problems as you do now. i am very glad i had it done. it makes doing my daily things and even working out easier. just make sure you talk to your doctor about what he does to ensure you won't get "dog ears". my ps told me before i had it done that when i loose the rest of the weight that i might need it done again, but now he has changed his mind and said that i shouldn't have to ever have it done again because it looks great. some people never have a problem with their apron and don't really understand how painful it can get. that the pain can last non-stop for weeks or months. i am going to wait untill i've been at goal for awhile for an arm lift and butt lift. best of luck to you
   — franbvan

April 4, 2004
Hi Ann - You sound very much like me. I was 440 and hoping to be 180. Had panni at 265 about 8 months ago. It has been HARD and I am still not healed. My profile is LONG and detailed if you really want to know -- plastic surgery stuff starts about April, 03. Bottom line, I would still do it, even with everything I'm going still through and will have to go through again after I'm at goal(hopefully without complications next time!). I'd be happy to share my letter if you email me. Good Luck!
   — jen41766

April 4, 2004
Hi Ann, I had my panni Nov. 02, about 40#s from goal. I have a very bad back (one of the reasons I was approved for wls), my doctor stated that the hanging apron was causing problems with my spine and that the apron resting on my legs when I sat down also caused extra pressure on my back. I also had rashes under the apron. Good luck on your consultation
   — connie m

April 4, 2004
Hi Ann! Like you, my nuisance gut had me looking into plastic surgery sooner than I had anticipated. Down from 475 to 225, would still like to lose at least another 40 or so but I carry a tremendous amount of that weight in my oddly large legs. My torso is lean by comparison, all ribcage and hanging skin. When I discussed with my general surgeon about repairing my huge incisional hernia, he said it was time for the pannus and batwings on my arms to go, they were so at odds with the rest of my body. The plastic surgeon he referred me to heartily agreed I would benefit tremendously and did not think it was too soon. My hernia repair, pannulectomy and brachioplasty (oh my!) are scheduled for April 26. The insurance approved the pannulectomy without hesitation after some truly horrifying polaroids were submitted along with a letter from the plastic surgeon stating my "potential" for rashes (have actually never had one!) and the truly aberrant appearance. He used the diagnoses of "acquired skin anomaly" and "muscle diastasis" and the appropriate insurance codes and I got approval quickly. Goal weight is such a relative thing. Using such factors as lean muscle mass under all the fat, losing 65% of excess weight on average and how long you've been obese (all my life) and body type (tall and wide in my case) my bariatric surgeon set a "reasonably attainable" goal of 240, the lowest I had ever been in my adult life. I'm now below that and with the help of PS will be even lower. Yet my BMI is still in the 30's but people are already asking when am I ever going to stop losing, so I must look OK! LOL If you feel you're ready and you have a qualified doctor agreeing with you, go for it! P.S. The hernia and pannulectomy are being covered by insurance, I'm paying for the brachioplasty since it is considered strictly a cosmetic procedure. How they can consider these arms to be any less of a functional problem than my apron, I do not know! Good luck! Here's hoping for the best for you!! :-)
   — Anna S.

July 21, 2010
I'm going for my consultation on next Wed. 28th 2010. I've been approved for Panniculectomy and diastasis of the muscles.
   — dmohead




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