Cosmetic Abdominoplasty and Panniculectomy

Doctor drawing preoperative marking on patient abdomen closeup - Cosmetic abdominoplasty and panniculectomy blog

Excess skin and fat in the abdominal region is a common reason for patients to seek consultation with a plastic surgeon. Some patients are bothered by the appearance of loose skin in the midsection. Others have significant loose skin that causes skin irritation and at times recurrent fungal or bacterial infections (panniculitis). Two procedures that are used for improvement in abdominal contour are a cosmetic abdominoplasty and a panniculectomy. However, the indications for each procedure differ.

Cosmetic Abdominoplasty

Commonly referred to as a “tummy tuck”, cosmetic abdominoplasty is a procedure that targets the entire anterior abdomen. Loose skin and fat are surgically removed and if needed, the abdominal wall muscles are tightened. The surgical incision is hidden in the bikini line. This is an aesthetic procedure not covered by insurance.

Patients who have lost significant weight or have loose skin after pregnancy opt for this procedure to achieve a more toned, flat abdomen. Liposuction may be offered to address localized fat deposits which can improve the overall aesthetic result.


A panniculectomy is a surgical procedure that addresses the excess skin and fat that hangs from the lower abdomen, called a pannus. This excess tissue may result in chronic, recurrent skin irritation in the fold of the pannus which may require medical treatment. Because this procedure is used to treat a medical condition, it is considered medically necessary. Thus, your insurance may cover it if specific criteria are met.

During a panniculectomy, excess skin and fat are removed. There is no tightening of the underlying muscles and excess skin and fat in the upper abdomen is not addressed. The surgical scar may extend from hip to hip, but can be relatively high compared to cosmetic abdominoplasty. Although there will be some improvement in abdominal contour with a panniculectomy, the overall aesthetic result will be less than seen with a cosmetic abdominoplasty.

Which Procedure is Right for me?

The choice between an abdominoplasty and panniculectomy depends on your goals. If your primary concern is addressing loose skin in the lower abdomen and improving comfort, then a panniculectomy may be the right choice for you. However, if you want a flatter, more contoured upper and lower abdomen, then you should consider an abdominoplasty.

If you are thinking about an abdominal contouring procedure, consider consulting with one of our board-certified plastic surgeons. They will evaluate your specific situation and guide you in making a decision that will help you achieve your desired results. Contact us to learn more.