Panniculectomy

[Kikiphiasmom 44]

So I had my panniculectomy surgery on June 7' date=' so I am appox. 4 weeks post op right now and could not be happier...the entire surgery procedure was so smooth. I woke up feeling great, didn't even have a bruise on my hand from the IV, and was home recovering by 1pm that same day. Total skin and fat removed was 5.5 lbs!

Pain was minimal. I had 2 drains and an automatic internal pain pump. Swelling scared me a bit, but at week 3 when it started going down I was very pleased with the final result. The drains were a pain, literally. I went back after week one to have them removed and surgeon decided to keep them in another week for swelling to subside more. I wanted to kill him and week two sucked but at least I was able to shower. Maneuvering around with those drains was so frustrating.

Now I'm back to work. Still need to wear compression garment for a few more weeks until final swelling is gone. I feel like a new person. I keep looking down and can't believe it's gone. My pants are flat in the front! I still get surprised everytime I look at my stomach. It was so worth it and can't believe it was free (covered by Kaiser!).

I don't know if I had a great surgeon or what, but the result is almost as good as a Tummy Tuck. I expected a lot more fat to be left at the top. There is some, but not an over-hang. I was also surprised how tightly it was lifted from the bottom up! I'm extremely happy to finally be flat! Dream come true! [/quote']

Who was your plastic surgeon ... I'm 3 years out and have only lost about 80_90 lbs .. I still have about 30-50 to lose. Dr. Zane was also my sleeve surgeon. My question to you is what did you do to be referred also do you really have to be at 30 BMI ? I'm still at 33 I think. Either way can you let me know what steps you took to get approved? I read on here that another patient was denied the panni? My apron is down to my public area and I can literally stretch my skin any which way lol ... any help or advice would be great .

[CamarilloCA 41]

Maura, I am going to Kaiser today for a breast reduction class, and I will ask what is needed to get a panni. I do believe that you would qualify given what your described is going on with your loose skin. I think all you need is for your primary care physician to send a referral to Plastics for you. Ask him to do that for you.

[CamarilloCA 41]

I went to the group class yesterday at Woodland Hills. They hand you a booklet, which you can read in about ten minutes, and then they go over each item in the booklet and present each page with slides and a slide presentation.

There really wasn't much that I didn't know already, but here is the gist of it:

1. If your BMI is over 30, you have to lose weight to get below a BMI of 30 before you can have a breast reduction.

2. You have to have a medical problem in order to qualify for surgery. Medical problems include a rash, disproportionate breasts, and shoulder grooves from bra straps that have dug in over the years.

3. Kaiser does not cover breast lifts as that is a cosmetic surgery; however, they do cover breast reductions, which is a surgery that removes tissue, skin, and fat and lifts the breast.

4. A panni and breast reduction can be done at the same time but often is done separately.

5. A breast reduction is a same day surgery, and you will go home that day.

6. You will have two drains and have to wear a zip front sports bra for the week or two and no underwire bras for six months.

7. It is important to be at your goal for a panniculectomy but not for a breast reduction.

8. In order to qualify for a panniculectomy, you must have an apron that hangs down below your genitals.

9. In order to qualify for a breast reduction, you must have 1 pound of tissue to remove on each side.

That last one, having a pound of tissue, fat, and skin on each side upset me. The nurse said that, if you don't have a pound on each side (equivalent to a pound of butter), that you could end up having to pay for the surgery yourself. She said that the surgeon literally weighs the amount he takes off you at the surgical table. She said that the rules are strict about this.

This upset me because I have lost 100 pounds from my heaviest weight and have breasts that sag down to infinity and beyond, and I have a terrible rash, but it is mostly skin, and I'm not at all sure that I have a pound on each side to remove. After the meeting, I went up to her, and she looked at me and said, "You don't have enough material to remove. Talk to her."

By "her," she meant the physician's assistant from the Plastic Surgery department that had come to the class to answer any questions. I went up to her and told her of my concern of not having a pound on each side, and she said, "We don't go by that. It's more about fixing whatever medical problem you have." What a relief.

The nurse running the class said that if anyone needs a breast lift they could have it done at cost through West L.A. and that it runs about $5000-$6000. I think she meant the Hollywood Kaiser.

The nurse said that Plastics will call for a consulation appointment at which time the surgeon will examine you to determine if you are a candidate. You can also request a particular surgeon, but you may have to wait months if that surgeon is in demand.

[HalfTheWoman 107]

Hey Sophia -- I just had a Tummy Tuck and a breast lift/augmentation done 2 weeks ago. I didn't need the panny b/c my skin wasn't *that* bad -- just a regular tummy tuck. the Panny is usually done when the skin hangs below the genital area. Tummy tuck is done with loose/stretched skin/muscles from pregnancy and lots of weight loss. Essentially they're the same surgery, but the panny is more extreme and takes longer (both in surgery and recovery). I had very little pain and recovery has been really simple so far. Look at my link to my youtube videos to see me talk about my plastics

Can you give me the link to your Youtube video?

[CamarilloCA 41]

For those that are following my progress on the breast reduction/lift, it looks like I don't qualify. Ironically, there isn't enough material for them to remove. According to the doctor, the rules set by Kaiser is that 400 grams of material has to be removed from each breast in order for a woman to qualify for reduction surgery, which includes a lift. Kaiser doesn't cover lifts alone even if you have a medical reason for a lift like a ever-present rash like I have. Since I have lost 100 pounds from my heaviest and 75 since my sleeve surgery, I have virtually no fat there. It is all skin, and that means that I don't have enough to remove. Had I gone in a few months earlier, I probably would have qualified. So I guess I just have to live with the rash that won't go away. I am going to try to file a grievance to see if that gets me anywhere. The doctor also said that plastic surgeons at Kaiser Woodland Hills will be able to perform cosmetic procedures at cost for Kaiser patients in about six months. The cost of a lift would probably be around $5000-$6000.