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Tummy Tuck vs. Panniculectomy: What’s the Difference?
Feb 18, 2018

An abdominoplasty, also known as a tummy tuck, gives the abdomen a more toned appearance by tightening the abdominal muscles and removing excess skin or fat. A panniculectomy, also known as apron surgery, focuses more specifically on removing fat and skin that hangs down over the genitals and thighs, typically after massive weight loss.

The right procedure for you will depend on your treatment goals and body type. In this article, Paramus’s Dr. Gary D. Breslow of The Breslow Center for Plastic Surgery in Paramus, New Jersey discuss the main differences between these two approaches.


Understanding the Anatomy of the Abdomen

There are three basic structures involved in procedures on the lower abdomen.

  • The abdominal wall is composed of muscle and connective tissue. These structures may become lax over time, or disrupted by surgery, a hernia, or trauma.
  • Subcutaneous fat is stored on the outside of the abdominal wall. While most of us have a small pouch there, sometimes there can be very large fat deposits in this area that sag down over the groin. This is known as a “pannus” or “apron”.
  • Skin drapes the abdomen, and molds to the underlying fat. This skin does not provides any structural support, and can become stretched after pregnancy or significant weight loss.

Abdominoplasty and Panniculectomy: Key Differences

While these two procedures are in many ways similar, a panniculectomy only removes excess, hanging skin. There is no impact on weakened or separated muscles in the abdominal wall.


  • Is mainly performed for cosmetic reasons, to attain a more flattened abdomen.
  • Addresses excess skin in the upper and/or lower abdominal area, as well as weakened or separated abdominal muscles.
  • In many cases, liposuction is also performed to eliminate excess belly fat.


  • Is considered a functional procedure, as it improves mobility and addresses skin concerns caused by chafing.
  • Focuses on the pannus, an apron-like flap of skin and fat in the lower abdomen area that can hang down over the groin.
  • Is often performed along with other body contouring procedures.

During abdominoplasty surgery in Paramus, incisions are made above the panty-line and around the belly button.

The skin is detached from the abdominal wall, giving access to the tissue underneath, which is tightened using sutures. Excess skin is removed, the belly button is repositioned, and the skin is pulled taught and sutured.

Sometimes liposuction is also performed on the flanks, along with other minor aesthetic revisions that your surgeon will discuss with you in advance.

During panniculectomy surgery, similar techniques are employed to address the excess skin and fat layers in the lower abdomen area, without repairing any muscle separation. Because there is usually a significant amount of excess tissue, a vertical incision may also be performed.

In essence, an abdominoplasty is a cosmetic procedure for the upper and lower abdomen, whereas a panniculectomy is a functional procedure for the lower abdomen that focuses on excising the abdominal apron.

tummy tuck exercise

RELATED: The Dos and Don’ts of Exercising After a Tummy Tuck

Does Insurance Cover Panniculectomy Surgery?

Your insurance will sometimes cover a panniculectomy for health reasons if the pannus results in skin rashes and interferes with your daily activities.

Some patients may develop a hernia, which occurs when tissue protrudes through a weakening in one of the muscle walls that enclose the abdominal cavity. This can often be repaired at the same time as a panniculectomy or tummy tuck and may be covered by insurance, although it’s unlikely to change the cost of the procedure significantly.

What Are the Potential Risks?

While these procedures are very common and the risks are low, any surgical procedure carries the risk of scar formation, infection, and body fluids collecting at the site of the operation.

More rarely, these procedures can lead to localized numbness, deep vein thrombosis, or persistent pain. In the case of panniculectomy, if there is a lot of residual weight patients may experience delayed wound closure and a resulting scar.

It’s important to have a clear goal and understand your options before considering either operation. The best procedure for you will depend on your body, your overall health, previous surgeries, and your desired aesthetic and functional outcomes. This should be discussed in a consultation with an experienced plastic surgeon.

Drs. Gary D. Breslow and Jordan P. Farkas have successfully performed abdominoplasty and panniculectomy procedures on numerous patients from New Jersey and beyond — feel free to reach out to us for a consult if you feel that one of these procedures may be right for you.

Additional Reading and References

About the Author

Dr. Gary Breslow, MD, FACS

Dr. Gary Breslow, MD, FACS

Is a highly regarded plastic surgeon in Paramus New Jersey, known by both patients and peers as a problem-solver with a warm, engaging personality, and an instinctive ability to identify and truly understand the goals of his patients and the patients, themselves. Dr. Breslow has dedicated his efforts to providing results of only the most unsurpassed quality, continually staying abreast of the most advanced techniques in cosmetic surgery for the benefit of his patients. Dr. Breslow is Board-Certified by the American Board of Plastic Surgery, is a member of the American Society of Plastic Surgeons, is a Fellow of the American College of Surgeons, and is licensed to practice plastic & reconstructive surgery in both New Jersey and New York.

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