In Ontario, patients who have abdominal skin that hangs over the groin crease and have a history of bad skin infections or other complications can ask their surgeon to apply for insurance (OHIP) coverage of a panniculectomy (removal of a skin apron). Depending on the severity of the pannus, this can be a life-saving operation, and at minimum will dramatically improve your quality of life. The operation is not intended as a cosmetic procedure, and we are careful to demonstrate at our consultations the limits of a panniculectomy and the benefits of adding an abdominoplasty (cosmetic) to the procedure. An abdominoplasty is much less expensive if a panniculectomy is already covered. On rare occasions, we have no opportunity to perform a cosmetic procedure (if the pannus is too large or infected), and we have to defer the cosmetic procedure to a second operation.