A panniculectomy is a surgical procedure to remove the pannus — excess skin and tissue from the lower abdomen. This excess skin is sometimes referred to as an “apron.”
Unlike a tummy tuck, the panniculectomy does not tighten the abdominal muscles for a more cosmetic appearance, disqualifying it as a cosmetic procedure. However, removing the excess fat can make your abdominal area flatter. The panniculectomy can also be performed alongside a tummy tuck or other abdominal procedures.
Purpose of a Panniculectomy
Excess skin can be caused by losing a significant amount of weight through gastric bypass surgery or lifestyle changes. It may also be caused by getting older, prior surgery, pregnancy, or heredity.
Your healthcare provider may recommend skin removal surgery if you have excess skin and fat on the lower abdomen that hangs over the thighs, particularly if it causes sores and rashes and interferes with daily activities like walking or personal hygiene. A panniculectomy can help prevent recurring skin irritations and infections underneath the fold of skin.
Panniculectomy may be referred to as a form of body contouring as it does result in a slimmer abdominal area. But skin removal surgery is only intended to remove the extra skin and fat and is not considered cosmetic surgery.
If your end goal is truly only appearance-related, you might consider opting for an abdominoplasty instead. This cosmetic surgery, better known as a tummy tuck, tightens the abdominal muscles in addition to removing fat.
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Who is a good candidate for panniculectomy?
After losing significant amounts of weight from exercise or surgery, people may be left with excess skin and loose tissue around the abdomen. The excess skin can cause skin rashes and irritation as well as odor from moisture.
You may be an ideal candidate for panniculectomy if:
. Excess abdominal fat causes health issues such as back pain, skin rashes, or ulcers
. You don’t smoke
. You are in good health
. Your weight has been stable for at least six months to one year
. You have realistic expectations from surgery
. You are maintaining a healthy diet
. You are physically active
Panniculectomy risks and complications
As with any surgical procedure, the panniculectomy can lead to some complications and potential risks. Some of these risks include:
. Bleeding at wound sites
. Persistent pain
. Fluid accumulation
. Blood clotting
. Nerve damage
If you begin to experience any irregular symptoms following your surgery, seek immediate medical attention.
Preparing for Panniculectomy Procedure
When preparing for panniculectomy surgery:
. Be open about your medical history to your surgeon. Let them know if you are taking any prescription or over-the-counter medicines.
. Beware of certain medications. Your surgeon can suggest that you avoid taking herbal supplements and anti-inflammatory drugs, which may increase bleeding and make it hard for your blood to clot.
. Avoid smoking. If you do, your surgeon may ask you to stop smoking to increase your chances of healing fast as smoking slows down wound healing.
During panniculectomy procedure
A qualified plastic surgeon performs a panniculectomy. This invasive surgical procedure that can last up to five hours. During the surgery, an anesthesiologist will administer general anesthesia to put you to sleep.
Your surgeon will then make two incisions:
. A horizontal cut from one hipbone to the next
. In some cases, a vertical cut extending to the pubic bone
The length of the cuts depends on how much skin needs to be removed. Through the incisions, the surgeon will remove excess fat and skin. The remaining skin and tissues are then pulled together and closed with stitches, and the incision areas are taped. Doctors may insert drains during the procedure to remove excess fluid.
In some cases, the belly button may be removed or repositioned. Your doctor will advise you of this in a consultation before making the decision in surgery.
In most cases, a panniculectomy is an outpatient surgery. But depending on the extent of your procedure, you may be required to stay overnight for observation and proper healing. Within your pre-consultation, your surgeon will advise you to have someone drive you home after surgery and help you for the first few days. There should be no heavy lifting or strenuous activities for a few weeks following your procedure.
If you have drains, your healthcare provider will give you instructions for care, including how to record the amount of fluid in the drains and how to empty them.
Your incision will be covered with gauze dressing or bandages. After a day or two, your healthcare provider may have you wear an elastic support or compression garment to help support the abdomen as it heals.
Panniculectomy patients can expect pain and discomfort from swelling and bruising at the incision sites. Your stitches may be removed within a week while deeper sutures dissolve on their own. Complete recovery will take months and you will be required to have follow-up appointments with your doctor to ensure lasting results.
To help take some pressure off the abdomen, try keeping your legs and hips bent while resting. Your healthcare provider may recommend waiting to shower until 48 hours after the surgery. It may take up to three months for the swelling to go down and for the wounds to completely heal.
Patients are generally pleased with results and often lose 5–10 pounds from the surgery. Some patients may notice improvement in their physical activity and personal hygiene.
The panniculectomy surgery is seen as a medically necessary procedure to remove excess fat from your abdominal area. This excess fat or pannus can cause ulcers and irritation and affect your physical activity.
The panniculectomy is not a cosmetic procedure, but it can be performed alongside cosmetic and corrective surgeries to improve the look of your stomach. Discuss your options and expectations with your doctor to determine the best procedure for you.