Panniculectomy

Overview

Panniculectomy is a surgical procedure designed to remove excess skin from the lower abdomen. This operation is different from an abdominoplasty because it is intended solely to relieve symptoms related to an overhanging apron of skin and is not considered a cosmetic operation. The procedure involves a scar that is located across the lower abdomen

Who Is a Candidate?

Patients of any age with an overhanging apron of skin on the lower abdomen may be candidates for this procedure. Symptoms may include:

• Skin irritation
• Fungal infections
• Lower back pain

Some patients with an apron of skin also may be candidates for a standard abdominoplasty. Patients with a lower body mass index at the time of surgery will get better results. Some insurance companies cover this operation. You should check with your individual insurance carrier to see what the requirements are for coverage (i.e., three months of prescription creams or oral antibiotics).

Before the Procedure

Your plastic surgeon will perform a comprehensive evaluation of your abdomen, including any scars from previous surgery. 

Some of the specific instructions you'll receive about preparing for surgery include:  

• Smoking cessation
• Medications to avoid
• When to take your prescribed medications
• Proper washing techniques
• Restrictions regarding eating and drinking the night before surgery

Procedure Details

Your plastic surgeon will listen carefully to your concerns about excess skin on your abdomen and your surgical goals and expectations. The length and position of the scar on the abdomen will be discussed, and the surgeon can draw the approximate scar location on your skin with a medical marker. Risks and benefits specific to this procedure will be discussed in greater detail at your initial consultation.

In addition to the panniculectomy evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

• Your blood pressure
• Bleeding tendencies
• History of adverse scar formation after previous surgeries

Where Will the Surgery Be Performed?

A panniculectomy usually is done in a hospital as outpatient surgery or it can involve an overnight stay. You must be driven to and from the hospital by a friend or family member.

Type of Anesthesia

Panniculectomy is performed under general anesthesia.

Immediate Postoperative Recovery

In most cases, patients will experience pain in the abdomen for the first 24 to 48 hours; a compressive binder is placed around the abdomen.

Short-term Recovery

In most cases, you will be able to go out in public in four to five days. You should stay flexed at the waist for several days. Showering is permitted within the first several days.  Vigorous physical activity is limited for four weeks following surgery. 

Risks

A panniculectomy removes skin on the lower abdomen, but involves a permanent scar and is considered major surgery. This operation will not correct loose skin on the upper abdomen, and the belly button may not be preserved. Portions of the wound may be slow to heal and require treatment with gauze dressings. In addition to the risks associated with anesthesia, infection and bleeding may occur with panniculectomy, but at a low frequency.

In some cases, a collection of fluid (called seroma) may occur under the skin and require drainage in the surgeon’s office.  Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to surgery.

Anticipated Results

Panniculectomy is expected to remove the apron of skin from the lower abdomen and relieve symptoms of skin rash and irritation.