Panniculectomy Surgery to Remove Skin After Weight Loss

A panniculectomy is a surgical procedure to remove a panniculus, or excess skin, from the lower abdomen. It is different from abdominoplasty, which, in addition to removing excess skin and fat, tightens abdominal muscles. A panniculectomy is performed to relieve symptoms that occur from an overhanging apron of skin and interferes with everyday activities. It is not considered a cosmetic procedure.

Candidates for panniculectomy typically have lost a significant amount of weight either through gastric or intestinal bypass surgery or with changes in nutrition and fitness habits. Other candidates may have the procedure due to the following:

• Fungal infections
• Skin irritation
• Lower back pain
• Excessive skin post-pregnancy

Some patients may also be candidates for a standard abdominoplasty.

Patients will be evaluated by their surgeon prior to the procedure. They will be advised as to how they should prepare. Some of the instructions include:

• Quitting smoking
• Avoiding certain medications
• Washing techniques
• Limiting certain foods or liquids
• Timing of medications

The patient will receive general anesthesia in either a hospital or outpatient surgery center. The surgeon will make an incision that runs vertically from the lower portion of the sternum to the pubic bone. Another incision will be made that runs horizontally across the pubic area. Excess skin and fat will be removed through the horizontal incision. Skin and fat above the belly button are pulled downwards and sutured in place. The belly button will be shifted to a normal position. Drains will be inserted to prevent the accumulation of fluids.

Depending on how much skin and fat are removed, the panniculectomy procedure can take from three to five hours to perform. If it is combined with another procedure, such as abdominoplasty, it may take longer. A compression binder will be placed around the abdomen after the procedure.

Patients will experience pain for up to 48 hours after the procedure. Showering is permitted in the first several days. Vigorous physical activity is limited for up to four weeks after the procedure. In most cases, patients will be able to move around in public in four to five days. Most patients may be able to return to work within two weeks of the procedure.

While there are risks with any surgery and anesthesia, the risks associated with a panniculectomy include the following:

• Accumulation of fluid under the skin
• Separation of skin
• Numbness in the surgical area
• Scarring
• Skin discoloration
• Blood clots
• Loose skin

The procedure may be covered by insurance but patients should check with their carrier to see what the requirements are for coverage.