What is Panniculectomy & Who is the Ideal Candidate?|Procedure, Recovery, Complications, Prognosis of Panniculectomy

Cosmetic surgeries have become very popular today with more and more women and men turning to such surgeries for improving their appearance, or sometimes, as a medical necessity. A panniculectomy is an invasive surgical procedure that removes the excess skin and tissue from the abdomen after weight loss. It is quite similar to a tummy tuck, but unlike a tummy tuck (which is done solely for cosmetic reasons, a panniculectomy is generally done as a medical necessity. Hence, this surgery does not really qualify as being a cosmetic procedure. Read on to find out about what is a panniculectomy and what the procedure involves.

What is a Panniculectomy?

A panniculectomy is an invasive surgical procedure that removes the excess skin and tissue from the lower abdomen that is usually left behind after significant weight loss. The excess skin is sometimes also known as an ‘apron’ or the pannus.

While the panniculectomy is very similar to a tummy tuck, the main difference is that a panniculectomy does not tighten the abdominal muscles as a tummy tuck does for giving a more cosmetic appearance. This is why a panniculectomy is not considered to be a cosmetic procedure. Nevertheless, removal of the excess fat will make you get a flatter abdominal area. It is also possible for your surgeon to perform a panniculectomy alongside a tummy tuck or any other abdominal procedure.

A panniculectomy can cost anywhere between $8,000 to $15,000. This cost covers not only the procedure cost, but also the cost of anesthesia, facility fees, and surgeon fees as well. A panniculectomy is not considered to be cosmetic surgery, and due to this, many insurance providers agree to pay for the procedure. However, you need to meet certain criteria in order to have the insurance company cover your costs. Also, the panniculectomy has to be considered as a medical necessity in order for the insurance company to cover the cost. You have to contact your insurance provider to discuss the payment modalities.(1)

Ideal Candidate for a Panniculectomy

When people lose a significant amount of weight either from surgery or through exercise, they are usually left with a lot of excess skin and loose tissue hanging around the abdomen or the belly area. This excess skin is known to cause problems such as irritation and skin rashes, and sometimes odor also starts emanating from moisture being trapped under the skin.

However, not everyone proves to be a good candidate for panniculectomy. You may be considered to be an ideal candidate for this surgery if you meet the following criteria:

  • Your excess abdominal fat is causing health issues such as skin rashes, ulcers, or back pain
  • You are not a smoker
  • You are in good overall health
  • You are physically active
  • You consume a healthy and nutritious diet
  • You have been maintaining a stable weight for the last six months to a year
  • You are aware of what the surgery will involve, and you have realistic expectations from the procedure

Procedure of a Panniculectomy Surgery

A panniculectomy is performed by a qualified plastic surgeon. It is an invasive surgical procedure that might last up to five to six hours. During the surgery, you will first be administered general anesthesia by an anesthesiologist that will put you to sleep.(2)

Once the panniculectomy surgery begins, your surgeon will proceed to make two incisions:

One will be a horizontal cut from your one hipbone to the next

The other, in some cases, will be a vertical cut that extends to the pubic bone

The length of these incisions depends on how much excess skin has to be removed. Your surgeon will remove the excess skin and fat through these incisions itself. The remaining tissues and skin are then pulled back together and closed up with stitches. The incision areas are also taped up. Some doctors may put in drain tubes during the procedure in order to help remove any excess fluid.

In some cases, it might become necessary to remove or reposition your belly button, though it is quite rare. If this is the case, then your surgeon will typically advise you of what will be involved before taking this decision suddenly during the surgery.

Recovering from a Panniculectomy

A panniculectomy is typically an outpatient surgery, though depending on what is the full extent of your procedure, you might sometimes be required to stay overnight in the hospital for proper healing and observation. During your pre-consultation, your surgeon will recommend that you should have someone to drive you back home after the surgery and also for helping you around the house for the first couple of days following the surgery. You need to avoid all types of heavy lifting or any type of physically strenuous activities for the next couple of weeks after your surgery.

Patients who have undergone a panniculectomy should expect to experience pain and discomfort from the bruising and swelling present at the incision sites. In fact, many patients find the pain to be quite severe during the first few days after the procedure, and your doctor will prescribe you with pain medications to deal with the pain.

The stitches are usually removed within a week or ten days. The deeper sutures will dissolve on their own.

Complete recovery from a panniculectomy procedure can take several months to a year, and you will need to have follow-up checkups or appointments with your doctor to ensure that you are healing properly and that the surgery has led to lasting results.

A majority of patients are usually pleased with the surgery results and tend to lose 5 to 10 pounds from the surgery. Some patients might also notice a significant improvement in their personal hygiene and overall physical activity.

What are the Complications of a Panniculectomy?

Similar to any surgical procedure, there can be some complications and potential risks from a panniculectomy as well. Some of these risks may include:

  • Bleeding from the incision sites
  • Scarring
  • Swelling
  • Numbness
  • Persistent pain
  • Infection
  • Blood clotting
  • Fluid accumulation
  • Nerve damage

If you start to experience any type of irregular symptoms after the surgery, you should inform your surgeon immediately.

Conclusion – What is the Outlook for a Panniculectomy Surgery?

A panniculectomy surgical procedure is considered to be a medical necessity for removing the excess fat from the belly area. This excess fat is also known as pannus and can be a potential cause for irritation, ulcers, and other medical conditions. It also affects your ability to do any physical activity.

The panniculectomy is not to be treated as a cosmetic procedure, even though it is performed by a plastic surgeon. This surgery can also be performed alongside any other corrective and cosmetic surgeries to improve the overall look of your stomach. In order to find out the best procedure for yourself, you should discuss all your options and expectations with your surgeon before deciding on the surgery.

References:  

  1. Pratt, J.H. and Irons, G.B., 1978. Panniculectomy and abdominoplasty. American Journal of Obstetrics and Gynecology, 132(2), pp.165-168.
  2. Gallagher, S., 2004. Panniculectomy: More than a tummy tuck. Nursing2019, 34(12), pp.48-50.

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