Panniculectomy
A panniculectomy is performed to remove a panniculus, which is an “apron” of excess skin and fat hanging from the lower abdomen.
Panniculectomy is different from abdominoplasty, which, in addition to removing excess skin and fat, tightens the abdominal muscles. Abdominoplasty is considered a cosmetic procedure; panniculectomy is not, because a panniculus can cause medical problems and interfere with everyday activities. Candidates for panniculectomy have typically lost a large amount of weight through gastric- or intestinal-bypass surgery, or changes in nutrition and fitness habits, or are normal-weight women who have excess skin post-pregnancy.
A panniculus is graded on a scale from one to five. A grade one panniculus extends to the pubic hair but does not cover the genitals; a grade five extends to the knees or lower.
The Panniculectomy Procedure
During panniculectomy, which is performed under general anesthesia in a hospital or outpatient surgery center, the surgeon typically makes two incisions: one across the mid-lower abdomen, and one that runs horizontally across the pubic area. Excess fat and skin are removed through the horizontal incisions. This is a skin-only excision to remove the “apron” and does not involve the umbilicus or the skin above it. Drains are usually inserted to prevent fluid from accumulating. Panniculectomy takes 2 hours to complete.
Recovery from Panniculectomy
The amount of time required to recover from panniculectomy is significant. Immediately after surgery, pain, swelling, and bruising are present, and pain medication is prescribed. Patients are encouraged to walk post-surgery, but must avoid other activities until sufficient healing has occurred, usually after 6 weeks. Roughly 90% of panniculectomy patients go home the same day with 10% staying in the hospital overnight.
Risks of Panniculectomy
In addition to the risks associated with surgery and anesthesia, those related to panniculectomy include the following:
Seroma (fluid accumulation under the skin)
Skin separation
Reduced sensation in the treatment area
Unsightly scarring
Discolored skin
Loose skin
Blood clots
Bleeding/Transfusion
Because panniculectomy is not considered a cosmetic procedure, it may be covered by insurance.
Procedures
Abdominoplasty
Blepharoplasty Eyelid Surgery
BOTOX ® Cosmetic
Brachioplasty
Breast Augmentation
Breast Augmentation with Breast Lift
Breast Reconstruction
Breast Reduction
Cheek Implants
Chemical Peels
Chin Augmentation
CO 2 Laser Skin Resurfacing
Dermabrasion
