What is a Panniculectomy?
A Panniculectomy is an extended type of abdominoplasty (tummy tuck) that removes the panniculus or skirt that hangs on the lower abdomen. The skin has been stretched from carrying excess weight. It can be a result of obesity or the result of loose tissue after pregnancy or massive weight loss and can resemble an “apron” which hangs from the abdomen. There may be skin conditions associated with this hanging tissue, such as skin break down and irritation in some patients. This tissue can be removed aiding in the physical movement of the patient post operatively and restoring the skin to a healthier state. Liposuction may or may not be used in conjunction with skin removal for a better cosmetic result.
Who is a Good Candidate for a Panniculectomy?
Most patients who have excess skin in the abdominal area but are not particularly concerned with tightening the abdominal muscles as in an abdominoplasty are good candidates for a panniculectomy. The typical candidate often suffers from uncomfortable symptoms like back pain or skin rashes as a result of the excess skin in the abdominal area. Most patients choose a panniculectomy after a considerable weight loss, but should ensure that they have been at a healthy and stable weight for six months to a year before undergoing the procedure. During a consultation, Dr. Maxwell will review your health history and any medications you take to see if a panniculectomy is a safe option for you. You should also be a non-smoker before the surgery, because smoking can interfere with the healing process.
Anesthesia and Sedation
A panniculectomy is performed under general anesthesia and can last up to five hours, though Dr. Maxwell will usually complete the surgery in less time.
Incision
First, a horizontal incision is made from one hipbone to the other, similar to the incision made in a tummy tuck. If necessary, a vertical incision may also be required. The length of these incisions will vary depending on the amount of skin that must be removed.
Excess Skin and Fat Removal
In addition to removing excess skin, Dr. Maxwell may also remove some fat, typically using liposuction. If necessary, the belly button may be removed and replaced for a natural-looking position.
Closure and Post-Procedure Care
Once all the necessary steps are complete, Dr. Maxwell will close the incisions with sutures and apply dressings, bandages, and compression garments.
Panniculectomy Recovery and Results
A panniculectomy is usually an outpatient procedure, meaning you can return home the same day as your surgery with a trusted friend or family member who can drive you. Swelling, bruising, and some discomfort are all normal side effects. Pain medication may be prescribed to keep you comfortable, and you should wear compression garments as instructed to reduce swelling. Most patients require about two weeks to rest and recover at home before returning to normal, non-strenuous routines, including work or school. Dr. Maxwell will schedule post-operative appointments to remove stitches and check on your healing progress and will let you know when you can safely return to strenuous activities like exercise.
After a panniculectomy, you will notice a smoother abdominal area free from loose skin and a balanced, proportionate, and flattering body contour. Symptoms like irritation from skin folds should be relieved. Swelling after surgery is typically resolved within about a month after the procedure.