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What Is A Panniculectomy?

A panniculectomy is a surgical procedure in which excess skin and fat (a pannus) from the abdomen is removed. This is generally done to help relieve rashes in the abdominal folds and back pain from the strain of the weight of the abdominal pannus.

Unlike in a tummy tuck, the six-pack muscles are not tightened to flatten the stomach area. The umbilicus may or may not be preserved depending on how much skin and fat need to be removed.

Panniculectomy is a reconstructive surgery that may be covered by your insurance plan. Patients may also opt to pay cash to complete the tummy tuck portion. This will involve tightening the six-pack muscles and preserving the belly button at the same time as the panniculectomy.


Who is a Good Candidate for a Panniculectomy?

Panniculectomy patients may vary widely in terms of their physical condition. Some patients may be skinny and have extra sagging skin after their weight loss. Others may be fairly obese and have difficulty cleaning the areas beneath their pannus folds. This is what typically leads to recurrent rashes and skin breakdown.

Unfortunately, many patients who need to have a panniculectomy performed find that the large pannus has prevented them from working out or exercising for a long time. This can make their weight issues worse over months or years. The weight gain can lead to multiple other health problems, including high blood pressure (hypertension), high cholesterol, diabetes, etc.

Patients looking to get a panniculectomy should ideally optimize their health. They should improve their diet and try to lose as much weight as possible. Any other health issues should be addressed by their primary care provider before surgery. However, Dr. Nguyen understands that there are often limitations to what patients can do before surgery.


panniculectomy patient prior to surgery

Panniculectomy patient prior to surgery.


How Do I Prepare for a Panniculectomy?

As mentioned above, patients will have the best results if they obtain their lowest possible weight prior to surgery and maintain it. Regaining weight after surgery may lead to suboptimal results. Losing weight and optimizing your health prior to surgery will reduce the risks of surgery as well.

The day before surgery, you may be asked to eat only a liquid diet and to drink a laxative. This will help you to empty your bowels so that your surgeon will be able to tighten your abdomen as much as possible during surgery.


What is Involved in the Panniculectomy Surgery?

Panniculectomies generally take anywhere from 2 to 4 hours to complete. Patients are placed under general anesthesia for the entire case.

A large incision is made from hipbone to hipbone. A "flap" of skin and fat is elevated from the underlying abdominal muscles. The belly button may be removed with the extra skin and fat if a large amount of tissue needs to be removed. The flap of skin and fat is then pulled down to the lower incision. The excess tissue is cut off. The incisions are repaired, and drains may be left to remove any fluid under the flap as it heals.

If you paid for a Tummy Tuck to be performed at the same time, some additional steps are included. The rectus muscles are sewn together in the midline to create a firmer, flatter abdomen as well as a narrower waistline. The belly button is also preserved and brought out through the flap into its new position.


panniculectomy specimen

Excited for the largest panniculectomy specimen we've ever removed - over 10 lbs! She's going to feel great!


What is the Recovery After a Panniculectomy?

Most patients will be able to go home the same day. Occasionally, an overnight stay in the hospital is required. This is more common if you have many medical problems.

Recovery time can range from 3 to 6 weeks, depending on the patient. Patients will have to stay flexed at the hips in a "beach chair" position for several days. After that, they will be allowed to slowly straighten their abdomens (this allows for proper healing before stretching out the incision). There may be a drain in place that is usually removed within 1-2 weeks as drainage decreases.

A scar will form from one hip to the other where the incision was placed. Over time, the incision generally softens and fades. Usually it is low enough to be hidden within underwear or a bikini. Scar massage starting at 3 weeks will help to soften it faster, and silicone gel or strips may be of use with any hypertrophic scars.

It is very important to maintain your weight with diet and exercise after surgery in order to maintain your results. Many patients will find this easier to do after the surgery once the pannus is no longer in the way.

See full postoperative instructions here.


What are the Risks Associated with a Panniculectomy?

There are always risks associated with surgery and anesthesia, and the anesthesiologist will discuss these with you. Every effort is made to minimize them. However, risks do increase if patients have more underlying medical problems. Risks related to Panniculectomy include:

• Bleeding
• Infection
• Dehiscence - minor to major separation of the incisions that require wound care
• Asymmetry
• Suboptimal aesthetic result
• Poor scarring
• Loose skin (especially with weight fluctuation after the surgery)
• Abnormal skin sensation (most commonly in the middle lower abdomen)
• Need for revision surgery

Patients may occasionally notice that their panniculectomy scars become more raised or widened with time. These patients may benefit from a scar revision to improve the appearance.


tummy tuck, abdominoplasty, panniculectomy, plastic surgery, plastic surgeon

Before & After of Panniculectomy (Tummy Tuck portion added to flatten rectus muscles and preserve the belly button)


Always be sure to consult with a Board Eligible or a Board Certified Plastic Surgeon to determine if getting a Panniculectomy is right for you! Dr. David Nguyen would be happy to see you in consultation to walk you through the process and discuss your results. Call 657-900-5055 for a complimentary consultation today! (You may have a copay if using insurance.)



Panniculectomy Cost: Depends on the deductible with your insurance plan,

-or- starts at $7025 $5550 (Limited Time Only Cash Price!)


See More Panniculectomy and Abdominoplasty Before & After Photos




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