Weight management options have evolved:

What is a panniculectomy?

A panniculectomy is a surgical procedure to remove the pannus — excess skin and tissue from the lower abdomen. This excess skin is sometimes referred to as an “apron.”

Unlike a tummy tuck, the panniculectomy does not tighten the abdominal muscles for a more cosmetic appearance, disqualifying it as a cosmetic procedure. However, removing the excess fat can make your abdominal area flatter
Since the panniculectomy is not typically seen as a cosmetic surgery, your insurance provider may help pay for the procedure. But, you must meet specific criteria, and the panniculectomy must be seen as a medical necessity.

Who is a good candidate?
After losing significant amounts of weight from exercise or surgery, people may be left with excess skin and loose tissue around the abdomen. The excess skin can cause skin rashes and irritation as well as odor from moisture.

You may be an ideal candidate for panniculectomy if:

excess abdominal fat causes health issues such as back pain, skin rashes, or ulcers
you don’t smoke
you are in good health
your weight has been stable for at least six months to one year
you have realistic expectations from surgery
you are maintaining a healthy diet
you are physically active
Panniculectomy procedure
A qualified plastic surgeon performs a panniculectomy. This invasive surgical procedure that can last up to five hours. During the surgery, an anesthesiologist will administer general anesthesia to put you to sleep.

Your surgeon will then make two incisions:

a horizontal cut from one hipbone to the next
in some cases, a vertical cut extending to the pubic bone
The length of the cuts depends on how much skin needs to be removed. Through the incisions, the surgeon will remove excess fat and skin. The remaining skin and tissues are then pulled together and closed with stitches, and the incision areas are taped. Doctors may insert drains during the procedure to remove excess fluid.

In some cases, the belly button may be removed or repositioned. Your doctor will advise you of this in a consultation before making the decision in surgery.

Panniculectomy recovery
In most cases, a panniculectomy is an outpatient surgery. But depending on the extent of your procedure, you may be required to stay over night for observation and proper healing. Within your pre-consultation, your surgeon will advise you to have someone drive you home after surgery and help you for the first few days. There should be no heavy lifting or strenuous activities for a few weeks following your procedure.

Panniculectomy patients can expect pain and discomfort from swelling and bruising at the incision sites. Your stitches may be removed within a week while deeper sutures dissolve on their own. Complete recovery will take months and you will be required to have follow-up appointments with your doctor to ensure lasting results.

Patients are generally pleased with results and often lose 5–10 pounds from the surgery. Some patients may notice improvement in their physical activity and personal hygiene.

Outlook
The panniculectomy surgery is seen as a medically necessary procedure to remove excess fat from your abdominal area. This excess fat or pannus can cause ulcers and irritation and affect your physical activity.

The panniculectomy is not a cosmetic procedure, but it can be performed alongside cosmetic and corrective surgeries to improve the look of your stomach. Discuss your options and expectations with your doctor to determine the best procedure for you.