A panniculectomy is a surgical procedure that removes excessive skin around the lower abdomen. The area of excess skin in this area can be known as an “apron” and can be both a cosmetic and medical issue for individuals. 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 procedure can last up to five hours and 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.
During panniculectomy, which is performed under general anesthesia in a hospital or outpatient surgery center, the surgeon typically makes two incisions: one that runs vertically from the lower portion of the sternum to the pubic bone, and one that runs horizontally across the pubic area.
Excess fat and skin are removed through the horizontal incision; skin and fat from above the belly button are pulled down and sutured in place; and the belly button is shifted to a normal position. Drains are usually inserted to prevent fluid from accumulating. Panniculectomy takes from 2 to 5 hours to complete; exactly how many hours depends on how much skin and fat need to be removed, and whether it is combined with other procedures.
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 clot
Because panniculectomy is not considered a cosmetic procedure, it may be covered by insurance.