Panniculectomy: Everything You Need to Know

Looking up excess skin removal surgeries, you’ll either get a panniculectomy or tummy tuck. Both surgeries achieve the same goal, so how do you know which is the right surgical treatment for you. Many wrongly assume that panniculectomy is the same as a tummy tuck. Panniculectomy is not a “medical term” for a tummy tuck; it is a different surgery. A tummy tuck is also known as abdominoplasty.

Both the surgeries involve the removal of excess, hanging skin and fat from the lower abdomen. But, one surgery is a medical necessity, while the other is cosmetic surgery. So, which surgery should you get after going through a major weight loss journey? For that, you need to know what panniculectomy is and how it is different from a tummy tuck. So, let’s get into it.

What Is Panniculectomy Surgery?

In a panniculectomy, the aim is the removal of excess fat and skin that hangs from the lower belly. This skin flap is known as the panniculus (not pannus). To determine whether a candidate is suitable for a panniculectomy, there is a grading scale from 1 to 5. It essentially measures how far down the skin hangs from the abdomen.

  • 1st Grade: the panniculus extends to the public hairline.
  • 2nd Grade: the panniculus extends to the public mound, also known as mons pubis and the genitals (pubic area).
  • 3rd Grade: the panniculus extends to the upper thigh.
  • 4th Grade: the panniculus extends to the middle of the thigh.
  • 5th Grade: the panniculus extends beyond the knee.

Grade 5 is the most severe and significantly impacts the daily life of the individual. The skin can also cover the hip area. Thus, the person isn’t able to walk, drive, sit, stand, or exercise comfortably. Also, constant chafing results in skin rashes.

The skin become more vulnerable to infections due to the accumulation of sweat and grime. It is also difficult to clean because of the skin folds. Other than that, it can cause back pain, irritation, sores, abscess, and ulcers. That is why the surgery is elective.

How Much Weight Can You Lose With A Panniculectomy?

According to the American Society of Plastic Surgeons, a panniculectomy is not a weight loss surgery in itself. Also, it does not get rid of the stretch marks unless they’re in the excision area. The patients who do get this surgery should have achieved a stable weight. Moreover, they need to maintain a healthy weight after the surgery. It is also recommended that women delay having a panniculectomy until they don’t plan to have any more children.

How much weight a person loses after a panniculectomy surgery depends on how much excess skin and fat is removed. On average, a person can lose 5-10 pounds from it. One study published in the journal of Plastic and Reconstructive Surgery showed that in patients who had lost more than 50% weight, panniculectomy further reduced the weight by 16 pounds.

Who Is A Good Candidate for Panniculectomy Surgery?

Those who have gotten gastric bypass or bariatric surgery usually get this surgery. If you had bariatric surgery, you can have a panniculectomy after a year. But, in some cases, the panniculus becomes very problematic, so you may want the surgery after a few months.

Those who have had a massive weight loss also get this surgery. Excess skin and fat are also a part of the post-pregnancy body. But, when the overhanging skin is in excess, a panniculectomy is suitable. The surgery aims to restore normal body functioning and movement. And yet, through panniculectomy, body contouring can also be achieved. If you’re having these problems, you should get medical advice, diagnosis or treatment. Persistent skin infections and infections make this surgery necessary.

Other than that, you need to be in good health. Those with diabetes, lung or heart disease cannot get this procedure. Moreover, you should not smoke, as it results in poor blood circulation. This delays wound healing after the procedure(s). You need to have realistic expectations from the surgery. You need to have a consultation with the surgeon before the procedure.

Panniculectomy Vs. Abdominoplasty

It’s commonly asked, “are panniculectomy and tummy tuck (abdominoplasty) the same?” Let’s find out.

Panniculectomy Tummy Tuck
Procedure Invasive surgery to remove excess skin and fat for medical reasons.  Invasive surgery to remove excess skin and fat and tighten the abdominal muscles for aesthetic reasons.
Suitability Suitable for people who have lost massive weight or had bariatric surgery and are dealing with skin problems and back pain from the panniculus. Suitable for people who are unable to get rid of excess fat and skin after diet and exercise. Takes care of loose skin after pregnancy. 
Surgery Time Panniculectomy can take between 2-5 hours. Tummy tuck can take between 2-5 hours.
Results They’re permanent.  Results are permanent. 
Recovery It can take two months.   The process can take 1-2 months.
Cost Panniculectomy is more expensive. It can cost between 5,000-10,000 GBP. Tummy tuck is cheaper. It can cost around 2,000 GBP.

It is possible for you to get both panniculectomy and tummy tuck surgery. It’s the latter that helps with body contouring.

What is the Procedure of Panniculectomy?

The surgery takes place under general anaesthesia, so it is painless. The surgeon will make two incisions:

  • Horizontally from one hip bone to the other between the pubic area and below the belly button. The incision’s length varies according to excess skin and tissue that needs removal.
  • In some cases, a vertical incision is made if the skin and fat are located transversally.

The surgeon will remove excess skin and tissue and then pull down the skin from the top for suturing. You may have some drains in the surgical area to get rid of excess fluid.

Is Recovery Painful?

It depends on the pain threshold of the patient. Usually, patients do feel pain after the surgery. The surgeon provides painkillers and antibiotics to the patient to avoid possible complications. Other than that, they may experience swelling, bruising, numbness and bleeding. It can also result in permanent scarring, which will fade with time.

You’ll have sutures after panniculectomy surgery. So, be careful not to stretch, bend or exert your body. You may feel pain around the incision when you stand or move around. Your doctor will suggest that you start taking short walks after some time. Blood circulation helps with recovery.

What Are the Risks and Complications of Panniculectomy Surgery?

Every surgery comes with the risk of certain complications. It’s important to know about them before the panniculectomy surgery. You may have:

  • Loose skin again, thus a need to redo the surgery
  • Infection
  • Nerve damage
  • Seroma (accumulation of fluids)
  • Poor wound healing
  • Permanent scarring

How Can You Eliminate the Risk of Complications After Panniculectomy Surgery?

For that, you need to find a board-certified, experienced surgeon who can perform the surgery well. The surgeon will take time to learn about your goals and expectations from the surgery. And s/he’ll study your medical history. Sometimes, a patient is more suitable for another surgery. The medical practitioner will discuss those treatment options with you.

Once the surgery’s done, it comes down to you to take care of your body. Make sure that you follow the aftercare instructions. You need to rest and not start exercising. No strenuous activities should take place for at least a month after surgery. You should maintain your body weight after recovery. The scarring after the surgery can take 1-2 years to fade. It may be significant even after the first year.

Make sure that you maintain good personal hygiene. The incision line is vulnerable to infections. Thus, you should pay special attention to the area and make sure that it’s clean. Lastly, make sure that you’re eating and living healthy.

The Takeaway

Panniculectomy is a surgery that’s medically necessary. That’s excess skin and fat inhibits normal functioning. Moreover, it can cause skin rashes, infections, ulcers, and back pain.

Panniculectomy surgery is also not the same as a tummy tuck. A tummy tuck helps with body aesthetics by contouring. But, in this too, the surgeon removes excess skin and tissue. Still, there are differences between the two surgeries.

After the surgery, you need to make sure that you maintain your body weight. If it fluctuates too much, there’s a chance that you’ll end up with loose skin again. If you’re planning to have more children, you should delay the surgery. Make sure that before deciding on anything, you talk to your doctor about it.

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