Panniculectomy is a demanding surgery and its final results are seen after several months. Not all people are suitable for this procedure, which is strictly medical and not cosmetic.

Last update: September 22, 2021

Panniculectomy is a surgical procedure that is carried out to remove excess skin from the lower abdomen. Such excess is called a “panicle” and is almost always the result of significant weight loss.

The panniculus is also known as “pannus” or “apron.” It is an area of ​​skin that protrudes and that also contains fat. Sometimes this causes significant discomfort or creates an unpleasant appearance., for which a panniculectomy is necessary.

It is important to clarify that panniculectomy is not considered cosmetic surgery, although as an effect of this the abdomen looks flatter. The patient must meet specific medical criteria for the procedure to be performed.

When is panniculectomy recommended?

Panniculectomy is a surgical procedure that removes excess skin from the abdomen.

As already noted, the panniculus usually arises when there is a great loss of weight. Nevertheless, It also appears for causes such as pregnancy, heredity, previous surgery or aging. In those cases, the skin can lose its natural elasticity, sag, and sag.

Sometimes the panniculus covers the genitals and even part of the legs. This causes various difficulties to sanitize and even to walk comfortably. It could also lead to frequent skin irritations on the abdomen, infections, rashes, and even back pain.

In the latter cases, it is convenient to perform a panniculectomy. It is only suitable if the person has decided to stay at the weight they are at at the time of surgery. This procedure is expensive.

It is important that the patient has realistic expectations about the outcome of the surgery. While it will improve your appearance, you must also understand that it is not a cosmetic procedure. The risk of complications is medium to high, so the person should be in good health and not smoke.

Who can do it?

The doctor is the person in charge of deciding whether a person is eligible for panniculectomy or not. In principle, it will take into account if the procedure is necessary and safe in that specific case. It will also be taken into account whether the surgery can be covered by health insurance or not.

In general, a candidate for panniculectomy must meet the following criteria:

  • The panniculus, or excess skin, causes significant discomfort or health problems.
  • The patient is not a smoker.
  • The state of health, in general, is good.
  • Body weight has been stable for at least the past six months.
  • You have a good understanding of what surgery can and cannot do for you. Expectations are realistic.
  • Maintains a healthy diet.
  • Get regular physical activity.

How is it the procedure?

Panniculectomy can be carried out on an outpatient basis, but in some cases hospitalization is necessary for one or two nights. Therefore, arrangements should be made to go home after surgery or to have a companion during the stay.

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Your doctor may order you not to take some medications in the days before surgery. It is best to wear loose clothing on the day of the procedure. Arriving, vital signs are checked and then the general anesthesia.

During the procedure, which lasts between three and six hours, the following actions are carried out:

  • A horizontal incision is made between the navel and the pubis.
  • Excess skin and fat are cut off with a scalpel. Sometimes a vertical incision is necessary to complete the procedure.
  • The remaining skin of the abdomen is pulled down and then the incision is closed with a suture.
  • A few temporary drains. These are thin tubes that are put under the skin so that there is no accumulation of fluids.
  • The abdomen is covered with a bandage.

Recovery and care

After surgery, many patients can go home with a companion.

After panniculectomy, the patient is taken to a recovery area. Once the anesthesia wears off, the patient may be asked to get up and take a few steps. Depending on the extent of the surgery, discharge or hospitalization will be ordered, depending on the case.

There is swelling and pain in the abdomen, especially during the week after surgery. Your skin is also likely to feel numb for several weeks or months. Likewise, it is common for the doctor to order the use of an elastic support or a compression garment on the abdomen for some time.

A follow-up appointment will be assigned to remove the drains and review the postoperative evolution. It is best to avoid any demanding physical activity for at least four weeks. The wound may heal up to three months later and only go away up to two years later.

It is important to be careful with the wound. In general, it is recommended not to bathe for a few days. Then, the wound should be washed daily with warm water and carefully dried. It is usual that it is advisable to sleep with the torso elevated, using pillows or in a reclining chair.

Risks and side effects

Like any surgical procedure, panniculectomy also has risks. A person with conditions such as diabetes, heart disease, or lung disease are at increased risk of complications.

Once the surgery is done, the biggest risks are wound infection or bleeding or more bleeding than normal. Therefore, it is very important to follow medical instructions to the letter.

Other possible risks are as follows:

  • Bad healing.
  • Incision opening.
  • Clot formation in the arms or legs. This compromises life.
  • Permanent scars
  • Seroma formation near the incision.
  • Neurological damage.
  • Loose skin.
  • Loss of skin
  • Accumulation of fluids under the skin.
  • Tissue death.

If you experience very severe symptoms after surgery, it is best to contact your doctor.. Also if there are unusual manifestations such as shortness of breath, lethargy or extreme fatigue.

Faced with the presence of discomfort, a doctor should be consulted

The medical control and follow-up after the panniculectomy is essential to guarantee the success of the surgery and to have greater safety. It is important to keep all scheduled appointments and contact your doctor in the event of any unusual symptoms.

The recovery process after panniculectomy is slow and demands a lot of care. Despite this, no effort should be spared in it. Most of the people achieve the desired results, if they observe the necessary care.

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