Panniculectomy

Overview

The most common concern of people who have lost weight with gastric bypass is sagging, excess abdominal skin. It often hangs and forms an "apron," which causes several problems for patients. It can make clothing fit improperly, create challenges in personal hygiene, and lead to cysts or infections in the skin folds, and lower back pain. Panniculectomy is a surgical procedure that removes excess abdominal skin only. It differs from a tummy tuck in that a panniculectomy does not tighten the muscles or include liposuction fat removal. Tummy tucks, which include liposculpting and muscle tightening, are classified as cosmetic procedures, whereas a panniculectomy may be performed for medical reasons.

Depending on the details of your plan, your insurance may cover a panniculectomy procedure if you meet certain requirements. The procedure is most likely to be covered by insurance if the hanging skin (pannus) is causing health problems, or it obstructs the pelvic area. You may need documentation, provided by your primary care physician, that shows physical symptoms such as infections, rashes, or back pain. Your Insurance may also require proof that you have tried more conservative options (such as chiropractic care for back pain or topical ointments for skin problems) to relieve the symptoms. At the time of your consultation, we will take photographs to document any rashes that are present, as well as the extent of the pannus.

The procedure

A panniculectomy is performed on an outpatient basis, and we work with a board-certified anesthesiologist to provide our patients with appropriate anesthesia. The first incision is created immediately above the pubic area, and it extends outward towards the hips. A secondary incision is created near the navel, and the excess skin between the two incisions is removed. The skin is then arranged and the incisions are sutured. Although the shape of the naval may change slightly, it will remain in the same location. If you have stretch marks below the naval, they may be lessened or removed during the procedure. Additionally, if you have a scar from a C-section, it can most often be incorporated into the new incision.

The procedure will take approximately three hours, after which you will rest for another hour before returning home. When the procedure is complete, the incisions will be covered and bandaged, and you will be wearing a supportive garment. There will also be a drain tube to prevent fluid accumulation in the treatment area during healing.

Results

Patients are generally quite pleased with their attractive new body shapes, and the comfort of being free of excess skin. Patients often lose between five and ten pounds, as well as one to four clothing sizes as a result of the procedure.

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