People who have experienced (or accomplished) significant weight loss find that they’re left with a pouch of loose, hanging skin in the lower abdomen. This pouch of skin is known as a pannus, which can be a small stubborn area of fat, or a large pouch that extends as far down as the legs. A pannus can weigh over 100 pounds. This troublesome condition should not be left untreated. It can cause back pain, skin rash, infection, and even odors and ulcers as a result of trapped perspiration in the folds of skin. A large pannus can affect a person’s ability to stand or walk.
This condition is treatable with a reconstructive procedure called a panniculectomy, which may be performed alone or in conjunction with an abdominoplasty, which tightens the abdominal muscles in addition to removing excess fat and skin. In some cases, panniculectomy is performed with a hysterectomy or hernia repair to help reduce the recovery times and operating costs of these abdominal procedures.
A panniculectomy is typically performed on patients who have reached their weight loss goal and maintained a stable weight for at least 6 months, or at least a year after weight loss surgery. Many women who struggle with excess weight from a pregnancy choose this procedure to restore their body shape. The best candidates for a panniculectomy include those who:
Women who plan to get pregnant should postpone this surgery, since weight gain during pregnancy can affect the results of a panniculectomy.
During a panniculectomy procedure, a horizontal incision is made across the abdomen, and a vertical incision from the bottom of the sternum to the pubic bone. Excess skin is then carefully removed and any existing hernias closed before the remaining skin is pulled together and sutured closed. Drainage tubes may be used to remove excess fat.
The panniculectomy is performed on an outpatient basis under general anesthesia. Surgery may take several hours, depending on the amount of skin to be removed, and patients are typically hospitalized for a few days following surgery.
Following surgery, swelling and bruising are normal, and a support garment is worn to help the area heal. Pain medication may be prescribed to alleviate any discomfort in the area. Patients will likely need to sponge bathe during the initial recovery period, and most patients are able to return to work and other regular activities within a few weeks.
For a full and safe recovery, it is critical for patients to avoid putting pressure on the abdomen from exercise or heavy lifting for several weeks following surgery. Dr. Chaudhari will provide specific post-operative instructions to promote efficient healing. It may take several months before the incisions are fully healed. Scars will be visible but will fade over time to become less noticeable.
The results of a panniculectomy are visible soon after surgery, and full results usually develop over a period of several months. Results are long-lasting as long as patients maintain their weight through a balanced diet and regular exercise. Additional treatment may be required for patients who experience additional weight loss.
Although panniculectomy is considered a safe procedure, there are certain risks associated with any kind of surgery, including infection, bleeding, excessive scarring, fluid collection or the need for revision surgery. Most patients achieve successful results from this procedure with minimal or no side effects. Dr. Chaudhari discusses the risks with each patient prior to surgery, and provides patients with specific instructions to minimize the risk of complications before, during and after a panniculectomy.