While weight loss can improve the health of many obese individuals, drastic weight loss, particularly when associated with bariatric surgery, can leave behind large amounts of excess skin. The excess skin and fat in the lower stomach area that hangs below the belt line is called the pannus, or abdominal “apron,” and can have several negative effects on one’s quality of life. The extra fold or folds of skin can hinder hygiene, put stress on the back, and make everyday activities difficult. Often, the areas in the pubic region under the pannus can become moist as perspiration is trapped. This can cause rashes, sin ulcers, and odor. Clothing may not fit comfortably, and if severe, even simple activities such as standing and walking can become difficult. In such cases, a surgical procedure called panniculectomy may be appropriate.

Are you a candidate for a panniculectomy?

People who have lost a large amount of weight and are experiencing negative side effects due to excess skin in the abdominal area are good candidates for panniculectomy. Be aware that a panniculectomy patient should have had stable weight for at least six months, and if a woman, should not be planning to bear children. A potential patient should also be following a reasonable diet and should be in relatively healthy condition.

Surgery: Panniculectomy is an invasive surgical procedure which can take from three to five hours to complete and may require an overnight stay at the hospital. Unlike abdominoplasty, panniculectomy does not tighten muscles or reposition the belly button. It only removes the excess skin and fat of the pannus from the lower abdomen, using a horizontal incision that runs from hip to hip with a downward curve, and a vertical incision from below the sternum to the pubic area. After overhanging skin and fat are removed, the remaining skin is pulled tight and sutured together.

Recovery: The first few days after a panniculectomy may be uncomfortable due to swelling and bruising. These symptoms can be eased with proper care and medication. Patients will need to sponge bathe and wear a support garment. Patients are also advised to avoid strenuous for a few weeks. However, patients can usually return to work within two weeks of the operation. Stitches are generally removed in about a week, while deeper sutures stay in for two or three weeks. The scars incurred by the surgery will begin to look worse before they look better, but this is normal. They will fade as healing continues. After a few months, patients will really begin to see the results of the surgery and will look and feel better.