Panniculectomy

During a panniculectomy, we remove excess drooping skin and fat – called a pannus – from the lower abdomen. In some patients, we also correct the separation of abdominal muscles, called a rectus diastasis, that can occur with weight gain or pregnancy.

Our highly experienced, board-certified plastic surgeons have performed thousands of cosmetic and reconstructive procedures. We invite you to book a consultation to discuss your goals and treatment options.

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Panniculectomy benefits:

  • Tightened skin and reduced sagging and dimpling in the stomach

  • Better mobility and comfort

  • Relief from skin irritation under the pannus

  • Improved self-confidence

Excess skin and fat can be heavy and cumbersome, making it difficult to move around and causing discomfort. Pannus skin folds may rub together, causing painful rashes and skin irritation. Removing excess tissue can help to alleviate these issues, helping patients exercise and perform everyday activities with more confidence and comfort. Patients also report improved body image after the procedure, resulting from a more toned and flatter lower abdomen.

What to Expect

We perform panniculectomies on an outpatient basis at our ambulatory surgery center in Flagstaff, AZ. The procedure is done under general anesthesia or IV sedation, which means you need to arrange to get a ride home after your surgery.

On the day of your panniculectomy, you will arrive at our clinic in Flagstaff, where you will be checked in and asked to complete some paperwork. You will change into a surgical gown in our surgery center and we’ll run some last-minute diagnostic tests, including weighing you. Then you will have a chance to talk to your surgeon to go over the surgical plan and ask any questions. Your surgeon will mark your skin and you will be administered anesthesia or IV sedation to make you more comfortable.

Your surgeon will then make a horizontal incision across the lower abdomen from hip to hip. Patients who have excess tissue in the transverse dimension may require an additional vertical incision up the midline. In some cases, an incision is made around the belly button. Abdominal skin is then pulled down, trimmed, and closed.

Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.

Recovery and Aftercare

You may feel some soreness and swelling after your panniculectomy, but you should feel ready to return to work and everyday activities within two weeks. Remember to take it easy while you recover and listen to your body.

To optimize healing, we ask our patients to follow these recovery guidelines after their procedure. If you notice increased redness, discharge, or pain near your incision, please give us a call right away.

  • Incision Aftercare: Please keep your incision areas clean and be gentle with them. You can shower after 48 hours but don’t use hot water. Don’t submerge your body while swimming or bathing for six weeks. Sleep on your back and avoid applying direct pressure on the abdomen while you’re healing.

  • Compression: We’ll give you a special compressive abdominal garment to wear continuously for around two months to yield the best results. The garment applies gentle pressure that reduces swelling, promotes healing, and supports the abdominal muscles.

  • Medications: We’ll give you a pain medication script to help you feel more comfortable while healing.

  • Exercise: Going on easy walks as soon as you feel well enough is recommended, but please don’t push yourself – especially for the first few weeks after surgery. By six weeks after surgery, most patients feel ready to resume all of their pre-operative activities, including high-intensity exercise and weight lifting.

  • Scar Massage: After two weeks, once your incisions are fully healed, we’ll advise you to gently massage the scar areas. This can improve the appearance of your incision lines and promote healing. Don’t worry about buying an expensive scar cream. Any gentle moisturizer, like Aquaphor or cocoa butter, will do the job.

  • Sun Protection: Wear sunscreen and avoid direct sun exposure on the incision areas to help keep your skin healthy and improve scar healing.

  • Laser Treatments: Laser skin resurfacing treatments can help improve the appearance of scars, and based on how you’re healing we may perform these during your follow-up appointments.

Panniculectomy FAQs

During your consultation, we’ll discuss your surgical goals and medical history to determine if you are a good candidate for a panniculectomy. In general candidates for panniculectomies are:

  • Generally healthy.
  • Nonsmokers.
  • Do not have medical conditions that impede wound helping.
  • Are not planning to get pregnant. If you are planning to have children after the procedure, then we may encourage you to postpone until after pregnancy to yield optimal results. 
  • Have realistic expectations about what their body will look like after their tummy tuck.
  • Are within 10 pounds of their goal weight, and are not planning to gain or lose a substantial amount of weight.

BMI is also a consideration.

Insurance companies may cover your panniculectomy if it is deemed medically necessary, however, they rarely cover tummy tucks, which are often considered cosmetic procedures. If your pannus interferes with your everyday activities and causes chronic rashes or skin conditions that do not go away with other medical treatments, when a panniculectomy may be medically necessary.

Pregnancy and significant weight fluctuations can cause extra skin and fat to hang over the abdomen. Natural aging and genetic factors can also cause a pannus to develop.

Most patients lose around 2-5 pounds of excess skin and fat, but it depends on the size of the pannus. If you’re adding liposuction, we can safely remove an additional 2-10 pounds. While the weight loss itself isn’t usually extreme, panniculectomies generally help patients feel tighter, slimmer, and more toned. Surgery is never a sustainable weight loss strategy. While you may lose some stomach fat and skin during your panniculectomy, there are limits to how much can be safely removed. However, some patients feel that they have improved mobility, making exercise and healthy lifestyle changes easier post-operatively.

Your scars will usually fade considerably within the first year after surgery, and they are easily concealed by underwear, clothing, and bathing suits. If you’ve had a cesarean section previously, we will try to incorporate the scars to reduce overall visibility. Practicing proper incision aftercare can help significantly reduce the appearance of panniculectomy scars. 

Gentle scar massage, scar gels or scar tape, laser skin treatments, and steroid injections can all help minimize surgical scarring. We also recommend that tummy tuck patients apply sunscreen to their scar area for the first year and prevent direct sun exposure on the incision areas.

Whereas an abdominoplasty, or tummy tuck, involves tightening the abdominal muscles to correct diastasis recti in addition to removing excess skin and fat from the abdomen, the panniculectomy is merely a pannus removal procedure.

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Book Your Panniculectomy Consultation

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