Panniculectomy surgery involves the removal of excess skin or tissue – medically called ‘pannus’. Often referred to as an apron, the skin can hang over the genitals or the thighs, which can make hygiene difficult. For some people, it also makes being mobile difficult. Different than that of an abdominoplasty, the panniculectomy only removes this skin and does not tighten the abdominal muscles. This surgery targets the skin underneath the belly button unlike that or a tummy tuck surgical procedure.
The excess skin typically occurs after losing a considerable amount of weight (via weight loss surgery or obesity treatment), excess skin may gather around the abdomen and only hang. This operation can be performed on its own or in combination with body contouring, thigh lift or any other cosmetic surgical procedure.
Candidates for this Surgery
To endure this surgery, a patient must be in good health and have no severe or active disease. It is not considered a treatment for obesity or a substitute for healthy living or exercise. Anyone who currently smokes or recently quit smoking may not be a candidate for this surgery. This is because smoking decreases the amount of blood that flows to the tissues. This leads to an increased risk of an extended amount of time for wounds to heal, skin loss, increased amount of scarring or infection.
A patient must have maintained their weight for at least six months. For those who recently had gastric sleeve surgery or gastric bypass surgery, experts suggest waiting a year after surgery to ensure that their body weight is stabilized.
What to Expect During a Consultation
During a discussion, a plastic surgeon will ask the patient about their weight loss goals. The doctor should work with individuals to reach a shared understanding of what to expect from this particular procedure and what benefits the patient will experience as a result of the surgery. The surgeon will examine the abdomen and the quality of the skin itself. They may also look for any existing scars, the status of the muscles underneath the excess skin or fat and the amount of excess fat. During the consultation, it may be determined that many of those interested in this procedure may be better suited for procedures such as liposuction or an abdominoplasty where the hanging skin in the abdominal area is reduced.
Cost of Surgery
The average cost of panniculectomy of surgery ranges from $8,000 to 12,000, according to the Cleveland Clinic. This cost generally includes any anesthesia, the operating room costs and the surgeon’s fee. The vast range in terms of cost is because of the variations that patients have in terms of amount of excess tissue and whether the surgery will be combined with other procedures. Most insurance companies consider this type of surgery cosmetic, some may cover it as they deem medically necessary especially if it is causing the patient back or other health issues.
How Surgery is Performed
Generally panniculectomy surgery is performed on an outpatient basis. The surgeon makes two incisions, one horizontal one from hipbone to hipbone and the other vertical just above the pubic area. These incisions allow the surgeon to work throughout all of the tissues found in the lower abdomen. For patients with excess fat more so than skin, a lipoplasty may be required which smoothes the skin and contours it so it looks natural. Surgery can take anywhere from two to five hours; this varies depending on the amount of skin or fat to be removed. General anesthesia is used so that the patient remains asleep and comfortable during surgery.
It can take several months for the patient to heal completely after surgery. Patients may experience discomfort, bruising and swelling during the first weeks after surgery. Patients generally are advised to wear compression garment which help support tissues that are healing. Any restricting movement or strenuous exercise is strictly forbidden until a doctor clears a patient safely. Many patients are back to work in just 3 weeks as long as no complications include. Some possible complications of panniculectomy surgery include blood clots, infection, bleeding or fluid leaks or buildup. If any of these complications occur, revisional surgery may be required. One of the biggest concerns of recovery is whether or not the incision line will heal properly, and for many, fade.
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