Panniculectomy Surgery
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Content written by Karen Vieira, PhD, MSM | Reviewed by EnhanceMyself Medical Team | Last updated 6/17/2023
- Overview
Overview
What is a panniculectomy?
A panniculectomy is a surgical procedure designed to remove excess skin and fat from the lower abdomen, specifically the pannus or panniculus—a large overhanging apron of skin and tissue. It is commonly performed on individuals who have experienced significant weight loss, often as a result of bariatric surgery or natural means.
Cost of panniculectomy procedure
The cost of panniculectomy surgery ranges from $8,500 to $10,000. Several factors can influence the cost of panniculectomy surgery. Here are some key factors that contribute to the overall cost:
- Surgeon’s Fee: The experience and reputation of the surgeon performing your procedure can affect the cost. Highly skilled surgeons often charge a premium for their services.
- Anesthesia Fees: The administration of anesthesia involves the expertise of an anesthesiologist. The type of anesthesia used, the duration of the procedure, and the qualifications of the anesthesia provider influence the anesthesia fees.
- Surgical Facility: The surgical facility where your procedure is being performed may impact the cost. These fees cover the usage of the operating room and other associated services.
- Location Matters: The cost of living and the average pricing for medical services in a particular area can affect the cost of your procedure. In general, urban areas tend to have higher procedure fees.
- Extent of Tissue Removal: The amount of excess skin and tissue that needs to be removed during the panniculectomy procedure can impact the cost. Patients with more substantial excess skin and larger panniculus (hanging abdominal skin and fat) may require more extensive surgery, leading to a higher cost.
- Pre and Postoperative Care: The care provided before and after affects the overall cost. This includes preoperative consultations, medical tests, surgical garments, prescription medications, and follow-up appointments.
- Additional Procedures: You may incur extra costs if you’re considering having other procedures alongside your panniculectomy.
- Insurance Coverage: In certain cases, panniculectomy surgery may be deemed medically necessary due to issues such as chronic rashes, infections, or difficulty with mobility. In these instances, health insurance may cover a portion of the procedure. However, insurance coverage can vary and specific criteria must be met to qualify for coverage.
To get an accurate quote, meet with a board certified plastic surgeon to determine the specific cost based on your individual circumstances.
Are you a candidate?
If you are looking to remove the excess skin and fat hanging below your abdomen, a panniculectomy may be right for you. While the removal of this excess skin does flatten the abdomen, note that a panniculectomy does not tighten the muscle wall like an abdominoplasty (“tummy tuck”) does.
An ideal candidate for a panniculectomy should:
- Maintain stable weight for at least 6 months after weight loss surgery
- Have good dietary habits
- Maintain a relatively active lifestyle
- Be a non-smoker
- Not have cardiac disease, lung disease or diabetes
- Have a body mass index of less than 40
- Have tried other treatments such as topical antifungals, corticosteroids and antibiotics but none of these treatments have worked
What to expect before surgery
Prior to surgery, your doctor will go over your medical history and examine your abdomen to determine your eligibility for this surgery. Your doctor will ask you about previous surgeries and prescriptions you are taking.
Some medications, such as aspirin, oral contraceptives and herbal supplements may affect the healing process and you may be advised to stop taking them before the procedure.
What happens during the procedure
The following is a general overview of how a panniculectomy is typically performed:
- Anesthesia: Once you arrive at the surgical facility, anesthesia will be administered. General anesthesia, which puts you to sleep. This ensures you remain comfortable and pain-free throughout the procedure.
- Incision: The surgeon will make an incision across the lower abdomen, typically extending from hip to hip. The exact length and shape of the incision may vary depending on the extent of excess tissue and the specific technique employed by the surgeon. The incision is strategically placed to be concealed within underwear or swimwear.
- Tissue Removal: The surgeon will carefully separate the excess skin and fat from the underlying tissues. The amount of tissue removed depends on your individual needs and goals. The panniculus is excised, and liposuction may be used to remove additional fat deposits if necessary.
- Muscular Repair (If Needed): In some cases, the surgeon may repair the underlying abdominal muscles. This is especially relevant for individuals who have experienced muscle separation (diastasis recti) as a result of weight fluctuations or pregnancy. The muscles are tightened and sutured together to create a firmer abdominal contour.
- Closure: Once the excess tissue has been removed and any necessary muscle repair has been completed, the surgeon will close the incisions. Deep sutures are used to provide strength to the incision site, and superficial sutures or skin adhesives are employed to close the skin. The goal is to create minimal tension on the incision and ensure a clean and well-approximated closure.
- Postoperative Care: After the procedure, you will be moved to a recovery area. The surgeon will provide you with recovery instructions on wound care and pain management. You will likely wear compression garments to reduce swelling and support the healing process.
Recovery time
The recovery time after a panniculectomy can vary depending on several factors, including the extent of the procedure, individual healing capabilities, and overall health. Generally, the recovery period for a panniculectomy is several weeks to a few months.
When will you see results?
It may take a few weeks or months to start seeing results due to swelling that occurs after the surgery. This is normal. As a matter of fact, it can take up to 2 years to fully see the results of the surgery. Most patients are happy with the outcome of the procedure.
How long will your results last?
You can expect that the final results from the panniculectomy will be maintained long-term if you continue to lead a healthy lifestyle with good diet and exercise.
Tummy tuck vs. panniculectomy
A panniculectomy is often considered to be a medically necessary procedure because the pannus interferes with mobility and can cause infections and discomfort.
An abdominoplasty, or “tummy tuck,” also removes excess skin and fat but additionally focuses on tightening the muscle wall to achieve increased muscle tone and a slender body.
For this reason, sometimes people choose to do both of these procedures. However, because an abdominoplasty focuses on appearance and is not medically necessary, it is considered a cosmetic treatment and tends not to be covered by insurance.
Here is a quick summary of some advantages and disadvantages of both procedures:
Panniculectomy
| Advantages | Disadvantages |
| Improves quality of life by resolving discomfort from excess skin and fat. | Often leaves hip-to-hip scar across lower mid-section. |
| Likely covered by insurance if medically necessary. | Will not tighten the abdominal muscles. |
Abdominoplasty (Tummy Tuck)
| Advantages | Disadvantages |
| Aesthetically trims and tightens the abdominal muscles for a firmer and smoother abdomen. | Procedure leaves permanent, yet well-hidden scar. |
| Removes or improves stretch marks, C-section, hysterectomy scars and lower back pain. | Likely is not covered by insurance. |
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