Panniculectomy

Panniculectomy is a surgical procedure that removes excess skin and fat from the lower abdomen, specifically the pannus that hangs below the waistline. It is distinct from an abdominoplasty (tummy tuck) because the operation generally does not involve tightening of the abdominal muscles or repositioning of the navel. The goal is to reduce skin irritation, infections, and functional difficulties caused by an oversized pannus, and to improve hygiene and mobility.

Indications for panniculectomy include chronic dermatitis, intertrigo, infections, or ulcers in the skin beneath the pannus, as well as functional impairment such as difficulty exercising or poor fitting of clothes. Candidates are typically evaluated for weight stability and comorbid conditions; obesity, diabetes, and smoking status are considered, and weight management or medical optimization may be recommended before surgery.

The procedure is usually performed under general anesthesia. An incision is placed along the lower abdomen, and the pannus is carefully elevated and removed. Blood vessels are preserved as much as possible, and drains may be placed to minimize fluid accumulation. The skin is closed with attention to contour, and sometimes a secondary procedure or partial correction is performed if needed. Recovery may involve a short hospital stay or outpatient care, wound care instructions, and the use of a compression garment. Activity is restricted for several weeks to support healing, and follow-up visits monitor healing and drain management if present.

Risks include infection, seroma or hematoma formation, wound dehiscence, scarring, numbness, and anesthesia-related complications. The outcomes are typically improved hygiene and skin comfort, enhanced mobility, and better fitting clothing, with results lasting provided weight remains stable. Alternatives include abdominoplasty, liposuction, or non-surgical weight management and skin care.